<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 019200672
Report Date: 02/11/2026
Date Signed: 02/11/2026 03:05:09 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND ASC, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/03/2026 and conducted by Evaluator David Doidge
COMPLAINT CONTROL NUMBER: 15-AS-20260203163211
FACILITY NAME:OPAL CARE LLCFACILITY NUMBER:
019200672
ADMINISTRATOR:PURUGANAN, VICTORIAFACILITY TYPE:
740
ADDRESS:3917 OPAL STREETTELEPHONE:
(510) 420-0731
CITY:OAKLANDSTATE: CAZIP CODE:
94609
CAPACITY:15CENSUS: 10DATE:
02/11/2026
UNANNOUNCEDTIME BEGAN:
09:07 AM
MET WITH:Administrator Ferdinand GutierrezTIME COMPLETED:
03:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Licensee does not ensure residents have their basic necessities

Faclity is not meeting the resident's incontinence care needs

Licensee does not ensure staff are present at all times

Staff do not ensure that residents have adequate hygiene supplies
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 02/11/2026 at 09:00 AM, Licensing Program Analysts (LPAs) David Doidge and Andrew Christy arrived unannounced to conduct an initial 10-day complaint investigation and to deliver findings in regards to the allegations above. LPAs met with Administrator Ferdinand Gutierrez and explained the purpose of the visit.

During the course of the investigation, LPAs obtained copies of the LIC 500, incontinence changing log for R1, and a copy of the facility's Admission Agreement. LPAs interviewed R1, R2, R3 R4, S1, S2 and S3.

Allegations: Licensee does not ensure residents have their basic necessities.

Continued on LIC9099-C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: David Doidge
LICENSING EVALUATOR SIGNATURE:

DATE: 02/11/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 8
Control Number 15-AS-20260203163211
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND ASC, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
FACILITY NAME: OPAL CARE LLC
FACILITY NUMBER: 019200672
VISIT DATE: 02/11/2026
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Continued from LIC9099

Investigation Findings: It was reported to the department that there was no toilet paper or paper towels in any of the residents’ bathrooms, and residents were using writing paper and newspapers as toilet paper. S2 reported that staff are instructed to put out only one roll of toilet paper per day. S2 has seen magazine and newspaper in toilets while cleaning, as did other staff members. LPAs observed only one roll of toilet paper in each bathroom and no paper towels in any bathroom. S3 informed LPAs that staff limit the amount of toilet paper and paper towels in each bathroom to prevent colgs as residents have been clogging toilets. Based on observation and interviews, the allegation is SUBSTANTIATED.

Allegations: Facility is not meeting the resident’s incontinent care needs

Investigation Findings: It was reported to the department that staff are not changing a resident with incontinence frequently. LPAs interviewed R1, who was not alert nor oriented enough to provide adequate information. The facility has a changing chart near the bed. Upon review, LPAs observed gaps between changing as long as 14 hours, and there is no log of staff checking R1’s diaper. Based on observation and record review, the allegation is SUBSTANTIATED.

Allegations: Licensee does not ensure staff are present at all times

Investigation Findings: It was reported to the department that the facility has no staff coverage on Monday through Sunday from 2:00 AM to 7:00 AM. LPAs reviewed the facility’s LIC 500 and confirmed there is no staff scheduled 2:00 Am to 7:00 AM Monday through Sunday, therefore this allegation is SUBSTANTIATED.

Allegations: Staff do not ensure that residents have adequate hygiene supplies

Continued on LIC9099-C

SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: David Doidge
LICENSING EVALUATOR SIGNATURE:

DATE: 02/11/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 8
Control Number 15-AS-20260203163211
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND ASC, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
FACILITY NAME: OPAL CARE LLC
FACILITY NUMBER: 019200672
VISIT DATE: 02/11/2026
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Continued from LIC9099

Investigation Findings: it was reported to the department that there is a lack of basic necessities, such as soap and shampoo in the facility. LPAs observed one bottle of shampoo and 1 bar of soap in a supply cabinet, but none in any bathroom. The facility’s Admission Agreement specifies that basic needs, including soap and shampoo, are included in the rent. S2 informed LPAs that some residents will buy their own products based on personal preference, however the facility does not have an adequate supply to cover residents that do not buy their own or run out. Based on observation, the allegation is SUBSTANTIATED.

Deficiencies are cited from Title 22 California Code of Regulations (see 9099D). Failure to submit proof of corrections by plan of correction due date and any repeat violation within 12 month period may result an additional civil penalty.

An Immediate and repeat Civil penalty of $1000.00 is assessed.

Deficiencies, plan and proof of corrections were discussed with Administrator Ferdinand Gutierrez

Exit interview conducted, Appeal Rights, and copy this report provided.

SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: David Doidge
LICENSING EVALUATOR SIGNATURE:

DATE: 02/11/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 8
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND ASC, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/03/2026 and conducted by Evaluator David Doidge
COMPLAINT CONTROL NUMBER: 15-AS-20260203163211

FACILITY NAME:OPAL CARE LLCFACILITY NUMBER:
019200672
ADMINISTRATOR:PURUGANAN, VICTORIAFACILITY TYPE:
740
ADDRESS:3917 OPAL STREETTELEPHONE:
(510) 420-0731
CITY:OAKLANDSTATE: CAZIP CODE:
94609
CAPACITY:15CENSUS: 10DATE:
02/11/2026
UNANNOUNCEDTIME BEGAN:
09:07 AM
MET WITH:Administrator Ferdinand GutierrezTIME COMPLETED:
03:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff do not ensure the residents are provided P&I money
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 02/11/2026 at 09:00 AM, Licensing Program Analysts (LPAs) David Doidge and Andrew Christy arrived unannounced to conduct an initial 10-day complaint investigation and to deliver findings in regards to the allegation above. LPAs met with Administrator Ferdinand Gutierrez and explained the purpose of the visit.
During the investigation, LPAs reviewed the facility’s Admission Agreement.

Allegations: Staff do not ensure the residents are provided P&I money

Investigation Findings: It was reported to the department that residents are not provided with an allowance to spend freely; instead, the owner uses their money to purchase groceries for the home. Upon review of the facility’s Admonishing Agreements, no resident has their SSI/SSP paid directly to the facility. The facility does not handle P&I money for residents, therefore this allegation is UNSUBTANTIATED.

Continued on LIC9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: David Doidge
LICENSING EVALUATOR SIGNATURE:

DATE: 02/11/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 5 of 8
Control Number 15-AS-20260203163211
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND ASC, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612

FACILITY NAME: OPAL CARE LLC
FACILITY NUMBER: 019200672
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/11/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/18/2026
Section Cited
CCR
87468.2(a)(1)
1
2
3
4
5
6
7
Additional Personal Right…addition to the rights..residents…shall have all of the following personal rights…to have …accommodations…personal care…family groups.
This requirement was not met as evidence by:
1
2
3
4
5
6
7
By POC date, licensee agrees to keep at least 4 rolls of toilet paper and one roll of paper towels in each bathroom at all times and submit proof to LPA by POC date.
8
9
10
11
12
13
14
Based on observation, the licensee did not comply with the section cited above by not having adequate amount of toilet paper and paper towels available which poses a potential health and safety risk to persons in care.
8
9
10
11
12
13
14
Type B
02/18/2026
Section Cited
CCR
87625(b)(3)
1
2
3
4
5
6
7
In addition to Section 87611,…licensee shall…Ensuring...are kept clean and dry …remains free of odors from incontinence.

This requirement was not met as evidence by
1
2
3
4
5
6
7
On POC date, Licensee will send a more detailed log that includes all incontinence checks every two to three hours in addition to all changing of briefs.
8
9
10
11
12
13
14
Based on record review, the licensee did not comply with the section cited above by not tracking and recording incontinent checks which poses a potential health and safety risk to persons in care.
8
9
10
11
12
13
14
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: David Doidge
LICENSING EVALUATOR SIGNATURE:

DATE: 02/11/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2026
LIC9099 (FAS) - (06/04)
Page: 6 of 8
Control Number 15-AS-20260203163211
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND ASC, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
FACILITY NAME: OPAL CARE LLC
FACILITY NUMBER: 019200672
VISIT DATE: 02/11/2026
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Continued from LIC9099

A finding that the complaint is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.

No deficiencies cited during the visit.

Exit interview conducted and a copy of this report provided.
SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: David Doidge
LICENSING EVALUATOR SIGNATURE:

DATE: 02/11/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2026
LIC9099 (FAS) - (06/04)
Page: 7 of 8
Control Number 15-AS-20260203163211
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND ASC, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612

FACILITY NAME: OPAL CARE LLC
FACILITY NUMBER: 019200672
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/11/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/18/2026
Section Cited
CCR
87468.2(a)(4)
1
2
3
4
5
6
7
To care, supervision, and ...meet their individual needs...by staff that are sufficient in numbers, qualifications, and competency...

This requirement was not met as evidence by:
1
2
3
4
5
6
7
By POC date, Licensee agrees create and submit a new LIC 500/staff schedule that show 24 hour resident supervisor.
8
9
10
11
12
13
14
Based on observation, the licensee did not comply with the section cited above by not having staff scheduled Monday to Sunday 2:00 Am to 7:00 AM which poses a potential health and safety risk to persons in care.
8
9
10
11
12
13
14
An Immediate and repeat Civil penalty of $1000.00 is assessed.
Type B
02/18/2026
Section Cited
CCR
87307(3)(D)
1
2
3
4
5
6
7
Personal Accommodations and Services …supplies necessary…readily available to each resident…if the resident is…licensee shall assure provision of…Hygiene items…such as soap….

This requirement was not met as evidence by
1
2
3
4
5
6
7
By POC date, Licensee agrees to buy more hygiene supplies and provide proof to LPA.
8
9
10
11
12
13
14
Based on observation, the licensee did not comply with the section cited above by not having an adequate supply to cover all residents which poses a potential health and safety risk to persons in care.
8
9
10
11
12
13
14
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: David Doidge
LICENSING EVALUATOR SIGNATURE:

DATE: 02/11/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2026
LIC9099 (FAS) - (06/04)
Page: 8 of 8