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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 079200827
Report Date: 04/23/2025
Date Signed: 04/23/2025 11:03:37 AM

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
04/09/2025 and conducted by Evaluator Carol Fowler
COMPLAINT CONTROL NUMBER: 15-AS-20250409154540
FACILITY NAME:LOVING HANDS CARE HOME LLCFACILITY NUMBER:
079200827
ADMINISTRATOR:SAN DIEGO-TOMAS, CECILIAFACILITY TYPE:
740
ADDRESS:748 VAQUEROS AVETELEPHONE:
(510) 245-3738
CITY:RODEOSTATE: CAZIP CODE:
94572
CAPACITY:6CENSUS: 4DATE:
04/23/2025
UNANNOUNCEDTIME BEGAN:
09:23 AM
MET WITH:EDELYN TUPAS, CAREGIVERTIME COMPLETED:
11:20 AM
ALLEGATION(S):
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Staff are not ensuring that resident receives their mail while in care.
INVESTIGATION FINDINGS:
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On 04/23/2025 at 09:23am, Licensing Program Analyst (LPA), Carol Fowler arrived unannounced to deliver complaint findings for the allegation above. LPA met with Edelyn Tupas Caregiver and explained the reason for the visit.

Allegation: Staff are not ensuring that resident receives their mail while in care.
Investigation Finding: unsubstantiated.

During the investigation LPA interviewed staff, conservator and resident. LPA obtained and reviewed physician report, appraisal needs and service plan,letter of conservatorship, and email from conservator.

Continue on LIC 9099C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Carol Fowler
LICENSING EVALUATOR SIGNATURE:

DATE: 04/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/23/2025
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-20250409154540
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: LOVING HANDS CARE HOME LLC
FACILITY NUMBER: 079200827
VISIT DATE: 04/23/2025
NARRATIVE
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Continue from LIC 9099

During an interview with resident R1 it revealed that R1 stated R1 did not receive a birthday card from a church that mailed R1 a birthday card last year. R1 thinks that the staff is withholding R1s mail. R1 stated that the birthday card is the only mail that R1 is missing. R1 stated that R1 knows that the church mailed R1 a card because they did so last year. Interview with W2 revealed that in the (very rare) event that R1 receives mail at Loving Hands facility, the facility calls W2 and W2 will go there in person to inspect and likely pick up the mail, If the mail is personal (including notices from the court), W2 would give the mail directly to R1. Interview with S1 revealed that R1 has a conservator that handles all of R1s mail, if mail is received at the facility S1 will contact the conservator and the conservator will come to the facility and inspect the mail and provide R1 with the mail unless it’s a bill or something the conservator needs to take care of. Interview with S2 reveals that when mail is received at the facility it is given directly to the resident it is addressed to. Therefore, this 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: Carol Fowler
LICENSING EVALUATOR SIGNATURE:

DATE: 04/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/23/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2