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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 075601424
Report Date: 01/14/2025
Date Signed: 01/14/2025 12:14:54 PM

Unsubstantiated


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
01/06/2025 and conducted by Evaluator James Sampair
PUBLIC
COMPLAINT CONTROL NUMBER: 15-AS-20250106123926
FACILITY NAME:AEGIS ASSISTED LIVING OF MORAGAFACILITY NUMBER:
075601424
ADMINISTRATOR:MARIA ANGELES STICKAFACILITY TYPE:
740
ADDRESS:950 COUNTRY CLUB DRIVETELEPHONE:
(925) 377-7900
CITY:MORAGASTATE: CAZIP CODE:
94556
CAPACITY:100CENSUS: 59DATE:
01/14/2025
UNANNOUNCEDTIME BEGAN:
08:15 AM
MET WITH:Executive Director Maria Angeles StickaTIME COMPLETED:
12:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff are not allowing resident to have visitors
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 1/14/2025 at 8:15 AM, Licensing Program Analysts (LPAs) James Sampair and David Doidge arrived unannounced to conduct this initial 10-day complaint investigation concerning allegation above. The LPAs met with Executive Director (ED) Maria Angeles Sticka and informed her of the allegation.

The complaint alleges that staff are not allowing resident to have visitors.
The LPAs reviewed the visitor log. The visitor log showed that between 12/20/2024 and 1/14/2025, resident R1 had 28 visits. 21 of which were from witness W1. The LPAs interviewed the ED about allowing visitors for resident R1. The ED explained that after a threat to her life by W1 on 12/31/2024, the police were called and the visitation rights of W1 were suspended. After a reconciliatory meeting on 1/1/2025 with the ED, W1, and a policeman, the visitation rights for W1 were reestablished. The data collected does not confirm the allegation.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove it; therefore, the allegation is UNSUBSTANTIATED.

Exit interview conducted and a copy of this report was provided.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: James Sampair
LICENSING EVALUATOR SIGNATURE:

DATE: 01/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/14/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
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