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

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 019201466
Report Date: 01/22/2026
Date Signed: 01/22/2026 05:54:51 PM

Substantiated


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
09/24/2025 and conducted by Evaluator Alicia Delmundo
COMPLAINT CONTROL NUMBER: 15-AS-20250924164748
FACILITY NAME:ALONDRA CARE HOME 3FACILITY NUMBER:
019201466
ADMINISTRATOR:AYE, THINNFACILITY TYPE:
740
ADDRESS:27765 DECATURTELEPHONE:
(510) 391-1257
CITY:HAYWARDSTATE: CAZIP CODE:
94545
CAPACITY:6CENSUS: DATE:
01/22/2026
UNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Thinn Aye/Licensee-Administrator TIME COMPLETED:
06:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Lack of supervision.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On this day, January 22, 2026, at 12:30 p.m., Licensing Program Analyst (LPA) Delmundo arrived unannounced to continue the investigation of the above allegation. LPA was granted entry by staff, Yu Zana, and informed the reason for visit. LPA called and spoke with Thinn Aye, administrator (ADM) who arrived at around 1:05 p.m.

During the course of investigation, LPA reviewed residents' records and obtained copies of including but not limited to the following documents: Admission Agreement; LIC602A Physician's Reports; LIC625 Appraisal/Needs and Services Plan. LPA also obtained copies of LIC500 Personnel Reports. LPA interviewed the following: residents (R3, R5) and ADM on August 29, 2025 and October 1, 2025; resident (R1) and staff (S1 and S3) on October 1, 2025; first responder (FR) on October 14, 2025.

...continued on 9099C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Alicia Delmundo
LICENSING EVALUATOR SIGNATURE:

DATE: 01/22/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/22/2026
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 3
Control Number 15-AS-20250924164748
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
FACILITY NAME: ALONDRA CARE HOME 3
FACILITY NUMBER: 019201466
VISIT DATE: 01/22/2026
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
R1 stated that on August 2025, R2 fell and there was no staff to assist. R1 called the staff but no response, so she end up calling 9-11. R3 and R5 stated they were not residents of the facility at the time the incident happened. Review of R2's record showed R2 has sundowning behavior. Although LPA was not able to obtain information from R2 due R2's medical condition, the first responder (FR) who confirmed attending to 9-11 call stated R2 was still on the floor when they arrived and no caregiver present. FR stated the other first responder banged the door of the garage but no one responded. The 2 staff interviewed stated there was no staff assigned at night when the incident happened. Review of LIC500 showed Thinn Aye (ADM) scheduled at night from 7:00 pm to 7:00 am, however, LIC500 for her other facilities showed her on the scheduled for same time from 7:00 pm to 7:00 am on Mondays, Wednesdays, Thursdays, Fridays, Saturdays and Sundays. She is also on the schedule on one of her other facility on Tuesdays from 7:00 am to 1:00 pm.

Although the R2 did not sustain injury when R2 fell, the allegation is substantiated based on information gathered that there was no staff present at night. A substantiated findings means that the preponderance of evidence is met. Deficiency is cited from Title 22 California Code of Regulations and listed on 9099D. A $500.00 civil penalty is assessed for deficiency section # 87411(a). Failure to submit proof of correction by plan of correction due date and any repeat violation may result in additional civil penalty.

Deficiency, plan and proof of correction and civil penalty were discussed with ADM. ADM has to leave and authorized Mya 'Clara' Thazin to sign and receive this report.

Exit interview conducted. Appeal Rights, LIC421FC, LIC9098 Proof of Correction and copy of this report provided.
SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Alicia Delmundo
LICENSING EVALUATOR SIGNATURE:

DATE: 01/22/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/22/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 15-AS-20250924164748
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612

FACILITY NAME: ALONDRA CARE HOME 3
FACILITY NUMBER: 019201466
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/22/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
01/23/2026
Section Cited
CCR
87411(a)
1
2
3
4
5
6
7
87411 Personnel Requirements - General: (a) Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs..........
-This requirement is not met as evidenced by:
1
2
3
4
5
6
7
Administrator to ensure staff coverage and submit updated copy of LIC500 Personnel Report by 1/23/26.

A $500.00 civil penalty is assessed.
8
9
10
11
12
13
14
-Based on records review and interviews, the licensee did not comply with the section when R2 fell and no staff present which posed and immediate safety, health and/or personal rights risks to person in care.
8
9
10
11
12
13
14
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
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: Bennett Fong
LICENSING EVALUATOR NAME: Alicia Delmundo
LICENSING EVALUATOR SIGNATURE:

DATE: 01/22/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/22/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3