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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 079201351
Report Date: 08/11/2025
Date Signed: 09/08/2025 02:24:10 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
08/05/2025 and conducted by Evaluator James Sampair
PUBLIC
COMPLAINT CONTROL NUMBER: 15-AS-20250805113016
FACILITY NAME:BRIDGE VIEW SENIOR LIVINGFACILITY NUMBER:
079201351
ADMINISTRATOR:COSTELLO, JINGJING WANGFACILITY TYPE:
740
ADDRESS:390 EL DIVISADERO AVETELEPHONE:
(510) 612-2240
CITY:WALNUT CREEKSTATE: CAZIP CODE:
94598
CAPACITY:6CENSUS: 6DATE:
08/11/2025
UNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Administrator Jingjing Wang CostelloTIME COMPLETED:
05:30 PM
ALLEGATION(S):
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Staff are not allowing the resident to leave the facility.
Staff does not allow resident to have access to mail.
Staff did not provide requested documents to a resident in care.
INVESTIGATION FINDINGS:
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On 8/11/2025, at 11:45 AM, Licensing Program Analyst (LPA) James Sampair arrived unannounced at the facility to investigate the allegations above. Upon entry into the facility, the LPA identified himself and stated the purpose of the visit to Administrator (ADM) Jingjing Wang Costello.

The LPA interviewed Witness W1, the ADM, Resident R1, Staff S1, and Staff S2. The LPA reviewed R1's Physician's Report (LIC 602A), R1's Medical and Financial Power of Attorney (POA) documents, and a letter dated 8/11/2025 from W4 (R1's estate attorney).

The complaint alleges that staff are not allowing R1 to leave the facility.
The ADM, S1, and S2 stated that R1 leaves the facility as needed for appointments and other outings. Witness W2 provides R1 with the transportation to and from appointments and other outings. The data collected does not support the allegation.

Continued on LIC 9099-C . . .
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: James Sampair
LICENSING EVALUATOR SIGNATURE:

DATE: 09/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/08/2025
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-20250805113016
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: BRIDGE VIEW SENIOR LIVING
FACILITY NUMBER: 079201351
VISIT DATE: 08/11/2025
NARRATIVE
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. . . Continued from LIC 9099

The complaint alleges that staff does not allow R1 to have access to mail.
R1 stated that he has access to mail. The ADM stated that they provide mail to W2 (as his POA) who provides R1 access to his mail. The data collected does not support the allegation.

The complaint alleges that staff did not provide requested documents to R1.
The ADM stated that R1 did not request his personal file. It was W1 and W3 who asked R1 to get his personal file. Based on the letter from Witness W4 (R1's estate attorney) dated 8/11/2025, neither W1 nor W3 have a legal right to examine any of the personal information contained in the documents they asked R1 to obtain for them, so it was correct that the requested documents were not provided. The data collected does not support the allegation.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove it; therefore, the allegation is UNSUBSTANTIATED.

Exit interview conducted with ADM and a copy of this report was provided.
SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: James Sampair
LICENSING EVALUATOR SIGNATURE:

DATE: 09/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/08/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2