079201246-1-30-2026-15-AS-BFOG-DR5SAU-20260209124253

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 079201246
Report Date: 01/30/2026
Date Signed: 01/30/2026 02:04:57 PM

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
01/22/2026 and conducted by Evaluator Daisy Panlilio

COMPLAINT CONTROL NUMBER: 15-AS-20260122104928

FACILITY NAME:	CONTRA LOMA HOME LLC		FACILITY NUMBER:	079201246
ADMINISTRATOR:	KUMAR, HARMESH		FACILITY TYPE:	735
ADDRESS:	4131 SHELTER COVE COURT		TELEPHONE:	(925) 826-6557
CITY:	ANTIOCH	STATE: CA	ZIP CODE:	94531
CAPACITY:	6	CENSUS: 1	DATE:	01/30/2026
		UNANNOUNCED	TIME BEGAN:	01:48 PM
MET WITH:	Brigida Moredo, Administrator		TIME COMPLETED:	02:45 PM

ALLEGATION(S):

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Staff did not provide resident with a safe environment
Staff yell at resident
Staff confiscate resident's personal property
Staff shoved resident
Staff speak inappropriately to resident

INVESTIGATION FINDINGS:

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On 01/30/26 at 1PM, Licensing Program Analyst (LPA) D Panlilio conducted subsequent complaint visit, met with Administrator (ADM) and delivered investigation finding to ADM. LPA explained the purpose of the visit with ADM.

During investigation, LPA conducted interviews with reporting party (RP), clients (C1, C2), staff (ADM, S1, S2), RCEB Case Manager and reviewed clients’ (C1, C2) records and police report regarding the incident. LPA also obtained the following documents from administrator - personnel record, clients’ roster, admission agreements, IPP/ISP plans, physician reports, needs & services plans, police report, incident reports.

Continued on next page, LIC 9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Daisy Panlilio
LICENSING EVALUATOR SIGNATURE:	DATE: 01/30/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/30/2026

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 4

Control Number 15-AS-20260122104928

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: CONTRA LOMA HOME LLC	FACILITY NUMBER: 079201246
	VISIT DATE: 01/30/2026

NARRATIVE

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Allegation: Staff did not provide resident with a safe environment
Investigation Finding: Unsubstantiated
During investigation, the Department conducted interviews with reporting party (RP), clients (C1, C2), staff (ADM, S1, S2), RCEB Case Manager and reviewed clients’ (C1, C2) records. On 01/13/26, RCEB Case Manager received an email from C1 requesting to be moved to a different facility because he was feeling afraid and was not able to eat. C1 was recently accused of rape involving another client. Law enforcement later determined that the encounter between the two clients was consensual. Despite the finding, C1 claims he is currently living in a hostile environment due to the accusation. LPA interviewed staff (S1, S2) who denied calling C1 a “rapist”. Both S1 and S2 stated that they treated C1 like a younger brother and did not verbally or physically abuse him. RCEB Case Manager stated he did not observe S1, S2 verbally or physically abuse any client at the facility during visits. LPA was unable to interview C1 because he moved out of the facility on 01/13/26 and could not be reached. Although the allegation may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. Therefore, the allegation that staff did not provide resident with a safe environment is unsubstantiated.

Allegation: Staff yell at resident
Investigation Finding: Unsubstantiated
During investigation, LPA conducted interviews with reporting party (RP), clients (C1, C2), staff (ADM, S1, S2), RCEB Case Manager and reviewed clients’ (C1, C2) records. C1 told RCEB Case Manager that staff yell at him after the 01/02/26 incident. S1 and S2 both denied yelling at C1 or any client. ADM stated he did not witness S1 or S2 yell at any client in care. RCEB Case Manager stated he did not observe S1, S2 verbally or physically abuse any client at the facility during visits. LPA was unable to interview C1 because he moved out of the facility on 01/13/26 and could not be reached. Although the allegation may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. Therefore, the allegation that staff yell at resident is unsubstantiated.

Continued on next page, LIC 9099-C pg2

SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Daisy Panlilio
LICENSING EVALUATOR SIGNATURE:	DATE: 01/30/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/30/2026

LIC9099 (FAS) - (06/04)

Page: 2 of 4

Control Number 15-AS-20260122104928

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: CONTRA LOMA HOME LLC	FACILITY NUMBER: 079201246
	VISIT DATE: 01/30/2026

NARRATIVE

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Allegation: Staff confiscate resident’s personal property
Investigation Finding: Unsubstantiated
During investigation, LPA conducted interviews with reporting party (RP), clients (C1, C2), staff (ADM, S1, S2), RCEB Case Manager and reviewed clients’ (C1, C2) records. S1 stated that after the 01/02/26 consensual encounter between the two clients, C1 volunteered to turn in his cell phone to staff before going to bed and not use the internet at night. As soon as C1 wakes up the next day, staff stated they would return C1’s cell phone and connect the internet at the facility for C1 to use. Staff denied confiscating C1’s cell phone. LPA was unable to interview C1 because he moved out of the facility on 01/13/26 and could not be reached. Although the allegation may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. Therefore, the allegation that staff confiscate resident’s personal property is unsubstantiated.

Allegation: Staff shoved resident

Investigation Finding: Unsubstantiated
During investigation, LPA conducted interviews with reporting party (RP), clients (C1, C2), staff (ADM, S1, S2), RCEB Case Manager and reviewed clients’ (C1, C2) records. C1 told RCEB Case Manager that staff shoved him during an argument in the laundry room. S1 and S2 both denied shoving or pushing C1 or any client in care. ADM stated he did not witness S1 or S2 shove or push any client at the facility. RCEB Case Manager stated he did not observe S1 and S2 physically abuse any client at the facility during visits. LPA was unable to interview C1 because he moved out of the facility on 01/13/26 and could not be reached. Although the allegation may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. Therefore, the allegation that staff shoved resident is unsubstantiated.

Continued on next page, LIC 9099C pg3

SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Daisy Panlilio
LICENSING EVALUATOR SIGNATURE:	DATE: 01/30/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/30/2026

LIC9099 (FAS) - (06/04)

Page: 3 of 4

Control Number 15-AS-20260122104928

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: CONTRA LOMA HOME LLC	FACILITY NUMBER: 079201246
	VISIT DATE: 01/30/2026

NARRATIVE

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Allegation: Staff speak inappropriately to resident
Investigation Finding: Unsubstantiated
During investigation, LPA conducted interviews with reporting party (RP), clients (C1, C2), staff (ADM, S1, S2), RCEB Case Manager and reviewed clients’ (C1, C2) records. C1 told RCEB Case Manager that staff curse at him after the 01/02/26 incident. S1 and S2 both denied cursing at C1 or any client. ADM stated he did not witness S1 or S2 curse at any client in care. RCEB Case Manager stated he did not observe S1, S2 speak inappropriately to any client at the facility during visits. LPA was unable to interview C1 because he moved out of the facility on 01/13/26 and could not be reached. Although the allegation may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. Therefore, the allegation that staff speak inappropriately to resident is unsubstantiated.

No deficiencies cited. Exit Interview conducted and a copy of this report provided.

SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Daisy Panlilio
LICENSING EVALUATOR SIGNATURE:	DATE: 01/30/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/30/2026

LIC9099 (FAS) - (06/04)

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