011440777-10-7-2025-15-AS-YFLS-DNF2ZC-20251114165008

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 011440777
Report Date: 10/07/2025
Date Signed: 10/07/2025 02:37:34 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
09/29/2025 and conducted by Evaluator Gregory Clark

COMPLAINT CONTROL NUMBER: 15-AS-20250929163353

FACILITY NAME:	WATERS EDGE LODGE		FACILITY NUMBER:	011440777
ADMINISTRATOR:	LAGASCA-CRUZ, MARIE ANN N		FACILITY TYPE:	740
ADDRESS:	801 ISLAND DRIVE		TELEPHONE:	(510) 748-4300
CITY:	ALAMEDA	STATE: CA	ZIP CODE:	94502
CAPACITY:	120	CENSUS: 69	DATE:	10/07/2025
		UNANNOUNCED	TIME BEGAN:	12:00 PM
MET WITH:	Stephen Zimmerman, Administrator		TIME COMPLETED:	02:45 PM

ALLEGATION(S):

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Residents developed pressure injuries while in care
Staff do not ensure residents incontinent care needs are being met
Staff do not ensure residents bathing needs are being met
Staff do not ensure facility is kept free of pests

INVESTIGATION FINDINGS:

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On 10/07/25 at 12:30 p.m., Licensing Program Analyst (LPA) Greg Clark arrived unannounced to conduct an initial 10-day complaint investigation and deliver findings in regard to the allegations above. LPA met with Stephen Zimmerman, Administrator and explained the purpose of the visit.

During the course of the investigation LPA interviewed W1, facility staff, facility residents, reviewed residents’ records and toured residents' apartments.

Allegation: Residents developed pressure injuries while in care
W1 alleged that R1 has bedsores on her buttocks. LPA reviewed R1’s LIC602 dated 9/30/25. R1’s LIC602 documents that R1 has no skin breakdown. S1 and S2 both confirmed that R1 does not have any pressure injuries. LPA was unable to interview R1 as she is currently in the hospital due to Urinary Tract Infection.

*** report continues on LIC9099C***

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Yvonne Flores-Larios
LICENSING EVALUATOR NAME: Gregory Clark
LICENSING EVALUATOR SIGNATURE:	DATE: 10/07/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2025

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 15-AS-20250929163353

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: WATERS EDGE LODGE	FACILITY NUMBER: 011440777
	VISIT DATE: 10/07/2025

NARRATIVE

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***report continues from LIC9099***

Allegation: Staff do not ensure residents’ incontinent care needs are being met

W1 alleged that R2 is often in a wet diaper when she comes on shift and that he smells of urine. LPA interviewed R2 in the dining room of the facility. R2 was in a good mood and enjoying his lunch. LPA observed R2 to be order free. LPA also toured R2’s apartment at the facility and observed a urinal by R2’s bedside and a pile of chucks at the foot of his bed. R2’s care plan states that R2 is a “Level 3” for incontinence care meaning his diaper is changed every 2 hours. LPA reviewed R2’s care notes which document that R2’s is receiving a high level of care on a daily basis. S2 stated that she reviews care plans to ensure that staff are following them as written.

Allegation: Staff do not ensure residents’ bathing needs are being met

W1 did not have any specific information on which residents she felt were not receiving their showers as needed. She felt most of the staff were lazy and not doing their jobs. S1 stated that all of the assisted living residents have shower schedules and staff document that they have given the resident their shower. S1 also stated that he is certain that if a resident did not get a shower as scheduled he would hear about it from the resident or their family and if a shower is missed it gets rescheduled.

Allegation: Staff do not ensure facility is kept free of pets

S1 stated that from time to time some apartments do have an issue with ants and when told about it S1 alerts the pest control company who come out and spray the affected apartment. In addition, the facility has a contract with the pest control company for regular and routine pest control. LPA toured apartments 112 and 262 and interviewed the residents residing in those apartments, R3 and R4. LPA did not observe any ants in either apartment. Both residents stated that they did have ants and that the facility handled the issue promptly. Both residents were happy with the service they received.

This agency has investigated the above allegations. We have found that the complaint was unsubstantiated. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED.

Exit interview conducted, a copy of this report provided.

SUPERVISORS NAME: Yvonne Flores-Larios
LICENSING EVALUATOR NAME: Gregory Clark
LICENSING EVALUATOR SIGNATURE:	DATE: 10/07/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2025

LIC9099 (FAS) - (06/04)

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