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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 019200672
Report Date: 04/23/2026
Date Signed: 05/04/2026 03:23:11 PM

Unsubstantiated


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: 7DATE:
04/23/2026
UNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Administrator Ferdinand GutierrezTIME COMPLETED:
11:15 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Lack of supervision resulted in resident elopement
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
*THIS IS AN AMENDMENT OF REPORT DATED 04/23/2026*
On 04/23/2026 at 10:30 AM, Licensing Program Analyst (LPA) David Doidge arrived unannounced to deliver findings in regards to the allegation above. LPA met with Administrator Ferdinand Gutierrez and explained the purpose of the visit.

Allegation: Lack of supervision resulted in resident elopement

Investigation Findings: It was reported to the department that there was an elopment of a resident due to the lack of coverage, as the resident was attempting to get to the hospital. This specific incident had already been reported to the department and addressed in a case management report dated 11/26/2025. The facility sent the department an Unusual Incident Report (LIC624) detailing that R1 left the facility. On 11/26/2025 at 11:45 AM, LPA A.Gharachorloo went to the facility. LPA interviewed staff. S2 reported to LPA that S2 followed R1 as R1 walked to Kaiser. S2 called 911 right after and filed a police report. It was determined by the department that the facility was observed to have followed protocol during this incident, therefore this allegation is UNSUBSTANTIATED.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED.

No deficiencies cited during the visit. Exit interview conducted and a copy this report was provided.
u
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: David Doidge
LICENSING EVALUATOR SIGNATURE:

DATE: 05/04/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/04/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
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