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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 075601014
Report Date: 02/12/2020
Date Signed: 10/08/2021 02:17:38 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
12/16/2019 and conducted by Evaluator Daisy Panlilio
COMPLAINT CONTROL NUMBER: 15-AS-20191216141054
FACILITY NAME:REYES GUEST HOMES-BELFORDFACILITY NUMBER:
075601014
ADMINISTRATOR:RAQUEL Y. COYLEFACILITY TYPE:
740
ADDRESS:2263 BELFORD DR.TELEPHONE:
(925) 280-9975
CITY:WALNUT CREEKSTATE: CAZIP CODE:
94598
CAPACITY:6CENSUS: 5DATE:
02/12/2020
UNANNOUNCEDTIME BEGAN:
12:40 PM
MET WITH:Raquel Coyle/AdministratorTIME COMPLETED:
03:00 PM
ALLEGATION(S):
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9
Staff harassed resident (R1).
INVESTIGATION FINDINGS:
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13
Licensing Program Analyst (LPA) Delmundo arrived unannounced to re-deliver the findings on the above allegation. LPA met with Raquel Coyle, administrator, and informed the purpose of visit.

Upon investigation, the reporting party (RP) stated that the facility staff had exhibited a pattern of harassment & wrongful conduct towards resident (R1), but informed the Department that the allegation is the same issue investigated in a previous complaint filed on July 2, 2019 (Unsubstantiated Finding), that there was no further or additional information specific to this allegation, and RP did not provide instances of harassment after the closure of that earlier complaint. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did occur, therefore this allegation is unsubstantiated.

......continued on 9099C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Alicia Delmundo
LICENSING EVALUATOR SIGNATURE:

DATE: 10/06/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/06/2021
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-20191216141054
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: REYES GUEST HOMES-BELFORD
FACILITY NUMBER: 075601014
VISIT DATE: 02/12/2020
NARRATIVE
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No deficiency cited.

Exit interview conducted and a copy of this report provided.
SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Alicia Delmundo
LICENSING EVALUATOR SIGNATURE:

DATE: 10/06/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/06/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 2