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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 075600998
Report Date: 12/26/2024
Date Signed: 12/26/2024 12:26:05 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
12/18/2024 and conducted by Evaluator James Sampair
PUBLIC
COMPLAINT CONTROL NUMBER: 15-AS-20241218100739
FACILITY NAME:PARADISE GARDENS CARE HOMEFACILITY NUMBER:
075600998
ADMINISTRATOR:LISING, ARSENIA E.FACILITY TYPE:
740
ADDRESS:686 MINERT ROADTELEPHONE:
(925) 944-9147
CITY:WALNUT CREEKSTATE: CAZIP CODE:
94598
CAPACITY:6CENSUS: 6DATE:
12/26/2024
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Caregiver Marie RegachoTIME COMPLETED:
12:30 PM
ALLEGATION(S):
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Facility staff does not allow resident to use the telephone to call the doctor.
Facility staff goes through the resident's belongings without consent from the resident.
Facility does not offer activities that meet the resident's needs.
INVESTIGATION FINDINGS:
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On 12/26/2024 at 9:00 AM, Licensing Program Analyst (LPA) James Sampair arrived unannounced to conduct this initial 10-day complaint investigation concerning allegations above. LPA met with Caregiver Marie Regacho and informed her of the allegations.

The complaint alleges staff does not alllow resident to use the telephone to call the doctor.
The LPA interviewed the Administrator and Resident R1, both of whom stated that R1 was able to use the phone at the facility to call their doctor and that R1 had recently gone to their dentist for an appointment R1 set up themselves. The data collected does not confirm the allegation.

The complaint alleges staff goes through the resident's belongings without consent from the resident.
The LPA interviewed the Administrator and Resident R1, both of whom stated that no one goes through their belongings. The data collected does not confirm the allegation.

Continued on LIC 9099-C . . .
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: James Sampair
LICENSING EVALUATOR SIGNATURE:

DATE: 12/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/26/2024
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-20241218100739
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: PARADISE GARDENS CARE HOME
FACILITY NUMBER: 075600998
VISIT DATE: 12/26/2024
NARRATIVE
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....Continued from LIC 9099

The complaint alleges facility does not offer activities that meet the resident's needs.
The LPA interviewed the Administrator and Resident R1, both of whom stated that the activities at the facility were enough to meet R1's needs. The data collected does not confirm the allegation.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove it; therefore, the allegation is UNSUBSTANTIATED.

Exit interview conducted and a copy of this report was provided.
SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: James Sampair
LICENSING EVALUATOR SIGNATURE:

DATE: 12/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/26/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2