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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 079201439
Report Date: 12/03/2025
Date Signed: 12/03/2025 02:56:11 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
08/05/2025 and conducted by Evaluator Tonica Syess-Gibson
PUBLIC
COMPLAINT CONTROL NUMBER: 15-AS-20250805163446
FACILITY NAME:SACRED HANDS LIVINGFACILITY NUMBER:
079201439
ADMINISTRATOR:PANESAR, RAJWANTFACILITY TYPE:
740
ADDRESS:2980 BLUMEN AVETELEPHONE:
(925) 392-8652
CITY:BRENTWOODSTATE: CAZIP CODE:
94513
CAPACITY:6CENSUS: 4DATE:
12/03/2025
UNANNOUNCEDTIME BEGAN:
01:03 PM
MET WITH:Charmaine Walters-Givens, CaregiverTIME COMPLETED:
03:10 PM
ALLEGATION(S):
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Staff poured hot water on resident causing injuries.
INVESTIGATION FINDINGS:
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On 12/03/2025 AT 1:03PM, Licensing Program Analyst (LPA), T. Syess-Gibson arrived unannounced to deliver the findings of the above allegation. LPA met with Charmaine Walters-Givens, Caregiver, and explained the purpose of the visit. Rajwant, Administer arrived at approximately 1:30PM.


During the course of the investigation, the department obtained medical records, letter of agreement (LOA), Staff daily notes, resident (R1) emergency contact information, and incident reports. The department interviewed resident(R1), staff (S1, S2), and R1’s case manager (CM).

Continue on LIC9099C...
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: Tonica Syess-Gibson
LICENSING EVALUATOR SIGNATURE:

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

DATE: 12/03/2025
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-20250805163446
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: SACRED HANDS LIVING
FACILITY NUMBER: 079201439
VISIT DATE: 12/03/2025
NARRATIVE
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Continued from LIC9099


Allegation: Staff poured hot water on resident causing injuries.

During the investigation interviews with S1, S2 and CM revealed, R1 was having problems with his ear, facility staff called paramedics and R1 was transported to hospital. R1 never mentioned anything about staff member pouring hot water on him and R1 has a history of making up stories that aren't true. Interview with R1 revealed, R1 was transported to hospital for ear problem. R1 also stated during interview of not reporting the hot water incident to staff, CM, paramedics or medical personnel during R1’s hospital visit. Records review revealed R1 was admitted to John Muir Health on June 19, 2025, due to a recent fall, medical records do not indicate anything related to a burn. Record review also revealed, R1 did not return to the facility after hospital visit.

Based upon the information obtained and the interviews conducted during investigation. The above allegation is unsubstantiated. A finding that the complaint is UNSUBSTANTIATED means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.

Exit interview conducted and a copy of report was given to Rajwant Panesar.

SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: Tonica Syess-Gibson
LICENSING EVALUATOR SIGNATURE:

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

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