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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 385600432
Report Date: 08/21/2025
Date Signed: 08/21/2025 03:20:26 PM

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
08/20/2025 and conducted by Evaluator Yi Sam Jian
COMPLAINT CONTROL NUMBER: 14-AS-20250820091316
FACILITY NAME:PSALM RESIDENTIAL CARE HOMEFACILITY NUMBER:
385600432
ADMINISTRATOR:ANNA VILLANUEVA-AOAYFACILITY TYPE:
740
ADDRESS:565 GROVE STTELEPHONE:
(415) 621-8505
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94102
CAPACITY:22CENSUS: 16DATE:
08/21/2025
UNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Anna Villanuva-AoayTIME COMPLETED:
02:33 PM
ALLEGATION(S):
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9
Staff does not ensure food served is of good quality to residents in care
INVESTIGATION FINDINGS:
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On 08/21/2025, Licensing Program Analyst (LPA) Yi Sam Jian conducted an unnannounced 10-day complaint visit. LPA met with administrator, Anna Villanuva-Aoay, LPA explained the purpose of the visit.
Regarding the allegation that facility staff do not ensure food served is of good quality, the reporting party claimed that staff have been serving expired and spoiled food to residents. During the visit, LPA inspected the kitchen and food storage areas, observing all food to be properly stored, labeled, and within expiration dates, with no expired or spoiled items present. A review of 30-day menus showed meals were balanced, and interviews with staff confirmed regular food deliveries, proper discarding of expired items. Resident interviews indicated that none reported receiving spoiled or expired food, and 4 out of 5 residents expressed satisfaction with the meals provided.
Base on interviews, and observations during the course of investigation, this allegation is unsubstantiated. Although the above investigations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is UNSUBSTANTIATED. This report is reviewed and discussed with administrator. A copy is provided.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Brenda Chan
LICENSING EVALUATOR NAME: Yi Sam Jian
LICENSING EVALUATOR SIGNATURE:

DATE: 08/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/21/2025
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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