079201246-1-30-2026-15-AS-BFOG-DR5SZT-20260209131940

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 079201246
Report Date: 01/30/2026
Date Signed: 01/30/2026 01:47:36 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
08/14/2025 and conducted by Evaluator Daisy Panlilio

COMPLAINT CONTROL NUMBER: 15-AS-20250814100654

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:	01:00 PM
MET WITH:	Brigida Moredo, Administrator		TIME COMPLETED:	02:45 PM

ALLEGATION(S):

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Staff did not prevent resident from sexually assaulting another 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, the Department conducted interviews with reporting party (RP), clients (C1, C2), staff (ADM, Licensee, S1, S2), local police officer, RCEB Service Coordinator, Contra Costa County District Attorney and reviewed client’s records including forensic interview 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)

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Control Number 15-AS-20250814100654

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 prevent resident from sexually assaulting another resident
Investigation Finding: Unsubstantiated
During investigation, the Department conducted interviews with reporting party (RP), clients (C1, C2), staff (ADM, Licensee, S1, S2), local police officer, RCEB Service Coordinator, Contra Costa County District Attorney (DA) and reviewed client’s records including forensic interview and police report regarding the incident. Antioch Police Department (APD) responded to the facility’s sexual abuse report involving clients (C1, C2) on 07/13/25. According to APD report # 25-6049, C1 was inappropriately touched by C2 around 0300 hours. Forensic interviews of clients (C1, C2) were conducted by police which showed C1 was inconsistent in her recollection of events and that C2 was unable to provide information because he was nervous. IB investigator interviewed C2 who repeatedly denied inappropriately touching C1. Staff denied witnessing any inappropriate behaviors between both clients. IB investigator also interviewed Regional Center of the East Bay Coordinator who stated that C1 has a history of making similar allegations which were unfounded due to attention seeking behaviors. On 01/05/26, IB investigator contacted the Contra Costa DA’s office who reported the sexual abuse case was declined for prosecution on 11/25/25 due to lack of sufficient evidence. 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 prevent resident from sexually assaulting another 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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