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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 079200587
Report Date: 09/16/2022
Date Signed: 09/16/2022 03:22:54 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
11/23/2021 and conducted by Evaluator Daisy Panlilio
COMPLAINT CONTROL NUMBER: 15-AS-20211123164713
FACILITY NAME:LINDA'S RESIDENTIAL CARE II LLCFACILITY NUMBER:
079200587
ADMINISTRATOR:PORTILLO, ERLINDAFACILITY TYPE:
735
ADDRESS:5220 FEATHER WAYTELEPHONE:
(925) 565-5106
CITY:ANTIOCHSTATE: CAZIP CODE:
94531
CAPACITY:6CENSUS: 6DATE:
09/16/2022
UNANNOUNCEDTIME BEGAN:
02:57 PM
MET WITH:Luis Fernandez, AdministratorTIME COMPLETED:
03:40 PM
ALLEGATION(S):
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Staff does not provide food of sufficient quality or quantity to residents
Staff does not treat clients with dignity and respect
Staff does not ensure that resident's dietary needs are met
INVESTIGATION FINDINGS:
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On 09/16/22 at 2PM, Licensing Program Analyst (LPA) D Panlilio conducted an unannounced subsequent visit and met with administrator to deliver the findings of above allegations. LPA explained the purpose of the visit with administrator.

Allegation: Staff does not provide food of sufficient quality or quantity to residents
Investigation Finding: Unsubstantiated
Based on interviews and record reviews, LPA observed all 6 clients appeared well groomed and not malnourished. Review of food receipts dated 09/21 until 11/21 and weekly menus (dated 11/08/21 until 12/12/21) confirm facility staff replenish their food supply frequently from Costco and serve clients a variety of food they prepare everyday. Clients (C1, C2, C3) confirm they are fed 3 meals a day plus snacks and drinks.
Continued on next page, LIC 9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Daisy Panlilio
LICENSING EVALUATOR SIGNATURE:

DATE: 09/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/16/2022
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-20211123164713
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: LINDA'S RESIDENTIAL CARE II LLC
FACILITY NUMBER: 079200587
VISIT DATE: 09/16/2022
NARRATIVE
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Clients stated that staff sometimes order pizza and sodas for them on occasion. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did occur, therefore the allegation is unsubstantiated.

Allegation: Staff does not treat clients with dignity and respect
Investigation Finding: Unsubstantiated
During investigation, staff denied maltreating any client at the facility. Clients (C1, C2, C3, C4) confirmed with LPA that staff treats them well and does not verbally or physically abuse them. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did occur, therefore the allegation is unsubstantiated.

Allegation: Staff does not ensure that resident’s dietary needs are met


Investigation Finding: Unsubstantiated
Based on interviews and record reviews, client (C4) was diagnosed with Type 2 diabetes without complication & without long term use of insulin on 11/15/21. Review of C4’s records show staff followed the Contra Costa Health services’ healthy meals recommendations for diabetes, limiting unhealthy fats and sugar and choosing healthy protein foods. C4 confirmed with LPA that he eats vegetables, fish and chicken that staff prepares for him. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did occur, therefore the allegation is unsubstantiated

No deficiencies cited during visit.



Exit Interview conducted and a copy of this report provided.
SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Daisy Panlilio
LICENSING EVALUATOR SIGNATURE:

DATE: 09/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/16/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 3