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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 079200587
Report Date: 08/08/2025
Date Signed: 08/08/2025 03:22:15 PM

Substantiated


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
08/05/2025 and conducted by Evaluator Daisy Panlilio
COMPLAINT CONTROL NUMBER: 15-AS-20250805133453
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:
08/08/2025
UNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Erlinda Portillo, AdministratorTIME COMPLETED:
03:30 PM
ALLEGATION(S):
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Staff did not maintain client's bed in good repair
INVESTIGATION FINDINGS:
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On 08/07/25 at 12:45PM, Licensing Program Analyst (LPA) D Panlilio conducted an unannounced complaint visit, met with staff (ADM, S1), gathered information and delivered investigation findings to ADM. LPA explained the purpose of the visit with staff.

During investigation, LPA conducted interviews with reporting party (RP), staff (ADM, S1), client (C1) and obtained the following documents from administrator – Personnel record (LIC500), Clients roster, admission agreement, physician’s report, needs & services plan, incident reports.

Continued on next page, LIC9099-C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Daisy Panlilio
LICENSING EVALUATOR SIGNATURE:

DATE: 08/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2025
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 5
Control Number 15-AS-20250805133453
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: 08/08/2025
NARRATIVE
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Allegation: Staff did not maintain client’s bed in good repair
Investigation Finding: Substantiated
On 08/07/25 at 12:55PM, LPA toured facility inside and out, including bedrooms, bathroom, living room, kitchen, dining area, and outside areas. LPA observed client’s (C1) bedframe on the left side support is broken with an old mattress and box spring on top. C1 stated the mattress is old and does not support her bad back. ADM did know that the bed frame support was broken. Based on LPA’s observations and interviews which were conducted and record review(s), the preponderance of evidence standard has been met, therefore the above allegation(s) that staff did not maintain client’s bed in good repair was found to be substantiated.

Deficiency is cited per Title 22 California Code of Regulations and listed on LIC9099D. Failure to submit proof of corrections (POCs) by plan of correction due dates and/or any repeat deficiencies within a 12-month period may result in civil penalties.

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

DATE: 08/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 15-AS-20250805133453
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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/08/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/05/2025
Section Cited
CCR
85088(c)(1)
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The licensee shall ensure provision to each client of the following furniture, equipment and supplies necessary for personal care and maintenance of personal hygiene. (1) An individual bed, except that couples shall be allowed to share one double or larger sized bed, maintained in good repair, and equipped with good bed springs, a clean mattress and pillow(s)
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By POC due date, ADM agrees to purchase and replace client’s broken bed frame and mattress and submit proof of purchase to CCLD in compliance with Section 85088(c) (1) regulation.
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This requirement was not met as evidenced by staff failing to maintain client’s bed and mattress in good repair which posed a potential health & safety risk to client in care.
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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: Daisy Panlilio
LICENSING EVALUATOR SIGNATURE:

DATE: 08/08/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 5
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
08/05/2025 and conducted by Evaluator Daisy Panlilio
COMPLAINT CONTROL NUMBER: 15-AS-20250805133453

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:
08/08/2025
UNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Erlinda Portillo, AdministratorTIME COMPLETED:
03:30 PM
ALLEGATION(S):
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Staff financially abused client
INVESTIGATION FINDINGS:
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13
On 08/07/25 at 12:45PM, Licensing Program Analyst (LPA) D Panlilio conducted an unannounced complaint visit, met with staff (ADM, S1), gathered information and delivered investigation findings to ADM. LPA explained the purpose of the visit with staff.

During investigation, LPA conducted interviews with reporting party (RP), staff (ADM, S1), client (C1) and obtained the following documents from administrator – Personnel record (LIC500), Clients roster, admission agreement, physician’s report, needs & services plan, incident reports.

Continued on next page, LIC9099-C pg 2
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Daisy Panlilio
LICENSING EVALUATOR SIGNATURE:

DATE: 08/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 15-AS-20250805133453
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: 08/08/2025
NARRATIVE
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Allegation: Staff financially abused client
Investigation Finding: Unsubstantiated
During investigation, LPA interviewed reporting party (RP), staff (ADM, S1, S2) and client (C1). Review of C1’s admission agreement, physician’s report, needs & services plan and individual service plan showed C1 was first admitted at the facility on 01/01/2016, is high functioning (independent with her ADLs) and is financially conserved.

Review of C1's admission agreement dated 08/02/21 showed that C1 is her own responsible person (POA) with her finances managed by a conservator. Staff (ADM, S1, S2) denied financially abusing C1. Staff stated that C1 is independent in deciding what she wants to purchase and that they do not influence or force her into buying expensive items. C1 stated that she treats staff like her own family since she has lived with staff at the facility since 08/02/2021 and loves to take them along on her vacations. C1 stated that she follows what her financial conservator tells her to do when it comes to purchasing items. C1 stated she wanted to purchase an electric scooter to aid in her mobility around the neighborhood. C1 stated staff does not influence or coerce her into buying expensive items. 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 that staff financially abused client is unsubstantiated.

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

DATE: 08/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 5