075600819-3-21-2025-15-AS-KHOS-DFHMSN-20250407095213

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 075600819
Report Date: 03/21/2025
Date Signed: 03/21/2025 02:24:45 PM

Unsubstantiated

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
03/18/2025 and conducted by Evaluator Jill Clancy-Czuleger

COMPLAINT CONTROL NUMBER: 15-AS-20250318135400

FACILITY NAME:	COMFORT CARE HOME, LLC		FACILITY NUMBER:	075600819
ADMINISTRATOR:	REY & MARY JANE VELASQUEZ		FACILITY TYPE:	740
ADDRESS:	870 SAN SIMEON DRIVE		TELEPHONE:	(925) 680-4682
CITY:	CONCORD	STATE: CA	ZIP CODE:	94518
CAPACITY:	6	CENSUS: 6	DATE:	03/21/2025
		UNANNOUNCED	TIME BEGAN:	01:45 PM
MET WITH:	Leonora Moneja, Admin		TIME COMPLETED:	02:45 PM

ALLEGATION(S):

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Staff do not provided an adequate amount of food to the residents in care
Staff are not providing adequate sleeping accommodations to residents

INVESTIGATION FINDINGS:

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On 03/21/2025 at 1:45 PM, Licensing Program Analysts (LPAs) J. Clancy-Czuleger arrived unannounced to conduct a complaint visit. LPA explained the purpose of the visit with Administrator Leonora Moneja.

During the initial 10-day complaint visit. LPA interviewed staff, and observed two days of perishable and seven days of non-perishables foods at the facility. LPA tour the facility and observed four resident bedrooms two single rooms and two shared rooms with a total of six beds for the six residents. Each bed is equipt with sheets and bedding for residents.

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

Exit interview conducted and a copy of this report provided.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: Jill Clancy-Czuleger
LICENSING EVALUATOR SIGNATURE:	DATE: 03/21/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2025

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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