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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 019200999
Report Date: 05/11/2022
Date Signed: 05/11/2022 03:23:11 PM

Unfounded


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
05/03/2022 and conducted by Evaluator Leslie Ibo
COMPLAINT CONTROL NUMBER: 15-AS-20220503092849
FACILITY NAME:WARM HOUSEFACILITY NUMBER:
019200999
ADMINISTRATOR:DELGADO, CLARAFACILITY TYPE:
740
ADDRESS:7693 DONOHUE DR.TELEPHONE:
(925) 323-8958
CITY:DUBLINSTATE: CAZIP CODE:
94568
CAPACITY:6CENSUS: 4DATE:
05/11/2022
UNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Steve Chou, facility managerTIME COMPLETED:
03:45 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility increased resident's fees without notifying the resident of the reason for the increase.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 5/11/2022, Licensing Program Analysts (LPAs) L. Ibo & K. Nguyen arrived unannounced to deliver complaint findings for the above allegation. LPAs met with Steve Chou, facility manager and explained the purpose of the visit.

During the course of the investigation, LPAs obtained information, collected documents and interviewed staff. Based on information obtained, R1 was notified of a rent increase due to recent increase of labor and operating cost, notification was sent out on January 27, 2022 with effective date of April 1, 2022. Based on records review 2 residents and 1 former resident received the 60 days rate increase notification.

Based on information gathered, the allegation is UNFOUNDED. A finding that the complaint is unfounded means that the allegation is false, could not have happened, and/or is without a reasonable basis.

Exit interview with conducted and a copy of this report provided.
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: Leslie Ibo
LICENSING EVALUATOR SIGNATURE:

DATE: 05/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/11/2022
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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