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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 079200974
Report Date: 02/03/2026
Date Signed: 02/03/2026 03:41:40 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
12/15/2025 and conducted by Evaluator Laura Hall
PUBLIC
COMPLAINT CONTROL NUMBER: 15-AS-20251215081800
FACILITY NAME:GOLDEN AURORA HEALTHCARE ENTRADAFACILITY NUMBER:
079200974
ADMINISTRATOR:RIVERA, MARIA THERESAFACILITY TYPE:
735
ADDRESS:2729 ENTRADA CIRCLETELEPHONE:
(408) 207-5172
CITY:ANTIOCHSTATE: CAZIP CODE:
94509
CAPACITY:6CENSUS: 4DATE:
02/03/2026
UNANNOUNCEDTIME BEGAN:
02:50 PM
MET WITH:Christina Bengco, Direct Care Support TIME COMPLETED:
03:50 PM
ALLEGATION(S):
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Staff do not ensure the facility has a sufficient amount of perishable food

Staff do not ensure the facility has a sufficient amount of beverages

INVESTIGATION FINDINGS:
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On 2/3/2026 at 2:50pm, Licensing Program Analyst (LPA), L. Hall arrived unannounced to deliver a complaint finding for the allegations above. LPA met with Christina Bengco, Direct Care Support. Administrator, Perseus Rivera, arrived at 3:15pm, and LPA explained the reason for the visit.

During the course of the investigation the Department conducted interviews with staff, witnesses, obtained and reviewed records.

Allegation: Staff do not ensure the facility has a sufficient amount of perishable food

During the initial interview it was reported the facility does not serve fresh

Continued on LIC9099C.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: Laura Hall
LICENSING EVALUATOR SIGNATURE:

DATE: 02/03/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2026
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 5
Control Number 15-AS-20251215081800
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: GOLDEN AURORA HEALTHCARE ENTRADA
FACILITY NUMBER: 079200974
VISIT DATE: 02/03/2026
NARRATIVE
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Continued from LIC9099.

fruits or vegetables. S1 stated that grocery shopping day is conducted on Tuesday and there is a client that eats all the fruits as long as they are visible. LPA toured garage and kitchen and observed there was not a sufficient amount of perishables for the four (4) clients that resided at the facility. W2 stated during interview that there should be more perishables to eat. LPA did not interview the other three (3) clients due to refusal of clients.
Allegation: Staff do not ensure the facility has a sufficient amount of beverages

During the initial interview W1 reported the facility does not have a sufficient amount of beverages. During tour of the kitchen LPA and observed an open liter of juice in the refrigerator. S1 stated there is one client that will take the juice and drink it all in one setting, so, staff keeps juice in the staff refrigerator downstairs in the garage. LPA observed juice was not available to clients.

Based on LPA’s interviews which were conducted and observations, 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. A copy of the appeal rights and this report provided.

SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: Laura Hall
LICENSING EVALUATOR SIGNATURE:

DATE: 02/03/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 15-AS-20251215081800
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: GOLDEN AURORA HEALTHCARE ENTRADA
FACILITY NUMBER: 079200974
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/03/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/10/2026
Section Cited
CCR
85076(d)(1)
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(d) The licensee shall meet the following food supply and storage requirements:
(1) Supplies of staple nonperishable foods for a minimum of one week and fresh perishable foods for a minimum of two days shall be maintained on the premises.
This requirement was not met as evidence by:
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On 12/23/2025, Administrator submitted photos of perishable and non-perishables foods that were purchased. Deficiency cleared.
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Based on observation and interview the License did not comply with the section cited above in having a 7-day supply of non-perishables and 2-day perishables which poses a potential health and personal rights risk to persons in care.
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Type B
02/10/2026
Section Cited
CCR
80076(a)
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(a) In facilities providing meals to clients, the following shall apply:
This requirement was not met as evidence by:
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*See above*
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Based on observation and interview the License did not comply with the section cited above in having a sufficient amount of beverages which poses a potential health and 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: Harpreet Humpal
LICENSING EVALUATOR NAME: Laura Hall
LICENSING EVALUATOR SIGNATURE:

DATE: 02/03/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2026
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
12/15/2025 and conducted by Evaluator Laura Hall
PUBLIC
COMPLAINT CONTROL NUMBER: 15-AS-20251215081800

FACILITY NAME:GOLDEN AURORA HEALTHCARE ENTRADAFACILITY NUMBER:
079200974
ADMINISTRATOR:RIVERA, MARIA THERESAFACILITY TYPE:
735
ADDRESS:2729 ENTRADA CIRCLETELEPHONE:
(408) 207-5172
CITY:ANTIOCHSTATE: CAZIP CODE:
94509
CAPACITY:6CENSUS: 4DATE:
02/03/2026
UNANNOUNCEDTIME BEGAN:
02:50 PM
MET WITH:Christina Bengco, Direct Care Support TIME COMPLETED:
03:50 PM
ALLEGATION(S):
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9
Staff do not provide adequate food service

Staff are unable to communicate with residents due to a language barrier
INVESTIGATION FINDINGS:
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On 2/3/2026 at 2:50pm, Licensing Program Analyst (LPA), L. Hall arrived unannounced to deliver a complaint finding for the allegations above. LPA met with Christina Bengco, Direct Care Support. Administrator, Perseus Rivera, arrived at 3:15pm, and LPA explained the reason for the visit.

During the course of the investigation the Department conducted interviews with staff, witnesses, obtained and reviewed records.

Allegation: Staff do not provide adequate food service

During initial interview with W1 it was reported facility did not provide three (3) meals per day plus snacks. W1 stated some of the food provided is rotten or

Continued on LIC9099C.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: Laura Hall
LICENSING EVALUATOR SIGNATURE:

DATE: 02/03/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2026
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-20251215081800
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: GOLDEN AURORA HEALTHCARE ENTRADA
FACILITY NUMBER: 079200974
VISIT DATE: 02/03/2026
NARRATIVE
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Continued from LIC9099.

not of good quality, and there is only water from the sink. S1 stated during interview that shopping is conducted at all stores and there is a filtered pitcher for water in the refrigerator. W2 stated during interview that the facility provides enough food and more if requested. LPA toured kitchen and garage during visit and observed there were snacks located in a cabinet in the garage. Facility also had two (2) cases of water in the garage. LPA checked canned goods and did not observe any expired cans.

Allegation: Staff are unable to communicate with residents due to a language barrier

During the initial interview W1 reported the staff doesn’t speak English well and it’s hard to communicate with the staff due to the language barrier. S4 stated during interview that all the staff can communicate but sometimes one of the clients speaks very fast and that’s when communicating becomes a problem. If the staff, ask the client to repeat themselves the client gets upset. During the visit the LPA observed three (3) of the clients communicating with the staff without a problem. LPA did not have any problems communicating with the staff that was present during the visit. W2 stated during interview all the staff can communicate.

Based upon observation and interviews conducted during investigation the above allegations are unsubstantiated. A finding that the complaint is UNSUBSTANTIATED means that although the allegations 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 report was given.

SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: Laura Hall
LICENSING EVALUATOR SIGNATURE:

DATE: 02/03/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2026
LIC9099 (FAS) - (06/04)
Page: 5 of 5