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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 019201446
Report Date: 05/20/2026
Date Signed: 05/20/2026 12:03:12 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
05/14/2026 and conducted by Evaluator Kelly Nguyen
COMPLAINT CONTROL NUMBER: 15-AS-20260514144329
FACILITY NAME:DIANA'S CARE HOMEFACILITY NUMBER:
019201446
ADMINISTRATOR:REANO-AQUINO, GRACEFACILITY TYPE:
740
ADDRESS:27402 MANON AVENUETELEPHONE:
(510) 786-9982
CITY:HAYWARDSTATE: CAZIP CODE:
94544
CAPACITY:35CENSUS: 34DATE:
05/20/2026
UNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Grace Reani-Aquino, Administrator TIME COMPLETED:
12:30 PM
ALLEGATION(S):
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Illegal eviction
INVESTIGATION FINDINGS:
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On 5/20/26 at around 8am Licensing Program Analyst (LPA) K. Nguyen arrived unannounced to conduct an investigation and deliver findings on the above allegation. LPA explained the purpose of the visit to the administrator (ADM) Grace Reano- Aquino.

Allegation: Illegal Eviction: Unsubstantiated

During the investigation, the Licensing Program Analyst (LPA) conducted interviews with Resident 1 (R1) and staff members and reviewed relevant resident records and facility documentation regarding the allegation that the facility was conducting an illegal eviction, including but not limited to R1's physician report, needs and service plan, Kaiser notice of action letter, invoices, and communication between the facility and Kaiser.

Report continued on LIC 9099c…
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Kelly Nguyen
LICENSING EVALUATOR SIGNATURE:

DATE: 05/20/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2026
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-20260514144329
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: DIANA'S CARE HOME
FACILITY NUMBER: 019201446
VISIT DATE: 05/20/2026
NARRATIVE
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Report continued…
During an interview with LPA, R1 stated that Staff 1 (S1) personally provided R1 with a written eviction notice and explained the reason for the eviction. R1 reported that S1 informed R1 that there was an outstanding balance of approximately $30,000 owed to the facility after Kaiser reportedly discontinued payment for R1’s care following approximately four and a half years of residency at the facility.

LPA confirmed that the Department received a copy of the eviction notice from the facility on 04/27/2026. LPA reviewed the notice and supporting documentation and determined that the facility had followed the required eviction procedures in accordance with applicable regulations.
Additionally, R1 stated that facility staff continued to provide care and assistance during the eviction process and reported that staff were actively helping R1 secure alternative placement. Specifically, R1 stated, “Staff still assist me and are helping me find a place to stay.”

During an interview with S2, LPA learned that the facility had been coordinating with a placement agency to assist R1 in locating and transitioning to another appropriate care facility. Documentation and staff interviews indicated that R1 was scheduled to relocate to another facility on 05/26/2026. The reporting party also alleged that R1 required assistance with the AWL Waiver. However, information obtained during the investigation revealed that coordination of those services was being managed through Kaiser’s Case Management (CM) services and was not related to the eviction process itself.

Based on interviews conducted and records reviewed, there was insufficient evidence to support the allegation that the facility conducted an illegal eviction. Therefore, the allegation is Unsubstantiated.

An exit interview is conducted a copy of this report is provided to ADM.
SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Kelly Nguyen
LICENSING EVALUATOR SIGNATURE:

DATE: 05/20/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2