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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 019200874
Report Date: 05/13/2025
Date Signed: 05/13/2025 01:06:45 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
05/08/2025 and conducted by Evaluator David Doidge
COMPLAINT CONTROL NUMBER: 15-AS-20250508161825
FACILITY NAME:1440 BY THE BAYFACILITY NUMBER:
019200874
ADMINISTRATOR:HALL, STEPHANIE JFACILITY TYPE:
740
ADDRESS:1440 40TH STREETTELEPHONE:
(510) 594-8800
CITY:EMERYVILLESTATE: CAZIP CODE:
94608
CAPACITY:175CENSUS: 76DATE:
05/13/2025
UNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Vivian Villegas Operation SpecialistTIME COMPLETED:
01:20 PM
ALLEGATION(S):
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Facility is not meeting resident's transportations needs
INVESTIGATION FINDINGS:
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On this day at 09:15 am, LPA David Doidge arrived unannounced to conduct 10-day investigation on the above allegation and deliver findings.LPA met with Vivian Villegas Operation Specialist and explained the purpose of the visit.

During the investigation, LPA interviewed one (1) resident and three (3) staff. LPA obtained a copy of R1's medical report, a doctor's letter and the Service Pan for R!. LPA also reviewed the admission Agreement for R1.

Allegation: Facility is not meeting resident's transportations needs

Findings: Based on interviews with three (3) staff, the facility offers a transportation service that accoumodates all resdients' needs. Residents are assisted on and off the van with or without an electric scooter or wheelchir.The facility has opted to discontinue a paid transportation service and use thier own transporttation van.

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

DATE: 05/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/13/2025
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-20250508161825
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: 1440 BY THE BAY
FACILITY NUMBER: 019200874
VISIT DATE: 05/13/2025
NARRATIVE
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Continued from LIC9099

Staff have made every effort to reasonably accommodate all residents' transportation needs. Resident have the option of booking their own transportation and paying out of pocket or utilizing the facilities van service.

Based on interviews and record reviews conducted, the above allegation is unsubstantiated.

Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is unsubstantiated.

No deficiencies cited during visit.

Exit interview was conducted, and a copy of this report was provided.

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

DATE: 05/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/13/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2