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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 079200618
Report Date: 02/18/2026
Date Signed: 02/18/2026 03:07:26 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
09/10/2025 and conducted by Evaluator Tonica Syess-Gibson
PUBLIC
COMPLAINT CONTROL NUMBER: 15-AS-20250910110741
FACILITY NAME:MACRI'S ADULT RESIDENTIAL FACILITYFACILITY NUMBER:
079200618
ADMINISTRATOR:USANA, JEREMY NFACILITY TYPE:
737
ADDRESS:4680 NEROLY ROADTELEPHONE:
(925) 679-4430
CITY:OAKLEYSTATE: CAZIP CODE:
94561
CAPACITY:4CENSUS: 3DATE:
02/18/2026
UNANNOUNCEDTIME BEGAN:
02:01 PM
MET WITH:Jeremy Usana, AdministratorTIME COMPLETED:
03:26 PM
ALLEGATION(S):
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Staff physically abused resident
Staff neglect resulting in resident developing a pressure injury
Facility is operating out of ratio
Staff force residents to leave the facility to evade licensing
INVESTIGATION FINDINGS:
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On 02/18/2026 at 2:01PM, Licensing Program Analyst (LPA) T. Syess-Gibson arrived unannounced to deliver complaint findings for the allegations above. LPA met with Jeremy Usana, Administrator, and explained the purpose of the visit.

During the course of the investigation, LPA interviewed S1, S2, obtained and reviewed the following documents: staff roster, client's roster, C1 and C2’s physician's report, individual program plan (IPP), dangerous propensity, appraisal needs and services plan, emergency information, admission agreement, C2’s after visit summary dated 08/28/2025 through 09/01/2025, incident reports for client (C1, C2), C2’s home health care notes, and Regional Center of East Bay (RCEB) individual rate sheet for clients.

Continue on LIC9099C....
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: Tonica Syess-Gibson
LICENSING EVALUATOR SIGNATURE:

DATE: 02/18/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/18/2026
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-20250910110741
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND ASC, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
FACILITY NAME: MACRI'S ADULT RESIDENTIAL FACILITY
FACILITY NUMBER: 079200618
VISIT DATE: 02/18/2026
NARRATIVE
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Allegation: Staff physically abused resident

Based on interview with S1, it was revealed that C1 does not have a cut over C1’s eye. S1 stated C1 suffers from Self-Injurious Behavior (SIB) but hasn’t had SIB in over a year. S1 stated C1 did have a cut over C1’s left eyebrow back in January 2022, as a result of SIB. Based on record review, it was revealed that C1 does have episodes of SIBs such as picking or scratching at himself repeatedly for more than 5 seconds or picks and scratches himself that result in bleeding.

Allegation: Staff neglect resulting in resident developing a pressure injury

Based on interview with S1 and S2, it was revealed that on August 8, 2025, C2 was transported to the hospital for evaluation due to lack of eating and abnormal bowel. S1 stated that on September 01.2025, C2 returned to facility with a pressure injury on buttock. S1 stated C2 returned to the facility with Home Health (HH) nurse once a week. Based on record review, it was revealed, C2 returned from the hospital with HH, HH care notes dated September 2, 2025, revealed C2’s skin is intact, and no redness.

Allegation: Facility is operating out of ratio

Based on interviews with S1, it was revealed that there are five staff members including lead staff scheduled on the AM and PM shift, and there are three staff members including lead staff on the NOC shift. Based on record review, it was revealed that all of the clients has client’s to staff ratio: C1 has 2:1, C2 has 1:1 and C3 has 1:1, record review also revealed facility is scheduling adequate staffing to support the client’s needs.

Continue on LIC9099C......

SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: Tonica Syess-Gibson
LICENSING EVALUATOR SIGNATURE:

DATE: 02/18/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/18/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 15-AS-20250910110741
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND ASC, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
FACILITY NAME: MACRI'S ADULT RESIDENTIAL FACILITY
FACILITY NUMBER: 079200618
VISIT DATE: 02/18/2026
NARRATIVE
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Continued from LIC9099C.....


Allegation: Staff force residents to leave the facility to evade licensing

Based on observation, LPA has observed clients present at facility during past visits. Based on interviews with S1 and S2, it was revealed that facility is working closely with the Regional Center of East Bay (RCEB) regarding daily community intergraded outings. S1 stated RCEB supports the daily outings as it has minimized client’s behaviors. S1 and S2 also stated the clients enjoy being outside, when they return home there are less behaviors.

Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation did occur, therefore the allegation is UNSUBSTANTIATED.

No deficiencies are being cited on this date.

Exit interview conducted and a copy of this report provided.

SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: Tonica Syess-Gibson
LICENSING EVALUATOR SIGNATURE:

DATE: 02/18/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/18/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3