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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 392700661
Report Date: 08/14/2025
Date Signed: 08/29/2025 03:36:27 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/25/2025 and conducted by Evaluator Charlie Yang
PUBLIC
COMPLAINT CONTROL NUMBER: 27-AS-20250625135812
FACILITY NAME:CASA DE ESPERANZAFACILITY NUMBER:
392700661
ADMINISTRATOR:BROWN, PAMELA & MAGANA, LUFACILITY TYPE:
735
ADDRESS:400 OLIVINE AVENUETELEPHONE:
(510) 385-8463
CITY:LATHROPSTATE: CAZIP CODE:
95330
CAPACITY:4CENSUS: 3DATE:
08/14/2025
UNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Giselle ContrerasTIME COMPLETED:
01:00 PM
ALLEGATION(S):
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Staff do not provide adequate supervision
INVESTIGATION FINDINGS:
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Unannounced complaint visit made out to this facility on 08/14/2025 by Licensing Program Analyst (LPA) Charlie Yang. This LPA was met by the facility staff person, Giselle Contreras, who was briefly interviewed at this time. This LPA requested that she go ahead and contact the facility designated Administrator, Luis Magana, to inform him that CCL was present at this time.
Current census was (3) residents, of which (1) resident, was out of the facility at their respectable day program at this time.
The purpose of this visit was to deliver the findings from this investigation to this facility, and it's representative, at this time.
Based on interviews conducted during the course of this investigation, it was learned that there was mainly only one staff person on duty during the three separate shifts throughout the span of 24 hours. These three shifts were the AM, PM, and NOC shift. It was learned that a staff person was responsible for completing their entire shift conducting adequate care and supervision unto the residents at all times.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Charlie Yang
LICENSING EVALUATOR SIGNATURE:

DATE: 08/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/14/2025
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 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/25/2025 and conducted by Evaluator Charlie Yang
PUBLIC
COMPLAINT CONTROL NUMBER: 27-AS-20250625135812

FACILITY NAME:CASA DE ESPERANZAFACILITY NUMBER:
392700661
ADMINISTRATOR:BROWN, PAMELA & MAGANA, LUFACILITY TYPE:
735
ADDRESS:400 OLIVINE AVENUETELEPHONE:
(510) 385-8463
CITY:LATHROPSTATE: CAZIP CODE:
95330
CAPACITY:4CENSUS: 3DATE:
08/14/2025
UNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Giselle ContrerasTIME COMPLETED:
01:00 PM
ALLEGATION(S):
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3
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9
Staff do not ensure facility is maintained clean

Staff are not properly addressing ants in the facility
INVESTIGATION FINDINGS:
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13
Unannounced complaint visit made out to this facility on 08/14/2025 by Licensing Program Analyst (LPA) Charlie Yang. This LPA was met by the facility staff person, Giselle Contreras, who was briefly interviewed at this time. This LPA requested that she go ahead and contact the facility designated Administrator, Luis Magana, to inform him that CCL was present at this time.
Current census was (3) residents, of which (1) resident, was out of the facility at their respectable day program at this time.
The purpose of this visit was to deliver the findings from this investigation to this facility, and it's representative, at this time.
Based on observations conducted during the course of this investigation, it was learned that this facility has been maintained to be clean and free of any odors at this time.
A tour of the facility bedrooms, restrooms, and commons areas was conducted. Furniture and furnishings were maintained in compliance and able to meet the needs of the residents at this time.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Charlie Yang
LICENSING EVALUATOR SIGNATURE:

DATE: 08/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/14/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 27-AS-20250625135812
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: CASA DE ESPERANZA
FACILITY NUMBER: 392700661
VISIT DATE: 08/14/2025
NARRATIVE
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Based on observations, this LPA was unable to spot any ants or other insects to be present at this facility. A review of the window sills, doorways, and exits was conducted with no signs of any insects present at this time.

As a result of this investigation, this Department found the allegations to be UNSUBSTANTIATED. A complaint allegation finding of Unsubstantiated meant that although the allegations may have happened or were valid, there was not a preponderance of the evidence to prove that the alleged violations occurred.

There were no deficiencies observed or cited at this time.

Exit Interview
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Charlie Yang
LICENSING EVALUATOR SIGNATURE:

DATE: 08/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/14/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 27-AS-20250625135812
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: CASA DE ESPERANZA
FACILITY NUMBER: 392700661
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/14/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/15/2025
Section Cited
CCR
80072(f)
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The licensee shall ensure that each client is accorded the personal rights as specified in this section and the applicable sections of chapters 2 through 7.
This facility was found to be deficient of the above regulation as evidenced by not allowing the residents to be able to stay home
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The facility designated representative stated that a plan will be created to address the issue of not having enough facility staff in order to meet all of the needs of the residents in care.
A statement of correction, along with the updated LIC 500, will be completed to reflect
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or go out into the community if they chose to do so. This posed an immediate threat to the Health, Personal Rights, and Safety unto all residents in care.
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the addition of facility staff to address for residents who desired to remain in the home while other staff could supervise the other residents who wished to be out in the community. All of this information will be submitted into CCL by the due date.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Charlie Yang
LICENSING EVALUATOR SIGNATURE:

DATE: 08/14/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/14/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 27-AS-20250625135812
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: CASA DE ESPERANZA
FACILITY NUMBER: 392700661
VISIT DATE: 08/14/2025
NARRATIVE
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It was learned that since there was only one staff person on duty during each shift, this facility was unable to accommodate all of the requests made from the facility residents. It was learned that while one resident wanted to go to the store another resident just wanted to stay home and watch television and had no interest in leaving the facility.
This meant that all of the residents would either have to all stay home or all go to the store together.
It was learned that if the facility staff person had to conduct facility business and needed to run an errand, the sole staff person would have to take all of the present residents with him/her since they were not allowed to be left unsupervised at any time.

As a result of this investigation, this LPA found the allegations to be SUBSTANTIATED - A finding that the complaint was Substantiated meant that the allegations were valid because the preponderance of the evidence standard had been met.

The following deficiencies were observed and cited on the following LIC 9099-D pursuant to Title 22 Rules and Regulations, Division 6 and Health and Safety Codes.

Appeal rights were printed and a copy was left with the facility designated representative at this time.

Exit Interview
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Charlie Yang
LICENSING EVALUATOR SIGNATURE:

DATE: 08/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/14/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 5