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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 079201152
Report Date: 10/24/2024
Date Signed: 11/05/2024 01:02:01 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
08/07/2024 and conducted by Evaluator Laura Hall
PUBLIC
COMPLAINT CONTROL NUMBER: 15-AS-20240807135801
FACILITY NAME:GREENRIDGE SENIOR LIVINGFACILITY NUMBER:
079201152
ADMINISTRATOR:SINGH, RUBYFACILITY TYPE:
740
ADDRESS:2150 PYRAMID DRIVETELEPHONE:
(510) 758-9600
CITY:RICHMONDSTATE: CAZIP CODE:
94803
CAPACITY:38CENSUS: 18DATE:
10/24/2024
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Patrick Blanc, AdministratorTIME COMPLETED:
11:25 AM
ALLEGATION(S):
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Due to a lack of supervision, residents with dementia and at risk of falling wander around

Staff did not provide comfortable accommodations for residents

Staff did not provide a safe and comfortable environment for residents
INVESTIGATION FINDINGS:
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This report was amended on 10/28/2024 to make report public.

On 10/24/2024 at 9:30am, Licensing Program Analyst (LPA), L. Hall arrived unannounced to deliver complaint findings for the allegations above. LPA met with Patrick Blanc, Administrator and explained the purpose of the visit.

During the investigation the LPA interviewed staff, three (3) residents, obtained and reviewed staff and resident roster.

Allegation: Due to a lack of supervision, residents with dementia and at risk of falling wander around.

During the investigation visit LPA observed four (4) staff between the 1st and 2nd

Continued on LIC9099.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: Laura Hall
LICENSING EVALUATOR SIGNATURE:

DATE: 10/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/24/2024
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 3
Control Number 15-AS-20240807135801
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: GREENRIDGE SENIOR LIVING
FACILITY NUMBER: 079201152
VISIT DATE: 10/24/2024
NARRATIVE
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Continued LIC9099C.

floor. During 2nd floor tour LPA observed a camera at the end of the hallway that was placed in the upper corner across from the stairwell that leads to the 1st floor. At the bottom of the stairwell there is a door that leads to the outside of the facility; however, the door that leads outside has an alarm. LPA also observed that both windows on the 2nd floor had screens that was not in disrepair. S3 stated the offices that are located on the 2nd floor also has staff but there was meeting today that staff had to attend. During record review LPA observed only one (1) resident had the diagnosis of dementia. Based on the investigation the above allegations are unsubstantiated.

Allegation: Staff did not provide comfortable accommodations for residents.

Upon arrival LPA observed the residents were having lunch in the dining room. The temperature was at 75 degrees inside the facility. LPA also observed a couple of the residents sitting outside the facility with family. The housekeeper was on the 2nd floor cleaning the rooms. LPA interviewed three (3) residents and all residents stated they are very comfortable. The staff stated if residents need anything they let them know and the family will speak to the staff if necessary.

Allegation: Staff did not provide a safe and comfortable environment for residents.

Based on interviews with staff and residents. All feel the facility is a safe place to live. The residents interviewed stated the staff treats them nice. R1 stated this is the second time around and if it wasn't safe she would not have returned.

Continued on LIC9099C.

SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: Laura Hall
LICENSING EVALUATOR SIGNATURE:

DATE: 10/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/24/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 15-AS-20240807135801
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: GREENRIDGE SENIOR LIVING
FACILITY NUMBER: 079201152
VISIT DATE: 10/24/2024
NARRATIVE
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Continued from LIC9099C.

Based on observation during tour LPA observed bells sitting on the night stands of residents to ring for assistance. LPA also observed a long string located at the side of the residents’ bed that can be pulled and the string then notifies staff that help is needed.

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

Exit interview conducted and a copy of this report provided.

SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: Laura Hall
LICENSING EVALUATOR SIGNATURE:

DATE: 10/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/24/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3