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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 075601431
Report Date: 06/03/2025
Date Signed: 06/03/2025 03:45:34 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
05/30/2025 and conducted by Evaluator David Doidge
COMPLAINT CONTROL NUMBER: 15-AS-20250530104523
FACILITY NAME:WALNUT CREEK WILLOWSFACILITY NUMBER:
075601431
ADMINISTRATOR:CORTES, ELIZABETHFACILITY TYPE:
740
ADDRESS:2015 MT. DIABLO BLVD.TELEPHONE:
(925) 256-8708
CITY:WALNUT CREEKSTATE: CAZIP CODE:
94596
CAPACITY:72CENSUS: 45DATE:
06/03/2025
UNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Administrator Assistant, Lynette SandovalTIME COMPLETED:
04:00 PM
ALLEGATION(S):
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 Resident’s personal belongings were stolen at the facility.
INVESTIGATION FINDINGS:
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On this day at 01:00 pm, LPAs David Doidge and Andrew Christy arrived unannounced to conduct 10-day investigation on the above allegation and deliver findings. LPAs met with Administrator Assistant, Lynette Sandoval and explained the purpose of the visit.

During the investigation, LPAs interviewed one (1) staff (S1). LPAs obtained a copy of R1's Admission Agreement, Client/Resident Personal Property and Valuables (LIC621), and Physician’s Report (602).

Allegation: Resident’s personal belongings were stolen at the facility.

Investigation Finding: LPAs review resident’s LIC621 and spoke with S1 regarding the missing items. LIC621 does not list the items that went missing. S1 informed LPAs when missing item are reported an investigation with staff and other residents is conducted. If the items are not found, the facility will reimburse the resident for the missing items within a time span of two weeks or less. S1 was made aware of missing items on the 29th of May and S1 was working towards finding the missing items by the time of this report. The items were not found and S1 is in the process of reimbursing R1 for those items.
Based on interview and record review conducted, the above allegation is unsubstantiated.

Continued on LOC9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: David Doidge
LICENSING EVALUATOR SIGNATURE:

DATE: 06/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/03/2025
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-20250530104523
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: WALNUT CREEK WILLOWS
FACILITY NUMBER: 075601431
VISIT DATE: 06/03/2025
NARRATIVE
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Continued from LIC9099

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

No deficiencies cited during visit.

Exit interview was conducted, and a copy of this report was provided.
SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: David Doidge
LICENSING EVALUATOR SIGNATURE:

DATE: 06/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/03/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2