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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 019200807
Report Date: 08/13/2020
Date Signed: 08/13/2020 11:31:46 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
FACILITY NAME:CONTINUANCE CARE HOME LLCFACILITY NUMBER:
019200807
ADMINISTRATOR:MARSHALL, SHIRLEYFACILITY TYPE:
740
ADDRESS:565 SCHAFER RDTELEPHONE:
(510) 684-6058
CITY:HAYWARDSTATE: CAZIP CODE:
94544
CAPACITY:16CENSUS: 9DATE:
08/13/2020
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:25 AM
MET WITH:Shirley Marshall, AdministratorTIME COMPLETED:
10:45 AM
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On 08/13/20 at 10:25 AM, Licensing Program Analyst (LPA) Daisy Panlilio conducted a Face time tele-visit case management with Administrator (ADM) Shirley Marshall while investigating a complaint. LPA explained that the reason for the tele-visit was regarding an illegal eviction on a resident that was discharged at the hospital on June 6, 2020. Due to COVID-19 shelter in place order issued on March 17, 2020 by the Governor, Administrator was not physically available to sign this report.

R1 was hospitalized and released for discharge back to the facility on June 6, 2020. ADM told ER nurse and R1's guardian that R1 needs a higher level of care in a skilled nursing facility due to seizures and psychotic disturbance. R1 was safely relocated to another residential care for the elderly facility on the same day. ADM did not comply with proper eviction procedures as specified in CA Title 22, Section 87224 - Eviction Procedures.

Deficiency cited under Technical Violation (LIC 9102 Advisory Notes) for illegal eviction.

Exit interview conducted and a copy of this report provided to Administrator via email.
SUPERVISOR'S NAME: Rajind BasiTELEPHONE: (510) 286-4201
LICENSING EVALUATOR NAME: Daisy PanlilioTELEPHONE: (510) 286-4201
LICENSING EVALUATOR SIGNATURE:

DATE: 08/12/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2020
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
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