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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 015600144
Report Date: 07/10/2025
Date Signed: 07/10/2025 01:52:34 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
02/17/2022 and conducted by Evaluator Alicia Delmundo
COMPLAINT CONTROL NUMBER: 15-AS-20220217155538
FACILITY NAME:HODGES RESIDENTIAL FACILITYFACILITY NUMBER:
015600144
ADMINISTRATOR:HODGES, A., C., & T.FACILITY TYPE:
735
ADDRESS:3320 LOMA VISTA WAYTELEPHONE:
(510) 536-0998
CITY:OAKLANDSTATE: CAZIP CODE:
94619
CAPACITY:6CENSUS: 2DATE:
07/10/2025
UNANNOUNCEDTIME BEGAN:
12:55 PM
MET WITH:Demauriee Ingraham/StaffTIME COMPLETED:
01:55 PM
ALLEGATION(S):
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Facility does not meet resident's nutritional needs.
INVESTIGATION FINDINGS:
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On this day, July 10, 2025, at 12:55 pm, Licensing Program Analyst (LPA) Delmundo arrived unannounced to deliver the findings for the above allegation. LPA was granted entry by Demauriee Ingraham,staff. LPA called and spoke with Anthony Hodges, administrator (ADM), and informed the reason for visit. ADM gave permission to the Mr. Ingraham sign and receive this report.

The reporting party (RP) stated that a resident told RP that when this resident eats any food at the facility, this resident feels nauseated and sick. The resident feels that the staff is “drugging the food”.

.....continued on 9099C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Alicia Delmundo
LICENSING EVALUATOR SIGNATURE:

DATE: 07/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2025
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-20220217155538
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: HODGES RESIDENTIAL FACILITY
FACILITY NUMBER: 015600144
VISIT DATE: 07/10/2025
NARRATIVE
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During the course of investigation, LPA obtained copies of resident roster and staff schedule. LPA also obtained copies and reviewed the following residents’ documents: LIC602 Physician’s Report; Individual Service Plan. LPA conducted an inspection on 2/24/22. The following were interviewed: staff (S1, S2) and resident (R2) on 2/24/22; RCEB case manager (CM) of one of the residents on 7/08/25.

Both staff provided information on what food they prepare and denied putting drugs on the meals they serve to the residents. CM stated she’d been at the facility and often checked on the resident in person and when COVID hits, she did virtual visits. CM also stated that the resident never mentioned anything about the food, nor mentioned any complaint against the facility or issues. LPA interviewed R2 but due to medical condition, LPA was unable to obtain information pertaining to the allegation. LPA was also unable to obtain information from other residents due to the residents being either with their family or in school.

During inspection, LPA observed food supplies adequate for 7 days of non-perishables and 2 days of perishables and of different varieties. LPA also observed one of the residents served snacks and this resident didn’t appear nauseated and sick after eating.

Based on information obtained and due to LPA unable to obtain information from residents, there is not a preponderance to prove that a violation occurred, therefore, the allegation is unsubstantiated.

No deficiency cited.

Exit interview conducted and a copy of this report provided.

SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Alicia Delmundo
LICENSING EVALUATOR SIGNATURE:

DATE: 07/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2025
LIC9099 (FAS) - (06/04)
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