079201337-1-14-2026-15-AS-BFOG-DQT3FG-20260129171242

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 079201337
Report Date: 01/14/2026
Date Signed: 01/14/2026 02:30:07 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
01/13/2026 and conducted by Evaluator Daisy Panlilio

COMPLAINT CONTROL NUMBER: 15-AS-20260113141900

FACILITY NAME:	RODMONHOMES, LLC		FACILITY NUMBER:	079201337
ADMINISTRATOR:	NUBLA, ROD		FACILITY TYPE:	735
ADDRESS:	5200 PUMA COURT		TELEPHONE:	(510) 220-2300
CITY:	ANTIOCH	STATE: CA	ZIP CODE:	94531
CAPACITY:	6	CENSUS: 6	DATE:	01/14/2026
		UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Rod Nubla, Administrator		TIME COMPLETED:	02:35 PM

ALLEGATION(S):

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Lack of supervision resulting in resident eloping from the facility

INVESTIGATION FINDINGS:

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On 01/14/26 at 1PM, Licensing Program Analyst (LPA) D Panlilio conducted an unannounced complaint visit, met with staff (ADM, S1, S2, S3), gathered information and delivered investigation findings to ADM. LPA explained the purpose of the visit with ADM.

During investigation, LPA conducted interviews with reporting party (RP), staff (ADM) and obtained the following documents from administrator – Personnel record (LIC500), Clients roster, admission agreement, physician’s report, Needs & services plan, ISP/IPP plans, Psychiatric reports, Daily logs, 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: 01/14/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/14/2026

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-20260113141900

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: RODMONHOMES, LLC	FACILITY NUMBER: 079201337
	VISIT DATE: 01/14/2026

NARRATIVE

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Allegation: Lack of supervision resulting in resident eloping from the facility
Investigation Finding: Unsubstantiated
During investigation, LPA conducted interviews with reporting party (RP), third party witness (W1) and facility staff (ADM, S1, S2, S3) and reviewed client (C1) documents. ADM stated client (C1) has a 1:1 staff per shift assigned who monitors him at the facility 24/7 due to his frequent AWOLs, Serious Bodily injury behaviors (SIBs) and physical aggression. RP stated he is the behavioral aide driver for C1’s school and that on 01/08/26, he arrived at the facility at around 07:10AM to pick him up. RP stated he observed two staff (S1, S2) outside looking for C1. S1 stated he told the driver that while C1 was having breakfast at the facility around 7AM, he climbed out the window and eloped from the facility. S3 stated he witnessed C1 climb out of the window and break the screen while running out. S3 stated he chased C1 around the neighborhood for 5 minutes until he caught him and brought him safely back to the facility the same day around 7:15AM. 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 lack of supervision resulted in resident eloping from the facility is unsubstantiated.

No deficiencies cited during visit.

Exit interview conducted and a copy of this report provided.

SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Daisy Panlilio
LICENSING EVALUATOR SIGNATURE:	DATE: 01/14/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/14/2026

LIC9099 (FAS) - (06/04)

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