<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 075601221
Report Date: 09/18/2025
Date Signed: 09/18/2025 11:19:19 AM

Substantiated


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
09/16/2025 and conducted by Evaluator Lori Alexander-Washington
PUBLIC
COMPLAINT CONTROL NUMBER: 15-AS-20250916101745
FACILITY NAME:LARKEY PARK HOME CAREFACILITY NUMBER:
075601221
ADMINISTRATOR:CAMACLANG, ALBERTINA RFACILITY TYPE:
740
ADDRESS:2532 LARKEY LANETELEPHONE:
(925) 287-8590
CITY:WALNUT CREEKSTATE: CAZIP CODE:
94597
CAPACITY:6CENSUS: 4DATE:
09/18/2025
UNANNOUNCEDTIME BEGAN:
09:05 AM
MET WITH:Jenny Lagana, CaregiverTIME COMPLETED:
11:45 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff are not ensuing the facility has food for the residents
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 09/18/2025 starting at 9:05 AM, Licensing Program Analyst (LPA) L. Alexander arrived unannounced to conduct initial 10-day complaint visit for the above allegation. LPA were greeted by Caregiver, and explained the purpose of the visit.

During investigation LPA interviewed Staff (S) and Residents (R). LPA toured the facility, including the kitchen and kitchen pantry.

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

DATE: 09/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2025
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 3
Control Number 15-AS-20250916101745
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: LARKEY PARK HOME CARE
FACILITY NUMBER: 075601221
VISIT DATE: 09/18/2025
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
LIC9099-C (Page 2)

Allegation; Staff are not ensuing the facility has food for the residents
Finding: Substantiated

On 09/18/2025 LPA L. Alexander observed four (4) residents at the facility. LPA interviewed R1 who was eating dried sliced apples. R1 was unable to verbalize much communication with LPA. LPA interviewed R2 that stated the food is delicious. R2 stated that sometimes for breakfast they get a muffin. LPA observed R3 and R4 were sleeping in their rooms. LPA observed expired canned goods in the covered pantry and expired canned goods in a box located on the floor in the kitchen. In addition, LPA observed expired boxed foods in the pantry. LPA observed rotten and dried fruits located on the counter. LPA observed expired milk, salad dressings, unlabeled foods in containers located in the refrigerator. LPA observed expired salami, meats in freezer.

LPA interviewed S1 that stated they were removing the expired canned goods from the pantry. LPA spoke with S3 over the phone that stated they didn't know where the canned goods came from located in a box on the floor. S3 stated that they started removing some of the expired cans to clean out the kitchen. S2 stated that there is no other foods like another refrigerator at the facility.

Based on LPAs observations and interviews which were conducted and record reviews, the preponderance of evidence standard has been met, therefore the above allegations are found to be SUBSTANTIATED. California Code of Regulations (Title 22, Division 6, Chapter 8), are being cited on the attached LIC 9099D.

Exit interview conducted. Appeal rights and copy of this report provided.
SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Lori Alexander-Washington
LICENSING EVALUATOR SIGNATURE:

DATE: 09/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 15-AS-20250916101745
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: LARKEY PARK HOME CARE
FACILITY NUMBER: 075601221
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/18/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/19/2025
Section Cited
CCR
87555(b)(8)(26)
1
2
3
4
5
6
7
87555 General Food Service Requirements.(b) The following food service requirements shall apply:(8) All food shall be of good quality..(26) Supplies of nonperishable foods for a minimum of one week and perishable foods for a minimum of two days shall be maintained on the premises.

This requirement is not met as evidenced by:
1
2
3
4
5
6
7
Administrator shall throw away all expired foods. Submit to CCLD self-certification understanding cited regulation. In addition, will purchase new canned/boxed/fresh fruits/snacks/meats/foods that the residents eat and send a photo of foods purchased along with a copy of receipt by due date.
8
9
10
11
12
13
14
Based on observation, and interview the licensee did not comply with the section cited above in by not having unexpired foods, including but not limited to meats, milk, canned goods, boxed foods in refrigerator/freezer/pantry for residents in care. Also, by not having foods that the residents eat including but not limited to eggs, bread, snacks, milk, drinks which poses an immediate health and safety risk to persons in care.
8
9
10
11
12
13
14
Immediate Civil Penalty assesed $500.00 today.
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
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: Bennett Fong
LICENSING EVALUATOR NAME: Lori Alexander-Washington
LICENSING EVALUATOR SIGNATURE:

DATE: 09/18/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3