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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 019200418
Report Date: 11/12/2025
Date Signed: 11/12/2025 05:10:09 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
10/08/2025 and conducted by Evaluator Patricia Manalo
COMPLAINT CONTROL NUMBER: 15-AS-20251008165103
FACILITY NAME:BORDON HOME IIFACILITY NUMBER:
019200418
ADMINISTRATOR:BORDON, SHIRLEY E.FACILITY TYPE:
735
ADDRESS:5659 DON COURTTELEPHONE:
(510) 668-0103
CITY:FREMONTSTATE: CAZIP CODE:
94538
CAPACITY:6CENSUS: 3DATE:
11/12/2025
UNANNOUNCEDTIME BEGAN:
03:50 PM
MET WITH:Shirley Bordon, Administrator TIME COMPLETED:
04:20 PM
ALLEGATION(S):
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Staff are physically abusing clients.
INVESTIGATION FINDINGS:
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On 11/12/2025 at 3:45 PM, Licensing Program Analyst (LPA) P. Manalo arrived unannounced to deliver the findings on the above allegation. LPA met with Administrator, Shirley Bordon, and explained the purpose of the visit.

During the course of the investigation, LPA interviewed the Administrator (ADM), staff, and witness.

LPA obtained and reviewed the following documents including but not limited to LIC500, staff contact information, client roster, and current staff training.

It was alleged that staff are physically abusing clients. 4 of 4 staff members that were interviewed all stated that they have not witnessed any of the other staff members hit or abuse the clients in care. Interview with Witness 1 (W1) confirmed that W1 has not noticed or observed any unusual marks or bruises on 3 of 3 clients.

Continue to LIC9099-C...
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Yvonne Flores-Larios
LICENSING EVALUATOR NAME: Patricia Manalo
LICENSING EVALUATOR SIGNATURE:

DATE: 11/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/12/2025
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-20251008165103
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: BORDON HOME II
FACILITY NUMBER: 019200418
VISIT DATE: 11/12/2025
NARRATIVE
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Continue from LIC9099...

Based on interviews and observations conducted, the above allegation is unsubstantiated. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are unsubstantiated.

There is no deficiency noted.

Exit interview was conducted with Administrator, and a copy of this report was provided.
SUPERVISORS NAME: Yvonne Flores-Larios
LICENSING EVALUATOR NAME: Patricia Manalo
LICENSING EVALUATOR SIGNATURE:

DATE: 11/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/12/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2