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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 079200634
Report Date: 12/03/2025
Date Signed: 12/03/2025 05:17:13 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
08/06/2025 and conducted by Evaluator Tonica Syess-Gibson
PUBLIC
COMPLAINT CONTROL NUMBER: 15-AS-20250806082129
FACILITY NAME:ELWYN CALIFORNIA - TERRA VERDEFACILITY NUMBER:
079200634
ADMINISTRATOR:WHITLEY, REBECCA LFACILITY TYPE:
737
ADDRESS:2934 TERRA VERDE LNTELEPHONE:
(925) 418-4168
CITY:OAKLEYSTATE: CAZIP CODE:
94561
CAPACITY:4CENSUS: 4DATE:
12/03/2025
UNANNOUNCEDTIME BEGAN:
03:41 PM
MET WITH:Rachel Murvine, AdministratorTIME COMPLETED:
05:30 PM
ALLEGATION(S):
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Staff spoke inappropriately in front of resident in care
INVESTIGATION FINDINGS:
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On 12/03/2025 at 3:40PM, Licensing Program Analyst (LPA), T. Syess-Gibson arrived unannounced to conduct the arrived to investigate and deliver complaint findings for the above allegation. LPA met with Rachel Murvine, Administrator, and explained the reason for the visit.

During the investigation, LPA interviewed four (4) staff members and obtained the following documents: Client’s roster (LIC9020), C1’s admission agreement and Individual performance plan (IPP), staff roster (LIC500), staff contact information, S1’s personnel record (LIC501) and training transcripts.
Continue on LIC9099C.....
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: Tonica Syess-Gibson
LICENSING EVALUATOR SIGNATURE:

DATE: 12/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2025
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 2
Control Number 15-AS-20250806082129
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: ELWYN CALIFORNIA - TERRA VERDE
FACILITY NUMBER: 079200634
VISIT DATE: 12/03/2025
NARRATIVE
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Continued from LIC9099

Allegation: Staff spoke inappropriately in front of resident in care.

During the investigation, LPA interviewed four (4) staff members, based on interviews with staff, staff treat clients with respect and do not speak inappropriately to the clients. S1 stated he have not been notified or observed any inappropriate behavior from staff towards clients. LPA wasn’t able to interview client, client in non-verbal.

Based upon the interviews during investigation. The above allegation is unsubstantiated. A finding that the complaint is UNSUBSTANTIATED means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.



Exit interview conducted and a copy of this report provided.
SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: Tonica Syess-Gibson
LICENSING EVALUATOR SIGNATURE:

DATE: 12/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2