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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 071440106
Report Date: 02/26/2026
Date Signed: 02/26/2026 02:20:56 PM

Substantiated


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
02/24/2026 and conducted by Evaluator Andrew Christy
COMPLAINT CONTROL NUMBER: 15-AS-20260224085456
FACILITY NAME:CONCORD HOUSEFACILITY NUMBER:
071440106
ADMINISTRATOR:LEYBA, MARY ANNFACILITY TYPE:
735
ADDRESS:2301 MT. DIABLO ST.TELEPHONE:
(925) 825-4423
CITY:CONCORDSTATE: CAZIP CODE:
94520
CAPACITY:16CENSUS: 12DATE:
02/26/2026
UNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Sister Mary Ann Lebya, AdministratorTIME COMPLETED:
03:00 PM
ALLEGATION(S):
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Staff are not adhering to protocols regarding the Ombudsman as necessary.
INVESTIGATION FINDINGS:
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On 02/26/2026 at 1:30PM, Licensing Program Analysts (LPAs) Andrew Christy and Lori Alexander-Washington arrived unannounced to conduct 10-day initial complaint and deliver findings for the above allegation. LPAs met with administrator Sister Mary Ann Lebya and explained the purpose of the visit.

During the course of the investigation, LPAs collected the following documents, including but not limited to: LIC500, Resident Registry.

Continued on LIC9099C.....
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: Andrew Christy
LICENSING EVALUATOR SIGNATURE:

DATE: 02/26/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/26/2026
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 3
Control Number 15-AS-20260224085456
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: CONCORD HOUSE
FACILITY NUMBER: 071440106
VISIT DATE: 02/26/2026
NARRATIVE
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Continued from LIC9099…..

Allegation: Staff are not adhering to protocols regarding the Ombudsman as necessary - Substantiated

Per the allegation, ombudsman staff were not given access to documents that were requested for various residents. LPAs were provided email proof that the staff were not providing said documents before consulting with LPA Andrew Christy on 02/24/2026 about the matter due to unfamiliarity with the Ombudsman program.

The preponderance of the evidence standard has been met, and therefore the allegation is SUBSTANTIATED.

Deficiency is cited under the California Code of Regulations listed on LIC 9099-D. Failure to submit proof of correction (POC) by plan of correction and/or any repeat deficiencies within a 12-month period may result in civil penalties.

Exit interview conducted. A copy of this report, along with Appeal Rights, was provided to the administrator.

SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: Andrew Christy
LICENSING EVALUATOR SIGNATURE:

DATE: 02/26/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/26/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 15-AS-20260224085456
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: CONCORD HOUSE
FACILITY NUMBER: 071440106
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/26/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/06/2026
Section Cited
CCR
85072(b)(3)
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(b) The licensee shall insure that each client is accorded the following personal rights.
(3) To have communications to the facility from his/her relatives or authorized representative answered promptly and completely.
This requirement is not met as evidenced by:
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Fixed on site. Administrator expressed understanding of the Ombudsman program and did provide records to the ombudsman after consulting with CCLD.
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Baed on record review, the representative was not provided prompt and complete access to resident records, which posed a personal rights risk to residents in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: Andrew Christy
LICENSING EVALUATOR SIGNATURE:

DATE: 02/26/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/26/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3