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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 019200520
Report Date: 12/30/2025
Date Signed: 12/30/2025 12:06:59 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
10/30/2025 and conducted by Evaluator Kelly Nguyen
COMPLAINT CONTROL NUMBER: 15-AS-20251030092137
FACILITY NAME:JAYAR HOMEFACILITY NUMBER:
019200520
ADMINISTRATOR:ALCANTARA, MARIAFACILITY TYPE:
735
ADDRESS:576 JAYAR PLACETELEPHONE:
(510) 324-8343
CITY:HAYWARDSTATE: CAZIP CODE:
94544
CAPACITY:4CENSUS: 4DATE:
12/30/2025
UNANNOUNCEDTIME BEGAN:
11:55 AM
MET WITH:Carrie (Maria) Alcantara, Adminstrator TIME COMPLETED:
12:45 PM
ALLEGATION(S):
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Staff handled resident in a rough manner
INVESTIGATION FINDINGS:
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On 12/30/2025 at 11:55 AM, Licensing Program Analyst (LPA) K. Nguyen conducted an unannounced visit to delivered finding for the above allegation. LPA met with Administrator, Carrie (Maria) Alcantara. LPA explained the purpose of the visit to the staff.

During the course of the investigation, LPA conducted a thorough investigation into the allegation that staff roughly handled residents. As part of the investigation, LPA attempted to interview the resident(s) involved, additional residents, direct care staff, supervisory staff, and facility management. LPA also reviewed facility policies and procedures related to resident care, supervision, and appropriate physical assistance, as well as staff training records and any relevant incident or complaint reports.

Report Continued on LIC 9099c…

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Kelly Nguyen
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-20251030092137
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: JAYAR HOME
FACILITY NUMBER: 019200520
VISIT DATE: 12/30/2025
NARRATIVE
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Report Continued…

During interviews, LPA observed that the resident(s) were non-verbal. LPA tried to communicate with residents through pictures. Resident 1 (R1), Resident 2 (R2), Resident 3 (R3), and Resident 4 (R4) were able to give a reaction. All smile at the happy face. LPA reached out to the residents' case manager multiple times but was not able to get a hold of them. LPA observed that staff did not handle residents roughly or inappropriately during the time LPA was there. Staff interviewed denied the allegation and consistently reported that physical assistance is provided calmly and respectfully, in accordance with facility policies and required training. Facility management confirmed that staff receive training on proper resident handling techniques and de-escalation, and that no concerns regarding rough handling had been reported or observed.

A review of records revealed no incident reports, injury documentation, medical records, or prior complaints indicating that residents were handled roughly by staff. LPA review did not identify any physical injuries, bruises, or other signs consistent with rough handling. No video footage, photographs, or other physical evidence was available to support the allegation.

Based on the interviews conducted, records reviewed, and lack of corroborating or physical evidence, there was insufficient information to support the allegation. Therefore, the allegation that staff handles residents in a rough manner is unsubstantiated.

Exit interview conducted and a copy is provided.

SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Kelly Nguyen
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
LIC9099 (FAS) - (06/04)
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