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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 019200464
Report Date: 12/30/2025
Date Signed: 12/30/2025 01:25:07 PM

Substantiated


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
12/11/2025 and conducted by Evaluator Ardalan Gharachorloo
COMPLAINT CONTROL NUMBER: 15-AS-20251211133328
FACILITY NAME:J & C CARE CENTER LLCFACILITY NUMBER:
019200464
ADMINISTRATOR:CHING, JESSICAFACILITY TYPE:
740
ADDRESS:4240 REDDING STREETTELEPHONE:
(510) 482-0108
CITY:OAKLANDSTATE: CAZIP CODE:
94619
CAPACITY:25CENSUS: 16DATE:
12/30/2025
UNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Ho Fung, AdministratorTIME COMPLETED:
03:35 PM
ALLEGATION(S):
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Licensee did not maintain adequate emergency supplies as required
INVESTIGATION FINDINGS:
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On 12/30/2025 at 1:20 PM, Licensing Program Analyst (LPA) Ardalan Gharachorloo arrived unannounced to deliver findings in regard to the allegation above. LPA met with Administrator Ho Fung and explained the purpose of the visit.

During the course of the investigation, the LPA toured the facility and confirmed that W1 had previously visited the facility . W1 stated that at the time of that visit, the facility did not have an emergency water supply available for residents. During the LPA’s visit, S1 was interviewed and stated that after W1’s visit, the facility purchased and obtained an emergency water supply.

Based on LPAs observations and interviews, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. Health and Safety code section 1569.695(a)(2) is being cited on the attached LIC 9099D.


Exit interview conducted, a copy of this report and appeal rights provided.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Yvonne Flores-Larios
LICENSING EVALUATOR NAME: Ardalan Gharachorloo
LICENSING EVALUATOR SIGNATURE:

DATE: 12/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/30/2025
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-20251211133328
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: J & C CARE CENTER LLC
FACILITY NUMBER: 019200464
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/30/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/31/2025
Section Cited
HSC
1569.695(a)(2)
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(2) Plans for the facility to be self-reliant for a period of not less than 72 hours immediately following any emergency or disaster, including, but not limited to,... and one or more utilities, including water, sewer, gas, or electricity, is notavailable, the facility shall have a plan and supplies available to provide alternative resources during an outage.
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Licensee shall submit proof of the required emergency water supply to the LPA by POC due date.
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based on observations and interviews,the licensee did not comply with the section cited above which poses a pontential health and safety risk to residents.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Yvonne Flores-Larios
LICENSING EVALUATOR NAME: Ardalan Gharachorloo
LICENSING EVALUATOR SIGNATURE:

DATE: 12/30/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/30/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2