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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 079200765
Report Date: 03/12/2025
Date Signed: 03/12/2025 05:32:25 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
E BAY DELTA AC/SC, 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
01/15/2025 and conducted by Evaluator Lori Alexander-Washington
PUBLIC
COMPLAINT CONTROL NUMBER: 15-AS-20250115141818
FACILITY NAME:PLEASANT HILL OASISFACILITY NUMBER:
079200765
ADMINISTRATOR:ELEGADO, LIZAFACILITY TYPE:
740
ADDRESS:40 BOYD RDTELEPHONE:
(925) 937-5348
CITY:PLEASANT HILLSTATE: CAZIP CODE:
94523
CAPACITY:49CENSUS: 48DATE:
03/12/2025
UNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Liza Elegado, Executive Director TIME COMPLETED:
03:30 PM
ALLEGATION(S):
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Licensee does not ensure the facility is free of roaches.
Licensee does not ensure community toilet is in good repair.
INVESTIGATION FINDINGS:
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On 03/12/2025 at 12:30 PM, Licensing Program Analyst (LPA) L. Alexander conducted a subsequent visit and met with Executive Director, Liza Elegado, to deliver the findings of above allegations. LPA explained the purpose of the visit with Executive Director.

During investigation, the Department obtained the following documents from the facility – Resident Roster, Staff Roster, Staff Schedules for January '25, Menu for Week 2, and Terminix Pest Control Agreements (12/26/24, 01/09/25).


LIC9099-C Continued...
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Lori Alexander-Washington
LICENSING EVALUATOR SIGNATURE:

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

DATE: 03/12/2025
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 7
Control Number 15-AS-20250115141818
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
E BAY DELTA AC/SC, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
FACILITY NAME: PLEASANT HILL OASIS
FACILITY NUMBER: 079200765
VISIT DATE: 03/12/2025
NARRATIVE
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LIC9099-C (page 2)

Allegation: Licensee does not ensure the facility is free of roaches.
Finding: Substantiated

On 01/22/2025, LPA interviewed witnesses (W) W1. W1 stated that they have seen roaches crawling on the walls. W1 stated that they also saw a roach on the mattress. W2 stated that while at the facility on 12/09/2024 they observed a can of roach spray in one of the rooms. LPA interviewed residents (R). R1, R2, R3 all stated that they have seen roaches and bed bugs at the facility. LPA observed a dead roach that R1 showed them in a napkin. R1 stated that there is bed bugs at the facility and that they saw bed bugs on their bed. R2 stated that they saw bed bugs in their room and that they got their sheets changed that morning.

On 01/22/2025, LPA interviewed staff (S). S1 stated that they have called pest control company, Terminix, out to do a treatment. LPA reviewed and obtained a copy of the Terminix contract.

On 03/12/2025, LPA interviewed S1 that stated they changed to a different new pest control company that will do a different type of treatments for the roaches. During visit, LPA observed a roach crawling on the glass indoor window and technician completing a pest inspection and treatment. W3 stated that they did not find any bed bugs, but did find German roaches in one of the residents' room. LPA obtained a copy of Pest Management Service Agreement.





LIC9099-C Continued...
SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Lori Alexander-Washington
LICENSING EVALUATOR SIGNATURE:

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

DATE: 03/12/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 7
Control Number 15-AS-20250115141818
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
E BAY DELTA AC/SC, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
FACILITY NAME: PLEASANT HILL OASIS
FACILITY NUMBER: 079200765
VISIT DATE: 03/12/2025
NARRATIVE
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LIC9099-C (Page 3)

Allegation: Licensee does not ensure community toilet is in good repair.
Finding: Substantiated

On 01/22/2025, LPA interviewed W1. W1 stated that the toilet in the community area is not anchored and the toilet moves. LPA observed the toilet and saw that the toilet is not properly anchored on the floor. LPA addressed the issue with S4 that stated the toilet would get fixed.

On 03/12/2025, LPA interviewed S2 that stated awareness of the toilet moving. S2 stated that R1 showed them that the toilet was moving because R1 is strong and moved the toilet. LPA went to community bathroom located in main hallway and observed that the same toilet observed on 01/22/25 was still not anchored and was sliding on the floor.

Based on LPA's observations and interviews which were conducted and record reviews, the preponderance of evidence standard has been met, therefore the above allegations are found to be SUBSTANTIATED. California Code of Regulations (Title 22, Division 6, Chapter 8), are being cited on the attached LIC 9099D.

Exit interview conducted. Appeal Rights and a copy of this report provided.
SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Lori Alexander-Washington
LICENSING EVALUATOR SIGNATURE:

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

DATE: 03/12/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 7
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
E BAY DELTA AC/SC, 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
01/15/2025 and conducted by Evaluator Lori Alexander-Washington
PUBLIC
COMPLAINT CONTROL NUMBER: 15-AS-20250115141818

FACILITY NAME:PLEASANT HILL OASISFACILITY NUMBER:
079200765
ADMINISTRATOR:ELEGADO, LIZAFACILITY TYPE:
740
ADDRESS:40 BOYD RDTELEPHONE:
(925) 937-5348
CITY:PLEASANT HILLSTATE: CAZIP CODE:
94523
CAPACITY:49CENSUS: 48DATE:
03/12/2025
UNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Liza Elegado, Executive Director TIME COMPLETED:
03:30 PM
ALLEGATION(S):
1
2
3
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5
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7
8
9
Licensee does not provide adequate food service for residents.
Staff does not ensure resident has clear access to toilet in room.
Licensee does not ensure one employee is on duty and on the premises awake during night supervision.
INVESTIGATION FINDINGS:
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2
3
4
5
6
7
8
9
10
11
12
13
On 03/12/2025 at 12:30 PM, Licensing Program Analyst (LPA) L. Alexander conducted a subsequent visit and met with Executive Director, Liza Elegado, to deliver the findings of above allegations. LPA explained the purpose of the visit with Executive Director.

During investigation, the Department obtained the following documents from the facility – Resident Roster, Staff Roster, Staff Schedules for January '25, Menu for Week 2, and Terminix Pest Control Agreements (12/26/24, 01/09/25).


LIC9099-C Continued...
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Lori Alexander-Washington
LICENSING EVALUATOR SIGNATURE:

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

DATE: 03/12/2025
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 7
Control Number 15-AS-20250115141818
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
E BAY DELTA AC/SC, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
FACILITY NAME: PLEASANT HILL OASIS
FACILITY NUMBER: 079200765
VISIT DATE: 03/12/2025
NARRATIVE
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LIC9099 (Page 4)

Allegation: Licensee does not provide adequate food service for residents.
Finding: Unsubstantiated

On 01/22/2025, LPA interviewed W1. W1 stated that the kitchen is disgusting. The dishes are dirty with food scraps and dishwasher is dirty. R1 stated that there is not enough food. R1 stated that they get served noodles and may get snacks. R1 stated that they have lost a lot of weight. R2 stated that the facility serves food that is heavy on carbs. R2 stated that they have to ask for more salad, the food is served “luke” warm and that they get snacks. R3 stated that they get served snacks, juice, decaf coffee and cookies. R4 and R5 stated that they get served hot soup, eggs, toast and orange slices like two times a week.

On 03/12/2025, LPA interviewed S3. S3 stated that they serve the residents breakfast, lunch and dinner. S3 has a list of residents that are on a modified diet. S3 stated that meals are prepped on plates which are served on trays. Trays are delivered to each resident in their rooms. S3 stated that some residents prefer their food hot and some prefer their food warm. S3 further stated that they have microwaves in the dining room and kitchen and if the residents like their food hot they can ask to have food microwave. LPA interviewed R6 that stated they are served their meal, sometimes the food is cold when it should be served hot. R6 stated that he is served an adequate portion and knows that there are microwaves to warm up food if he asks the caregivers. LPA observed during visit that the kitchen prepared ham, potatoes and mixed vegetables to be served for dinner.




LIC9099-C Continued...
SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Lori Alexander-Washington
LICENSING EVALUATOR SIGNATURE:

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

DATE: 03/12/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 7
Control Number 15-AS-20250115141818
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
E BAY DELTA AC/SC, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
FACILITY NAME: PLEASANT HILL OASIS
FACILITY NUMBER: 079200765
VISIT DATE: 03/12/2025
NARRATIVE
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LIC9099-C (Page 5)

Allegation: Staff does not ensure resident has clear access to toilet in room.
Finding: Unsubstantiated

On 01/22/2025, LPA interviewed W1 that stated R6's toilet riser is not accessible and that R6 has to yell for help.

On 03/12/2025, LPA interviewed R6 that stated they have no problems with their bathroom, accessing the toilet, and the toilet riser is ok.

Allegation: Licensee does not ensure one employee is on duty and on the premises awake during night supervision.
Finding: Unsubstantiated

On 01/22/2025, LPA interviewed W1. W1 stated that at night sometimes there is only one (1) caregiver and that they are sleeping by midnight.

On 03/12/2025, LPA interviewed R7, R8, R9, and R10 and all stated that they have not observed any caregiver on NOC shift sleeping. R7, R8, R9 and R10 all stated that there is more than one (1) caregiver during the NOC shift. LPA interviewed S1 that stated they have come to the facility around 3:00 AM in the morning to conduct in-service training and have not observed any staff sleeping.

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

Exit interview conducted and a copy of this report provided.
SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Lori Alexander-Washington
LICENSING EVALUATOR SIGNATURE:

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

DATE: 03/12/2025
LIC9099 (FAS) - (06/04)
Page: 6 of 7
Control Number 15-AS-20250115141818
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
E BAY DELTA AC/SC, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612

FACILITY NAME: PLEASANT HILL OASIS
FACILITY NUMBER: 079200765
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/12/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/28/2025
Section Cited
CCR
80087(a)(1)
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80087 Buildings and Grounds
(a)The facility shall be clean, safe, sanitary and in good repair at all times for the safety and well-being of clients, employees and visitors. (1) The licensee shall take measures to keep the facility free of flies and other insects.

This requirement is not met as evidenced by:
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Administrator agreed to submit a copy of pest inspection reports and contract agreements for the months of March, April and May to CCLD by POC due date.
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Based on interviews and observations, the licensee did not comply with the section cited above in by having roaches in the facility and residents' bedrooms which poses a potential health, safety or personal rights risk to persons in care.
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Type B
04/09/2025
Section Cited
CCR
87303(a)
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87303 Maintenance and Operation
(a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors.

This requirement is not met as evidenced by:
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Administrator agree to repair toilet and submit repair invoice along with photos of toilet repaired, anchored and floors sanitized clean to CCLD by POC due date.
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Based on interviews and observations, the licensee did not comply with the section cited above in by not having the toilet properly anchored to the floor including but not limited also the flooring and toilet area shall be clean and sanitized which poses a potential health, safety or personal rights risk to persons 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: Lori Alexander-Washington
LICENSING EVALUATOR SIGNATURE:

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

DATE: 03/12/2025
LIC9099 (FAS) - (06/04)
Page: 7 of 7