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

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 079200801
Report Date: 01/27/2026
Date Signed: 01/27/2026 03:59:34 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
09/09/2024 and conducted by Evaluator Carol Fowler
COMPLAINT CONTROL NUMBER: 15-AS-20240909081424
FACILITY NAME:WESTMONT OF PINOLEFACILITY NUMBER:
079200801
ADMINISTRATOR:REMIGIO, RICHARDFACILITY TYPE:
740
ADDRESS:2850 ESTATES AVETELEPHONE:
(510) 758-1122
CITY:PINOLESTATE: CAZIP CODE:
94564
CAPACITY:100CENSUS: DATE:
01/27/2026
UNANNOUNCEDTIME BEGAN:
01:28 PM
MET WITH:RICHARD REMIGIO, EXECUTIVE DIRECTORTIME COMPLETED:
04:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Resident sustained injuries due to staff neglect
Staff are forcing resident to take medication
Staff did not allow resident to have visitors
Staff are not able to meet resident's needs
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 01/27/2026 at12:15pm, Licensing Program Analyst (LPA), Carol Fowler arrived unannounced to deliver complaint findings for the allegations above.

During the course of the investigation LPA interview five (5) staff and one witness (W1), obtained and reviewed records including but not limited to residents' rosterinterview five (5) staff, obtained and reviewed records including but not limited to residents' roster 3/1/24 to 5/1/24,

Continue on LIC9099C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Carol Fowler
LICENSING EVALUATOR SIGNATURE:

DATE: 01/27/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2026
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-20240909081424
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: WESTMONT OF PINOLE
FACILITY NUMBER: 079200801
VISIT DATE: 01/27/2026
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
CONTINUE FROM LIC 9099
employee roster, personnel records, admission agreements, MAR, visiting roster for 4/1/24 to 5/1/24, physicians' reports, needs and services plans, level of care notes/factional assessments, special incident reports, hospice binder, and care notes.

Allegation: Resident sustained unexplained injuries while in care.

Investigation Finding: unsubstantiated.

W1 reported that R1 had bruises and scratches from fighting with staff because R1 was refusing medication, W1 also reported that the facility would call W1 and ask if W1 could come and get R1 to take R1s medication and staff informed W1 that the facility wanted to keep R1 medicated due to R1s aggressive behaviors. . S2 further reported that S2 will try 2 or 3 times before charting. S5 reported that S5 has not seen any bruises or scratches on R1 however R1 would hit, and dig R1s nails in staff skin. S5 reported S5 has never witnessed any neglect to R1. S5 reported that the facility has never witnessed R1 with bruises and scratches, S5 stated that S5 worked directly with R1. Therefore, this allegation is UNSUBSTANTIATED.

Allegation: Staff are forcing resident to take medication

Investigation Finding: unsubstantiated.

W1 reported that staff would force R1 to take R1s medication, W1 reported that W1 has never witnessed staff forcing R1 to take R1s medication. W1 further reported that R1 was aggressive and violent and has slapped staff, and threw R1s walker at staff trying to give R1 medication. S2 reported that R1 would often refuse medication and S2 would continue to make rounds and come back and ask R1 again and if R1 would refuse S2 stated that S2 would try a third time and if R1 still refused S2 would chart R1 refused medication. S4 stated that when R1 would refused medication the Medication Technician would prompt R1 2 to 3 times and R1 would sometimes get aggressive and refused and it would be charted. Therefore, this allegation is UNSUBSTANTIATED.

Allegation: Staff did not allow resident to have visitors

Investigation Finding: unsubstantiated.

W1 reported that W1 was not allowed to visit with R1 for two weeks because the facility was lockdown due to COVID. W1 stated that W1 was told all staff and residents had COVID. W1 further reported that R1 was on hospice and W1 was denied visits.

CONTINUE ON LIC 9099C2

SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Carol Fowler
LICENSING EVALUATOR SIGNATURE:

DATE: 01/27/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 15-AS-20240909081424
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: WESTMONT OF PINOLE
FACILITY NUMBER: 079200801
VISIT DATE: 01/27/2026
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
CONTINUE FROM LIC 9099C
W1 reported that W1 informed the Executive Director, and the Executive Director apologized to W1 for W1 not being allowed into the facility to visit. S1 reported that the facility had lockdown orders from the county, but families of hospice residents were allowed to visit their family. S1 further reported that it was brought to S1s attention W1 was at the facility visiting with R1 before R1 passing and W1 and another family member was at the facility while R1 was passing. LPA conducted a record review which showed that W1 had signed into the facility on some days during the period before the period of R1s passing. S5 informed LPA that W1 would sometimes enter the facility in the memory care area, which no one should enter because there is no sign in sheet and that’s the reason some of the days W1 visited the facility was not on the sign in log. Therefore, this allegation is UNSUBSTANTIATED.

Allegation: Staff are not able to meet resident's needs

Investigation Finding: unsubstantiated.

W1 reported that the facility was unable to meet resident needs, alleging that staff could not provide proper care for R1, including administering medications and preventing injuries. S1 stated that the facility was abe to adequately care for R1, noting that the facility was fully staffed and that R1 was receiving hospice services, ensuring continuous care. S2 reported that they attempted to assist R1 with getting out of bed, and when R1 declined, they returned R1 to bed. S2 further stated that R1 was monitored frequently throughout their shift. S3 reported working directly with R1 and indicated that R1 would occasionally refuse assistance with activities of daily living (ADLs). S3 stated that staff continued to check on R1, ensuring the resident was clean, repositioned as needed, and comfortable. S5 confirmed that staff routinely checked on R1 and ensured staff availability whenever care was needed. S2 additionally stated that R1 was on hospice care and received regular visits from hospice nursing staff.

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



No deficiencies observed during visit. Exit interview conducted and a copy of this report provided.
SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Carol Fowler
LICENSING EVALUATOR SIGNATURE:

DATE: 01/27/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3