019200660-5-27-2026-15-AS-BFOG-DV4TN6-20260616145213

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 019200660
Report Date: 05/27/2026
Date Signed: 05/27/2026 04:48:13 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
05/19/2026 and conducted by Evaluator David Doidge

COMPLAINT CONTROL NUMBER: 15-AS-20260519135651

FACILITY NAME:	VERMONTCARE LLC		FACILITY NUMBER:	019200660
ADMINISTRATOR:	ROSELI AND EDSEL MAGALONG		FACILITY TYPE:	740
ADDRESS:	865 VERMONT STREET		TELEPHONE:	(510) 835-3632
CITY:	OAKLAND	STATE: CA	ZIP CODE:	94610
CAPACITY:	10	CENSUS: 6	DATE:	05/27/2026
		UNANNOUNCED	TIME BEGAN:	01:40 PM
MET WITH:	Administrator Roseli Maglong		TIME COMPLETED:	05:00 PM

ALLEGATION(S):

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Staff are not ensuring residents have activities

INVESTIGATION FINDINGS:

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On 05/27/2026 at 01:40 PM, Licensing Program Analyst (LPA) David Doidge arrived unannounced to conduct an initial 10-day complaint investigation and to deliver findings regarding the allegation above. LPA met with Administrator Roseli Maglong and explained the purpose of the visit.

During the course of the investigation, LPA obtained copies of the Physician’s Reports, and Appraisal Needs and Services Plans for all six (6) residents. LPA interviewed all six residents and the Administrator. LPA obtained a copy of the facilities activities calendar and spoke with two (2) witnesses.

Allegations: Staff are not ensuring residents have activities.

Investigation Findings: It was reported to the department that the facility does not seem to offer any activities to their residents. Upon entering the facility LPA observed R1 reading a book in the kitchen with staff making conversation.

Continued on LIC9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: David Doidge
LICENSING EVALUATOR SIGNATURE:	DATE: 05/27/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/27/2026

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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Control Number 15-AS-20260519135651

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: VERMONTCARE LLC	FACILITY NUMBER: 019200660
	VISIT DATE: 05/27/2026

NARRATIVE

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Continued from LIC9099

R2 was out of the facility and upon return engaged win conversation with R1. R3 was reading a book when LPA entered R3’s room. R4 had a guest visiting. R5 also had a guest visiting. R6 was being changed and having a conversation with staff. LPA observed staff frequently checking in on residents and engaging with them. LPA did not see any resident without something to do or someone to talk to. LPA reviewed the facilities activity calendar and saw that the facility has multiple activities planned throughout the day for residents to participate in. S1 informed LPA that three of the six residents are bedridden, on hospice and are not physically able to come out of their rooms. S1 stated that R4, R5 and R6 each have multiple visitors throughout the day. W1 confirmed that W1 ensures that R4 has enough visitors throughout the day to engage with R4. R4 said at times, R4 feels like there is too much to do with all the different visitors. W1 informed LPA that R5 cannot hold things in R5’s hands and cannot get out of bed. W1 does come every day to spend time with R5 and feels staff engage with R5 enough. R5 spoke very little, but did affirm R5 feels cared for and has enough activities do to. R5 enjoys listening to music and watching television. R1 informed LPA that R1 would like to go outside more but has not asked staff to take R1 out for walks. R1 enjoys socializing with R2 and reading. R2 has planned outing with Center for Elderly Independence (CEI) twice a week. R2 will talk with R3 and sometimes play card games. All 6 residents have their own television and there is a television in the living room that is mainly used for music. S1 informed LPA that staff will put on local news or other shows in the evenings and R1. R2 and R3 will sometimes watch together. R1 and R3 enjoy reading, but not the same things and expressed having have enough reading material. All six residents and the two witnesses independently stated that residents always have something to do or someone to talk to.S1 informed LPA that coming up with groups activities can be a challenge due to three of the six residents being bedridden and on hospice however, S1 does ensure residents have something to do and someone to talk to. Based on interviews and record review 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 violation did or did not occur, therefore the allegation is UNSUBSTANTIATED.

No deficiencies observed or cited during this visit.

Exit interview conducted and a copy this report was provided.

SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: David Doidge
LICENSING EVALUATOR SIGNATURE:	DATE: 05/27/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/27/2026

LIC9099 (FAS) - (06/04)

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