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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 079201309
Report Date: 03/12/2025
Date Signed: 03/12/2025 12:34:20 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
02/26/2025 and conducted by Evaluator James Sampair
PUBLIC
COMPLAINT CONTROL NUMBER: 15-AS-20250226153346
FACILITY NAME:ABEMU RESIDENCE CAREFACILITY NUMBER:
079201309
ADMINISTRATOR:JOY MANALANG-ENRIQUEZFACILITY TYPE:
740
ADDRESS:3101 BOWLING GREEN DRIVETELEPHONE:
(650) 278-1899
CITY:WALNUT CREEKSTATE: CAZIP CODE:
94598
CAPACITY:6CENSUS: 4DATE:
03/12/2025
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Administrator Joy Manalang-EnriquezTIME COMPLETED:
01:00 PM
ALLEGATION(S):
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Resident sustained pressure injuries while in care.
Resident in care was diagnosed with severe dehydration.
Staff did not seek timely medical care for resident care.
Staff did not report resident's incident to resident's authorized representative.
Staff did not provide adequate meals to resident in care.
Staff did not prevent the spread of illness at the facility.
INVESTIGATION FINDINGS:
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On March 12, 2025, at 9:30 AM, Licensing Program Analysts (LPAs) James Sampair and Yasamin Brown arrived unannounced to continue the investigation of the allegations above. Upon entry into the facility, the LPAs identified themselves and stated the purpose of the visit to Licensee Joy Manalang-Enriquez and Administrator Jhon Marie Wolffenden.

The complaint alleges that resident sustained pressure injuries while in care.
The LPAs interviewed Witness W1, Staff Members S1 and S2 and reviewed caregiver notes, resident records, facility records, and hospital records. Based on the data gathered, the resident did not sustain any pressure injuries while in care. The data collected does not confirm the allegation.

Continued on LIC 9099-C1. . . .
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: James Sampair
LICENSING EVALUATOR SIGNATURE:

DATE: 03/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2025
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-20250226153346
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: ABEMU RESIDENCE CARE
FACILITY NUMBER: 079201309
VISIT DATE: 03/12/2025
NARRATIVE
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. . .Continued from LIC 9099

The complaint alleges that resident in care was diagnosed with severe dehydration.
The LPAs interviewed Staff Members S1 and S2 and reviewed caregiver notes, resident records, facility records, and hospital records. Based on the data gathered, the resident was provided adequate water while living at the facility. The data collected does not confirm the allegation.

The complaint alleges that staff did not seek timely medical care for resident care.
The LPAs interviewed Witness W1, Staff Members S1 and S2 and reviewed caregiver notes, resident records, facility records, and hospital records. Based on the data gathered, the staff did seek timely medical care for the resident. The data collected does not confirm the allegation.

The complaint alleges that staff did not report resident's incident to resident's authorized representative.
The LPAs interviewed Witness W1, Staff Members S1 and S2 and reviewed caregiver notes, resident records, facility records, and hospital records. Based on the data gathered, the resident's authorized representative was notified in a timely manner. The data collected does not confirm the allegation.

The complaint alleges that staff did not provide adequate meals to resident in care.
The LPAs interviewed Witness W1, Staff Members S1 and S2 and reviewed caregiver notes, resident records, facility records, and hospital records. Based on the data gathered, the resident was provided adequate meals while living at the facility. The data collected does not confirm the allegation.

The complaint alleges that staff did not prevent the spread of illness at the facility.
The LPAs interviewed Witness W1, Staff Members S1 and S2 and reviewed the caregiver notes and the hospital records. Based on the data gathered, the staff did prevent the spread of illness at the facility. The data collected does not confirm the allegation.

Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove them; therefore, the allegations are 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: 03/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2