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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 385600385
Report Date: 06/05/2025
Date Signed: 06/05/2025 10:28:44 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/30/2025 and conducted by Evaluator Dominic Tobola
COMPLAINT CONTROL NUMBER: 14-AS-20250530125500
FACILITY NAME:CORINTHIAN GARDEN RESIDENTIAL CARE HOMEFACILITY NUMBER:
385600385
ADMINISTRATOR:ENCARNACION, WILLIAM S.FACILITY TYPE:
740
ADDRESS:170 APTOS AVENUETELEPHONE:
(415) 841-0311
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94127
CAPACITY:6CENSUS: 5DATE:
06/05/2025
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:William Encarnacion, LicenseeTIME COMPLETED:
10:30 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility staff are not meeting residents nutritional needs
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 6/5/2025, Licensing Program Analyst (LPA) Tobola arrived unannounced for the purpose of initiating complaint investigation and was greeted by Licensee, William Encarnacion. LPA toured the facility, interviewed resident and made observations during the investigation.

Complaint alleges facility staff are not meeting resident (R1) nutritional needs. Upon inspection of facility, LPA observed an ample amount of both perishable and non-perishable food supplies enough for residents in care. Food was observed to be fresh with various options offering nutritional value. Upon statement from Adult Protective Services Worker (I1), the facility was inspected at a previous date and found no concerns or a lack of food supply. I1 had also gathered contradicting statements after interview with R1. LPA conducted interview with R1 during the visit and R1 stated that they did not have any concerns with the food and confirmed that they receive 3 meals per day. R1's statements had contradicted the allegation. LPA observed staff cooking baked chicken for lunch and for residents to take on their outings.

A finding that the complaint allegation facility staff are not meeting clients nutritional needs is unsubstantiated meaning that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED. No deficiency cited.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: April Cowan
LICENSING EVALUATOR NAME: Dominic Tobola
LICENSING EVALUATOR SIGNATURE:

DATE: 06/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2025
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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