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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 019200693
Report Date: 08/14/2025
Date Signed: 08/14/2025 01:39:53 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
08/05/2025 and conducted by Evaluator Kelly Nguyen
COMPLAINT CONTROL NUMBER: 15-AS-20250805113548
FACILITY NAME:A-N-D CARE HOMESFACILITY NUMBER:
019200693
ADMINISTRATOR:HAMZA, MORENIKEFACILITY TYPE:
740
ADDRESS:3284 COURTHOUSE PLACETELEPHONE:
(510) 574-9305
CITY:UNION CITYSTATE: CAZIP CODE:
94587
CAPACITY:3CENSUS: 2DATE:
08/14/2025
UNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:HAMZA, MORENIKE. Adminstrator TIME COMPLETED:
02:00 PM
ALLEGATION(S):
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Staff does not ensure facility has adequate food and water supply.
INVESTIGATION FINDINGS:
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On 8/14/2025 at 10:00 a.m., Licensing Program Analyst (LPA) K. Nguyen, arrived unannounced to investigate the above allegations. LPA met with Morenike 'Nikky' Hamza, administrator, and informed the reason for visit.

During the course of investigation, LPA interviewed resident (R), and administrator/licensee. LPA tour the facility with ADM. LPA reviewed residents’ records.

Report continued on LIC9099C...
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Kelly Nguyen
LICENSING EVALUATOR SIGNATURE:

DATE: 08/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/14/2025
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-20250805113548
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: A-N-D CARE HOMES
FACILITY NUMBER: 019200693
VISIT DATE: 08/14/2025
NARRATIVE
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Allegation: Staff does not ensure facility has adequate food and water supply.

It was alleged Staff does not ensure facility has adequate food and water supply. LPA observed that there are two cases of portable water, iced tea, juices and soda are stack in the garage. LPA observed that there are 2-week supply of perishable and non- perishable food at the facility. LPA observed in the refrigerator are eggs, hams, bagels, cheese, vegetables, ect. LPA interviewed R1, R1 stated “I like to drink water and facility usually bring it to me. There’s enough food to eat. I am never hungry here. My roommates always have food and drinks as well”.

Based on all information obtained, the allegations were closed as unsubstantiated. A finding that a complaint is unsubstantiated means that although the allegations may have happened or are valid, there's not a preponderance of evidence to prove that the alleged violation occurred.

No deficiency cited. Exit interview conducted and copy of this report provided.

SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Kelly Nguyen
LICENSING EVALUATOR SIGNATURE:

DATE: 08/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/14/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2