<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 019200082
Report Date: 10/10/2022
Date Signed: 10/10/2022 04:22:01 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
08/24/2022 and conducted by Evaluator Lisha Holmes
PUBLIC
COMPLAINT CONTROL NUMBER: 15-AS-20220824090154
FACILITY NAME:ROYAL COLONY IN BERKELEYFACILITY NUMBER:
019200082
ADMINISTRATOR:ALEGRE, FELIX JAMESFACILITY TYPE:
735
ADDRESS:1606 ALCATRAZ AVE.TELEPHONE:
(510) 655-8221
CITY:BERKELEYSTATE: CAZIP CODE:
94703
CAPACITY:32CENSUS: 28DATE:
10/10/2022
UNANNOUNCEDTIME BEGAN:
03:45 PM
MET WITH:Administrator Felix James AlegreTIME COMPLETED:
04:35 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff are not addressing bed bug problems in the facility
Clients in care do not receive proper food service
Staff did not ensure facility was free from pests
Staff are not properly handling food preparation
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 10/10/2022 at 3:45 PM, Licensing Program Analyst (LPA) L. Holmes arrived unannounced to deliver the complaint findings for the above allegations. LPA met with Staff #1 (S1) and explained the purpose for the visit.

During the course of the investigation, LPA interviewed four (4) Clients, two (2) Care Staff and two (2) witnesses. LPA reviewed pest control invoices dated 1/06/21, 05/24/22, 6/15/22, and 7/20/22. LPA inspected C1’s room which has two (2) beds, and the room across the hallway with one (1) bed. LPA did not observe any bed bugs or other pest. Interviews with Clients and Staff revealed that there was no presence of bed bugs on their beds, or around their rooms. Invoices showed that pest control is contracted monthly and is available to address specific pest issues that may arise; facility will inspect for bed bugs. LPA further observed breakfast, lunch, and dinner menus posted in the dining area, and serving times were visible for Clients. S1 and S2 said snacks are available at all times.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Yvonne Flores-Larios
LICENSING EVALUATOR NAME: Lisha Holmes
LICENSING EVALUATOR SIGNATURE:

DATE: 10/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2022
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-20220824090154
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: ROYAL COLONY IN BERKELEY
FACILITY NUMBER: 019200082
VISIT DATE: 10/10/2022
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
...continued from LIC9099

C2 stated that he/she eats different things, C4 stated that everything is great, C5 stated he/she is safe and comfortable, and there's always something to eat, and C6 said there's no problems. The facility had a sufficient supply of 2-day perishables and 7-days of nonperishables. S1 stated that dining times were agreed upon amongst Clients and meals are saved if a Client requests to eat outside of the facility. The kitchen and dining area were in good repair. S1 and S2 appeared to exercise safe and proper food handling while preparing meals during the investigations.


Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did occur, therefore the allegations are UNSUBSTANTIATED.

Exit interview conducted. A copy of this report provided Administrator Felix James Allegre
SUPERVISORS NAME: Yvonne Flores-Larios
LICENSING EVALUATOR NAME: Lisha Holmes
LICENSING EVALUATOR SIGNATURE:

DATE: 10/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2