019200474-4-20-2021-15-AS-KHOS-C2HR2A-20210428123800

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 019200474
Report Date: 04/20/2021
Date Signed: 04/20/2021 10:40:14 AM

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
05/07/2020 and conducted by Evaluator Praveen Singh

PUBLIC

COMPLAINT CONTROL NUMBER: 15-AS-20200507110648

FACILITY NAME:	STONERIDGE CREEK PLEASANTON		FACILITY NUMBER:	019200474
ADMINISTRATOR:	EZEKIEL GRIFFIN		FACILITY TYPE:	740
ADDRESS:	3300 STONERIDGE CREEK WAY		TELEPHONE:	(925) 227-6800
CITY:	PLEASANTON	STATE: CA	ZIP CODE:	94588
CAPACITY:	828	CENSUS:	DATE:	04/20/2021
		UNANNOUNCED	TIME BEGAN:	10:15 AM
MET WITH:	Ezekiel Griffin, Executive Director		TIME COMPLETED:	10:40 AM

ALLEGATION(S):

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-Facility fails to provide basic services

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Praveen Singh conducted this unannounced tele-visit with Executive Director (ED) Ezekiel Griffin to deliver findings on the above allegation. Due to the present shelter in place order by the Governor, this inspection was conducted via video-conference.

On 6/26/20, the Department's Continuing Care Contracts Bureau (CCCB) concluded its assignment to investigate the allegation. CCCB conducted interviews and reviewed the contracts pertaining to this complaint. Based upon the review of the information, the Department was unable to substantiate the allegation mentioned above and determined that the facility had not violated the continuing care contract statutes regarding this matter.

This agency has investigated the complaint allegation. We have found that the complaint was unfounded, meaning that the allegation was false, could not have happened and/or is without reasonable basis. We have therefore dismissed the complaint.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Yvonne Flores-Larios	TELEPHONE: (510) 286-0517
LICENSING EVALUATOR NAME: Praveen Singh	TELEPHONE: (510) 622-2625
LICENSING EVALUATOR SIGNATURE:	DATE: 04/20/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/20/2021

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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