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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 071440541
Report Date: 02/11/2025
Date Signed: 02/11/2025 02:38:38 PM

Unfounded


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
E BAY DELTA AC/SC, 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
02/05/2025 and conducted by Evaluator Lori Alexander-Washington
PUBLIC
COMPLAINT CONTROL NUMBER: 15-AS-20250205123313
FACILITY NAME:CHATEAU PLEASANT HILLFACILITY NUMBER:
071440541
ADMINISTRATOR:JOHN MCCRAWFACILITY TYPE:
740
ADDRESS:2726-2770 PLEASANT HILL RD.TELEPHONE:
(925) 935-1660
CITY:PLEASANT HILLSTATE: CAZIP CODE:
94523
CAPACITY:165CENSUS: 143DATE:
02/11/2025
UNANNOUNCEDTIME BEGAN:
12:34 PM
MET WITH:Jon McCraw, Executive DirectorTIME COMPLETED:
02:45 PM
ALLEGATION(S):
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Staff are not accepting resident back for re-entry.
INVESTIGATION FINDINGS:
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On 02/11/2025 at 12:34 PM, Licensing Program Analyst (LPA) L. Alexander arrived unannounced to conduct initial 10-day complaint visit for the above allegation. LPA met with Executive Director (ED), Jon McCraw, and explained the reason for the visit.

During the investigation, the Department obtained Resident (R), R1’s physician’s report (01/30/25), exception letter request (01/31/25), and After Visit Summary with discharge notes (dated 01/30/25), Resident Face Sheet and Admissions Agreement.



LIC9099-C Continued...
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Lori Alexander-Washington
LICENSING EVALUATOR SIGNATURE:

DATE: 02/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2025
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-20250205123313
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
E BAY DELTA AC/SC, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
FACILITY NAME: CHATEAU PLEASANT HILL
FACILITY NUMBER: 071440541
VISIT DATE: 02/11/2025
NARRATIVE
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LIC9099-C (Page 2)

Allegation: Staff are not accepting resident back for re-entry.
Finding: Unfounded

On 02/06/2025 LPA interviewed Witness (W1). W1 stated that R1 was treated for an infection that they got while they were in the hospital and was ready to be discharged back to the facility. W1 stated that they received phone calls from R1’s responsible party and that they were told that Staff (S1) was not accepting R1 back to the facility. W1 stated that R1’s responsible party told them that they did not know if R1 was colonized with an prohibited health condition.

On 01/31/2025 S1 submitted a formal exception request (CCR 87616) to accept and retain R1 whom has a prohibited health condition (CCR 87615(a)(4)). The Department granted approval of an exception to accept R1 on 02/06/2025.

This agency has investigated the complaint alleging “Staff are not accepting resident back for re-entry.” We have found that the complaint was UNFOUNDED, meaning that the allegation was false, could not have happened and/or is without a reasonable basis.

No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.
SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Lori Alexander-Washington
LICENSING EVALUATOR SIGNATURE:

DATE: 02/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2