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

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 019200737
Report Date: 12/26/2025
Date Signed: 12/26/2025 02:18:09 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
12/16/2025 and conducted by Evaluator Yasamin Brown
COMPLAINT CONTROL NUMBER: 15-AS-20251216100733
FACILITY NAME:CALIFORNIA MENTOR-MARINEVIEW HOMEFACILITY NUMBER:
019200737
ADMINISTRATOR:HARLAN, MAEHELLENAFACILITY TYPE:
740
ADDRESS:2420 MARINEVIEW DRIVETELEPHONE:
(510) 957-5612
CITY:SAN LEANDROSTATE: CAZIP CODE:
94577
CAPACITY:4CENSUS: 4DATE:
12/26/2025
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Tahmeya Stover, Program SupervisorTIME COMPLETED:
11:00 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff does not ensure facility is kept free of mal odors
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 12/26/2025 at 9:30 AM, Licensing Program Analyst (LPA) Y. Brown arrived unannounced to conduct a complaint visit. LPA explained the purpose of the visit with Care staff Donise Lewis. Program Supervisor Tahmeya Stover arrived to the facility around 11:40 AM.

During the complaint visit, LPA attempted to interview Clients, reviewed the LIC 500 (Personnel report), LIC9020 (client roster) and client records.

Allegation: Staff does not ensure facility is kept free of mal odors
During review of the complaint submitted the complainant stated that the facility has a strong odor smell from a staff member but the complainant denies the staff being under the influence while working.

Continued to LIC9099-C.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: Yasamin Brown
LICENSING EVALUATOR SIGNATURE:

DATE: 12/26/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/26/2025
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 2
Control Number 15-AS-20251216100733
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: CALIFORNIA MENTOR-MARINEVIEW HOME
FACILITY NUMBER: 019200737
VISIT DATE: 12/26/2025
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.

The interview with the RP/Complainant revealed that the smell coming from the staff member does not interfere with work or with the clients. The interview with S1/ADM revealed that they have never smelled an odor at the facility and it revealed that there were no concerns with a smell coming from a staff member at the facility. The interview with S2 revealed that there weren't any smells coming from a staff member that was hindering the safety of clients. The interview with S3 revealed that they have never smelled any odor coming from staff members and has worked all shift times. The interview with S4 revealed that they have never smelled any odor coming from a staff member that would interfere with work. LPA attempted to interview clients but was unable to due to clients being non-verbal.

Based on interviews with staff and clients and observations during visit, the allegation that staff does not ensure facility is kept free of mal odors was found to be unsubstantiated. A finding that a 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 deficiency cited. Exit Interview conducted with Tahmeya and copy of this report provided.

SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: Yasamin Brown
LICENSING EVALUATOR SIGNATURE:

DATE: 12/26/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/26/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2