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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 019201167
Report Date: 01/30/2026
Date Signed: 01/30/2026 03:19:53 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
01/21/2026 and conducted by Evaluator Ardalan Gharachorloo
COMPLAINT CONTROL NUMBER: 15-AS-20260121141426
FACILITY NAME:EMERALD VALLEYFACILITY NUMBER:
019201167
ADMINISTRATOR:ESPINOZA, MARISSA KFACILITY TYPE:
740
ADDRESS:7601 AMADOR VALLEY BLVDTELEPHONE:
(925) 361-0913
CITY:DUBLINSTATE: CAZIP CODE:
94568
CAPACITY:80CENSUS: 78DATE:
01/30/2026
UNANNOUNCEDTIME BEGAN:
10:18 AM
MET WITH:Janelle Douglas, Executive DirectorTIME COMPLETED:
03:10 PM
ALLEGATION(S):
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Staff are not adhering to food storage safety protocols.
INVESTIGATION FINDINGS:
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On 10/30/2025 at 10:18 AM, Licensing Program Analyst (LPA) Ardalan Gharachorloo arrived unannounced to deliver findings in regard to the allegation above. LPA met with Janelle Douglas, Executive Director and explained the purpose of the visit.

During the course of the investigation, the Licensing Program Analyst (LPA) toured the kitchen and interviewed staff (S1–S3). LPA also reviewed pictures submitted by W1 ,reviewed staff schedule and staff roster, S2 and S3's file as well as the food menu.

the Licensing Program Analyst (LPA) conducted an on-site inspection of the facility’s kitchen and food preparation areas. The LPA observed that the kitchen conditions were consistent with the photographs submitted by W1. food items were observed stored uncovered and and improperly wrapped, raw food items stored in close proximity to ready-to-eat foods, and food containers placed directly on the floor or in unsanitary location.

***CONTINUE ON 9099C***
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Yvonne Flores-Larios
LICENSING EVALUATOR NAME: Ardalan Gharachorloo
LICENSING EVALUATOR SIGNATURE:

DATE: 01/30/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/30/2026
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 5
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
01/21/2026 and conducted by Evaluator Ardalan Gharachorloo
COMPLAINT CONTROL NUMBER: 15-AS-20260121141426

FACILITY NAME:EMERALD VALLEYFACILITY NUMBER:
019201167
ADMINISTRATOR:ESPINOZA, MARISSA KFACILITY TYPE:
740
ADDRESS:7601 AMADOR VALLEY BLVDTELEPHONE:
(925) 361-0913
CITY:DUBLINSTATE: CAZIP CODE:
94568
CAPACITY:80CENSUS: 78DATE:
01/30/2026
UNANNOUNCEDTIME BEGAN:
10:18 AM
MET WITH:Janelle Douglas, Executive DirectorTIME COMPLETED:
03:10 PM
ALLEGATION(S):
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9
Facility is unsanitary.
INVESTIGATION FINDINGS:
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On 01/30/2026 at 10:18 AM, Licensing Program Analyst (LPA) Ardalan Gharachorloo arrived unannounced to deliver findings in regard to the allegation above. LPA met with Janelle Douglas, Executive Director and explained the purpose of the visit.

During the course of the investigation, the Licensing Program Analyst (LPA) toured the facility including but not limited to 3 resident rooms, Bathrooms, common area, activity room and medication room. LPA conducted interviews with S1 and two residents (R1 and R2). LPA also reviewed staff roster, staff schedule and housekeeping schedule.

LPA toured common areas accessible to residents, including dining areas, hallways, and 3 resident rooms. While the kitchen area exhibited sanitation deficiencies addressed under Allegation 1, the LPA did not observe unsanitary conditions in resident living areas, bathrooms, or common use areas . No odors, pest activity, or trash were observed in resident-accessible areas during the inspection.

***Continue on 9099C***

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Yvonne Flores-Larios
LICENSING EVALUATOR NAME: Ardalan Gharachorloo
LICENSING EVALUATOR SIGNATURE:

DATE: 01/30/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/30/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 15-AS-20260121141426
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: EMERALD VALLEY
FACILITY NUMBER: 019201167
VISIT DATE: 01/30/2026
NARRATIVE
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***CONTINUE FROM 9099***

LPA also conducted interviews with two residents (R1 and R2). Both residents stated that they are satisfied with the cleanliness of their apartments and reported that they frequently observe housekeeping staff maintaining the apartment, dining area, and common areas in a sanitary condition.

This agency has investigated the allegation above. We have found that the allegation was 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.

Exit interview conducted, a copy of this report provided.
SUPERVISORS NAME: Yvonne Flores-Larios
LICENSING EVALUATOR NAME: Ardalan Gharachorloo
LICENSING EVALUATOR SIGNATURE:

DATE: 01/30/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/30/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 15-AS-20260121141426
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: EMERALD VALLEY
FACILITY NUMBER: 019201167
VISIT DATE: 01/30/2026
NARRATIVE
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***CONTINUE FROM 9099***

The LPA also observed soiled cooking equipment, including grills and stove tops with accumulated grease and food debris, which posed a risk of cross-contamination.

Based on LPA's observation and record reviews, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations (Title 22, Division 6, Chapter 8), is being cited on the attached LIC 9099D



Exit interview conducted and a copy of this report and appeals rights provided.
SUPERVISORS NAME: Yvonne Flores-Larios
LICENSING EVALUATOR NAME: Ardalan Gharachorloo
LICENSING EVALUATOR SIGNATURE:

DATE: 01/30/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/30/2026
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 15-AS-20260121141426
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: EMERALD VALLEY
FACILITY NUMBER: 019201167
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/30/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/06/2026
Section Cited
CCR
87555(b)
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87555(b) The following food service requirements shall apply:...(9) Procedures which protect the safety, acceptability and nutritive values of food shall be observed in food storage, preparation and service....(27) All kitchen areas shall be kept clean and free of litter, rodents, vermin and insects.
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Licensee shall ensure that all food is stored, prepared, and served in a safe and sanitary manner and provide a photographs of the facility's kitchen including food storage area and cooking equipment to CCL by POC date.
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Based on observation and records review, the kitchen was observed to have food items stored uncovered, raw food stored in close proxitimity to read to eat foods, and cooking equipment heavily soiled with grease and food debris which pos a potential health and safety risk to residents.
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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: Yvonne Flores-Larios
LICENSING EVALUATOR NAME: Ardalan Gharachorloo
LICENSING EVALUATOR SIGNATURE:

DATE: 01/30/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/30/2026
LIC9099 (FAS) - (06/04)
Page: 5 of 5