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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 079201196
Report Date: 04/29/2026
Date Signed: 04/29/2026 12:24:03 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
04/20/2026 and conducted by Evaluator Tonica Syess-Gibson
PUBLIC
COMPLAINT CONTROL NUMBER: 15-AS-20260420161002
FACILITY NAME:COGIR OF BRENTWOODFACILITY NUMBER:
079201196
ADMINISTRATOR:FREETH, JEFFREYFACILITY TYPE:
740
ADDRESS:150 CORTONA WAYTELEPHONE:
(925) 308-9040
CITY:BRENTWOODSTATE: CAZIP CODE:
94513
CAPACITY:150CENSUS: 115DATE:
04/29/2026
UNANNOUNCEDTIME BEGAN:
09:48 AM
MET WITH:Jessica Depasquale, Executive Director (acting)TIME COMPLETED:
12:45 PM
ALLEGATION(S):
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Facility overcharged Resident
INVESTIGATION FINDINGS:
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On 04/29/2026 at 9:48AM, Licensing Program Analyst (LPA) T. Syess-Gibson arrived unannounced to conduct an initial10-day complaint investigation and deliver findings in regard to the allegation above. LPA met with Jessica Depasquale, Executive Director (acting), and explained the purpose of visit.

During the course of the investigation, LPA interviewed witnesses (W1, W2) and Staff (S1). LPA obtained the following documents: Resident (R1) admission agreement, facility’s staff schedule, residents’ roster, email thread between facility and W2, and facility invoice statement showing a refund check in the amount of $55.00 with check #17599 paid to W2 on 04/27/2026.

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

DATE: 04/29/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2026
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 2
Control Number 15-AS-20260420161002
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: COGIR OF BRENTWOOD
FACILITY NUMBER: 079201196
VISIT DATE: 04/29/2026
NARRATIVE
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Continued from LIC9099


Allegation: Facility overcharged Resident

Interview with S1 revealed facility issued a check in the amount of $55.00, and the check was delivered to W2 by Federal Express (Fed Ex) priority overnight with a tracking number of #871114796786. Interview with W2 revealed check in the amount of $55.00 was delivered by Fed Ex and it was received on 04/48/2026. Record review revealed facility received knowledge of Fed Ex envelope arrived to W2 04/28/2026. Record review also revealed, Fed Ex delivered a package to W2's address with a tracking number of #871114796786 on 04/28/2026 at 10:30AM.

Based upon the information obtained 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 report was given.

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

DATE: 04/29/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2