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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 079201249
Report Date: 02/18/2026
Date Signed: 02/18/2026 02:31:10 PM

Substantiated


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
11/04/2024 and conducted by Evaluator Carol Fowler
PUBLIC
COMPLAINT CONTROL NUMBER: 15-AS-20241104113626
FACILITY NAME:HILLCREST MEMORY CAREFACILITY NUMBER:
079201249
ADMINISTRATOR:BROUSSARD, EUGENIEFACILITY TYPE:
740
ADDRESS:825 E 18TH STREETTELEPHONE:
(925) 706-7944
CITY:ANTIOCHSTATE: CAZIP CODE:
94509
CAPACITY:90CENSUS: 85DATE:
02/18/2026
UNANNOUNCEDTIME BEGAN:
10:22 AM
MET WITH:JARED PICKARD ADMINISTRATORTIME COMPLETED:
03:00 PM
ALLEGATION(S):
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Staff do not ensure that resident has clean laundry
INVESTIGATION FINDINGS:
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On 02/18/2026 at 10:20am, Licensing Program Analyst (LPA), Carol Fowler arrived unannounced to deliver complaint findings for the allegations above. LPA met with Jared Pickard, Administrator and explained the reason for the visit.

During the investigation LPA interviewed W1, S1, S2, S3, S4 and S5. LPA reviewed facility and Staff Roster, Physician Reports, Care Notes, and Laundry Schedule.

CONTINUE ON LIC 9099C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Carol Fowler
LICENSING EVALUATOR SIGNATURE:

DATE: 02/18/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/18/2026
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 6
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
11/04/2024 and conducted by Evaluator Carol Fowler
PUBLIC
COMPLAINT CONTROL NUMBER: 15-AS-20241104113626

FACILITY NAME:HILLCREST MEMORY CAREFACILITY NUMBER:
079201249
ADMINISTRATOR:BROUSSARD, EUGENIEFACILITY TYPE:
740
ADDRESS:825 E 18TH STREETTELEPHONE:
(925) 706-7944
CITY:ANTIOCHSTATE: CAZIP CODE:
94509
CAPACITY:90CENSUS: 85DATE:
02/18/2026
UNANNOUNCEDTIME BEGAN:
10:22 AM
MET WITH:JARED PICKARD ADMINISTRATORTIME COMPLETED:
03:00 PM
ALLEGATION(S):
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Resident sustained an unexplained injury
Staff are not adequately trained
Facility is in disrepair
Staff do not ensure that resident is appropriately dressed
INVESTIGATION FINDINGS:
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On 02/18/2026 at 10:20am, Licensing Program Analyst (LPA), Carol Fowler arrived unannounced to deliver complaint findings for the allegations above. LPA met with Jared Pickard, Administrator and explained the reason for the visit.

During the investigation LPA interviewed W1, S1, S2, S3, S4 and S5. LPA reviewed facility and Staff Roster, staff trainings, physician reports, care notes, and laundry schedule.

CONTINUE ON LIC 9099C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Carol Fowler
LICENSING EVALUATOR SIGNATURE:

DATE: 02/18/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/18/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 6
Control Number 15-AS-20241104113626
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: HILLCREST MEMORY CARE
FACILITY NUMBER: 079201249
VISIT DATE: 02/18/2026
NARRATIVE
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CONTINUE FORM LIC 9099A
Allegation: Resident sustained an unexplained injury

Investigation Finding: unsubstantiated.

During the investigation, the LPA interviewed W1, S2, and S3. Interview with W1 revealed that W1 was concerned about an injury on R1s leg and was upset no one knew where the injury came from. Interview with S2 revealed that R1 had a couple of injuries that came from repositioning R1, S2 stated that R1 had a couple skin tears on R1s arm and leg. Interview with S3 revealed that R1 has an area on R1s leg that S3 felt like it came from the Hoyer lift, S3 stated that S3 was the one that reported the injury, and the family was aware. THEREFORE THIS ALLEGATION IS UNSUBSTANTIATED.

Allegation: Staff are not adequately trained

Investigation Finding: unsubstantiated.

During the investigation LPA interviewed W1, S2 , S3, S4 and S5.

W1 expresses concerns that the facility staff are not trained to take came of the residents. LPA conducted a record review which revealed that all staff has been trained and also continues attending in-service training's. Interview with S2 revealed that S2 had yearly annual training's and in-service training's as well. Interview with S3 revealed that the facility has training's annual training and in-service, S3 also stated that the facility had a lot on non-english speaking staff but the training's were being translated for them as well. Interview with S4 revealed that S4 is a CNA (certified Nursing Assistant) and S4 has training's to keep S4 certificate current. S4 also stated that the facility also has in-service training. S5 stated that the facility has training, video training and in-service training. THEREFORE THIS ALLEGATION IS UNSUBSTANTIATED.

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

DATE: 02/18/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/18/2026
LIC9099 (FAS) - (06/04)
Page: 4 of 6
Control Number 15-AS-20241104113626
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: HILLCREST MEMORY CARE
FACILITY NUMBER: 079201249
VISIT DATE: 02/18/2026
NARRATIVE
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CONTINUE FROM LIC 9099C

Allegation: Facility is in disrepair

Investigation Finding: unsubstantiated.

During the investigation LPA interviewed W1, S2, S3 and S4.

W1 reported Concerns with a hole in the wall located in R1s room, W1 reported that W1 didn’t know how the hole got there and it needed to be repaired. LPA conducted a tour and the hole in the wall had been repaired. Interview with S2 revealed that the family brought a lot of furniture and R1s room was a small room, S2 stated that S2 is not sure if it was the furniture or R1s bed that made the hole in the wall but it was repaired within a week. Interview with S3 revealed that the family reported the hole to S3 and S3 reported the hole to the Administrator. S3 stated that S3 feels that the hole in the was might have been caused by R1s bed hitting against the wall when R1 was being transferred on the Hoyer lift. S3 stated that the facility fixed the hole after maybe a month. Interview with S4 revealed that S4 stated that the walls are so thin that the hole in the wall could have come from the door, and the facility repaired it fast. THEREFORE THIS ALLEGATION IS UNSUBSTANTIATED.

Allegation: Staff do not ensure that resident is appropriately dressed

Investigation Finding: unsubstantiated.

During the investigation LPA interviewed W1, S2, S3 and S4. W1 reported Concerns regarding the way R1 was dressed and felt R1 should have been dressed better. Interview with S2 revealed that S2 had never seen R1 not dressed appropriately, however the family would complain but the family would bring R1s clothes to wear. Interview with S3 revealed that R1s family brought clothes for R1 to wear and that family would complain in R1s socks didn’t match. S3 stated that R1 would always be wearing sweats with a t-shirt and the matching jacket and sometime a hat because R1 would be cold. S3 also stated that the family would come in and would wash R1 up and change R1s clothes. S3 also stated that R1 was always clean and dress appropriately. Interview with S4 revealed that R1 was always dressed well and the family would bring good clothes for R1. S4 stated that R1 was always taken real good care of. THEREFORE THIS ALLEGATION IS UNSUBSTANTIATED.

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 cited 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: 02/18/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/18/2026
LIC9099 (FAS) - (06/04)
Page: 5 of 6
Control Number 15-AS-20241104113626
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: HILLCREST MEMORY CARE
FACILITY NUMBER: 079201249
VISIT DATE: 02/18/2026
NARRATIVE
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CONTINUE FROM LIC 9099

Allegation: Staff do not ensure that resident has clean laundry

Investigation Finding: unsubstantiated.

During the investigation LPA interviewed W1, S1, S2, S3, S4 and S5.

W1 reported Concerns regarding laundry services. W1 reported that R1s laundry would pile up and the family would have to take the laundry home to wash. Inter with S1 revealed that when S1 arrived at the facility there was no laundry department and knows that there was an issue with the laundry services S1 also stated that the company has purchased 6 new washers and dryers, 3 for the 1st floor laundry room and 3 for the second-floor laundry room. S2 Interview revealed R1s family would complain about the laundry. S2 also stated that the facility has only 2 washers and 2 dryers and they were not working well and there was only staff that washed laundry in the mornings. S2 stated that the facility was short staffed during that period of time. Interview with S3 revealed that laundry was always a problem, the facility was short staffed, and the laundry was overflowing and if you needed something washed you would have to go to the laundry room to ask the staff to wash the item for you. Interview with S4 revealed that the facility had a problem with the washer and dryer and at one time the facility rented washers and dryers, S4 stated that staff was always complaining about the laundry. Interview with S5 revealed that there is 2 washers and 2 dryers and they have problems, S5 also stated the facility has bought new washers and dryers and they should be delivered today 2/18/2026. THIS ALLEGATION IS SUBSTANTIATED.

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

DATE: 02/18/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/18/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 6
Control Number 15-AS-20241104113626
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: HILLCREST MEMORY CARE
FACILITY NUMBER: 079201249
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/18/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/06/2026
Section Cited
CCR
87307(a)(F)
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87307 Personal Accommodations ...
(a) Living accommodations and grounds shall be ...function. The facility shall... provide comfortable ... residents, staff, and ... The following provisions shall apply: (F) Basic laundry service (washing, drying, and ...).
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Administrator agreed that the facility will purchase new washer and dryers and provide the department with
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Based on interviews and observation, licensee did not comply with the section cited above by not having timely basic laundry services, not replacing washers and dryers and hiring additional laundry staff.
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a copy of purchase order and photos of the new machines once installed.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Carol Fowler
LICENSING EVALUATOR SIGNATURE:

DATE: 02/18/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/18/2026
LIC9099 (FAS) - (06/04)
Page: 6 of 6