019200807-8-25-2023-15-AS-KHOS-CWGJ4H-20231010064310

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 019200807
Report Date: 08/25/2023
Date Signed: 08/25/2023 04:32:37 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
09/09/2022 and conducted by Evaluator Grace Luk

PUBLIC

COMPLAINT CONTROL NUMBER: 15-AS-20220909164658

FACILITY NAME:	CONTINUANCE CARE HOME LLC		FACILITY NUMBER:	019200807
ADMINISTRATOR:	MARSHALL, SHIRLEY		FACILITY TYPE:	740
ADDRESS:	565 SCHAFER RD		TELEPHONE:	(510) 398-8994
CITY:	HAYWARD	STATE: CA	ZIP CODE:	94544
CAPACITY:	16	CENSUS: 14	DATE:	08/25/2023
		UNANNOUNCED	TIME BEGAN:	02:40 PM
MET WITH:	Shirley Marshall, Administrator		TIME COMPLETED:	04:47 PM

ALLEGATION(S):

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Resident not getting hygiene needs met

INVESTIGATION FINDINGS:

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On 8/25/2023 at 2:40PM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct a complaint investigation and deliver findings in regards to the allegation above. LPA met with Administrator, Shirley Marshall and informed her the reason for visit.

During the course of investigation, LPA interviewed 5 residents, 3 staff, and complainant. LPA also obtained and reviewed documents including physician's report, care plan, and emergency information. Interview with residents revealed that residents' hygiene needs are being met. R1 stated she handles her own ADL (Activities of Daily Living) care and does not need assistance with hygiene needs.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did occur, therefore the allegation is UNSUBSTANTIATED. Exit interview conducted. A copy of this report provided.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Harpreet Humpal	TELEPHONE: (510) 285-3928
LICENSING EVALUATOR NAME: Grace Luk	TELEPHONE: (510) 286-4201
LICENSING EVALUATOR SIGNATURE:	DATE: 08/25/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/25/2023

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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