435202599-2-27-2026-26-AS-RMAO-DS2NRS-20260310104200

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 435202599
Report Date: 02/27/2026
Date Signed: 02/27/2026 12:06:50 PM

Unfounded

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131

This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/17/2025 and conducted by Evaluator Simranjit Rai

COMPLAINT CONTROL NUMBER: 26-AS-20251117140918

FACILITY NAME:	DIYA SENIOR CARE HOME		FACILITY NUMBER:	435202599
ADMINISTRATOR:	KAUR, BHUPINDER		FACILITY TYPE:	740
ADDRESS:	276 CLEARPARK CIRCLE		TELEPHONE:	(408) 629-0388
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95136
CAPACITY:	6	CENSUS: 5	DATE:	02/27/2026
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Administrator, Bhupinder (Bani) Kaur		TIME COMPLETED:	12:20 PM

ALLEGATION(S):

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Facility staff were unable to effectively communicate with resident due to a language barrier.
Facility staff are not ensuring that residents are provided with activities while in care.
Facility staff did not ensure resident was provided supervision wherein resident pushed another resident.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Simi Rai conducted an unannounced visit to conclude the complaint investigation. LPA Rai met with the Adminstrator, Bhupinder (Bani) Kaur and stated the purpose of today’s visit.

On 11/17/2025, the Department received a complaint with the above allegations. On 11/26/2025, the Department conducted an initial investigation at the facility.

Continuation on LIC 9099-C, Page 1 of 3.

Unfounded

Estimated Days of Completion:

SUPERVISORS NAME: Romeo Manzano
LICENSING EVALUATOR NAME: Simranjit Rai
LICENSING EVALUATOR SIGNATURE:	DATE: 02/27/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2026

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 26-AS-20251117140918

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131

FACILITY NAME: DIYA SENIOR CARE HOME	FACILITY NUMBER: 435202599
	VISIT DATE: 02/27/2026

NARRATIVE

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Page 2 of 3.
Facility staff were unable to effectively communicate with resident due to a language barrier.
On 11/26/2025, LPA Rai interviewed 3 staff (S1-S2) including Administrator (ADM) Bani Kaur. ADM stated all facility staff are provided training in English and they are able to communicate with the ADM, other staff and residents. LPA Rai interviewed both staff present at the facility and S1 and S2 were able to communicate and understand in English. Both staff expressed the care and supervision needs of the residents at the facility and were able to explain the emergency plan of the facility.

On 11/26/2026, LPA Rai interview 6 residents (R1-R6). 4 Out of 6 residents refused to be interviewed or were not able to provide information about the above allegation. R3 and R4 stated they are able to understand and communicate with the facility staff. R3 and R4 expressed they were able to communicate their needs to the facility staff and the facility staff would appropriately communicate back to them.

During visit, LPA Rai observed facility staff S1 and S2 communicating with R3 and R4 and both residents were able to understand S1 and S2’s questions and answers. Based on review of staff training at random, 2 out of 2 staff completed 40 hours of staff training in English.

Facility staff are not ensuring that residents are provided with activities while in care.
On 11/26/2025, LPA Rai interviewed 3 staff (S1-S2) including Administrator (ADM) Bani Kaur. ADM stated there are multiple areas for residents to do activities in the facility which include the living room, dining room and their individual rooms.

On 11/26/2026, LPA Rai interview 6 residents (R1-R6). 4 Out of 6 residents refused to be interviewed or were not able to provide information about the above allegation. R3 and R4 stated the facility staff do provide activities and the residents can decide if they want to part of the activities. R3 and R4 were able to show LPA Rai the facility’s activity calendar and point out the different areas of the facility to do the activities. R3 and R4 provided LPA Rai different activities they do in the dining room and their room.

During visit on 11/26/2025, LPA Rai observed different areas with activities such as the activity cart which included games, puzzles, books, newspapers and other gaming cards which the residents requested. LPA Rai observed a piano and elliptical for residents to use. Based on review of facility activity calendar, facility staff are conducting 1 activity per day with the rest of the day for residents to conduct their own activities.

SUPERVISORS NAME: Romeo Manzano
LICENSING EVALUATOR NAME: Simranjit Rai
LICENSING EVALUATOR SIGNATURE:	DATE: 02/27/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2026

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 26-AS-20251117140918

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131

FACILITY NAME: DIYA SENIOR CARE HOME	FACILITY NUMBER: 435202599
	VISIT DATE: 02/27/2026

NARRATIVE

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Page 3 of 3.
LPA Rai observed the resident rooms and observed each resident doing activities in their own rooms and activity supplies were present in the room pertain to resident’s choice and preferences.

Facility staff did not ensure resident was provided supervision wherein resident pushed another resident.
On 11/26/2025, LPA Rai interviewed 3 staff (S1-S2) including Administrator (ADM) Bani Kaur. ADM stated there was an incident on 11/11/2025 where resident R1 pushed resident R2 on the chest while R1 and R2 was in their room. ADM stated staff S1 was present in the room, in front of the residents, providing supervision and trying to de-escalate the verbal altercation. ADM stated once S1 observed the interaction between R1 and R2, S1 separated the residents into different areas of the facility. S1 stated he/she was supervising the residents in the room and trying to de-escalate the verbal altercation between R1 and R2. S1 stated once R1 pushed R2 on the chest. S1 separated both residents by taking R1 out of the room. Based on review of resident’s Progress Notes on 11/11/2025, staff documented resident R1 and R2’s altercation.

On 11/26/2026, LPA Rai interview 6 residents (R1-R6). 4 Out of 6 residents refused to be interviewed or were not able to provide information about the above allegation. R3 and R4 are not aware of the incident that occurred on 11/11/2025 regarding R1 pushing R2 on the chest. Both staff stated the facility staff are always present at the facility and they are available to assist the residents. R3 and R4 could not recall a time when facility staff were not present at the facility. R1 and R2 did not want to speak with LPA Rai regarding the incident which occurred on 11/11/2025.

The Department has completed the investigation of the above allegations. Based on interviews conducted and record reviews, the department has found that the above allegations were UNFOUNDED, meaning that the allegations were false, could not have happened and/or are without a reasonable basis.

No deficiencies cited from California Code of Regulations, Title 22.

This report was reviewed with Administrator, Bhupinder (Bani) Kaur and a copy of the report was provided.

SUPERVISORS NAME: Romeo Manzano
LICENSING EVALUATOR NAME: Simranjit Rai
LICENSING EVALUATOR SIGNATURE:	DATE: 02/27/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2026

LIC9099 (FAS) - (06/04)

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