415600964-9-4-2025-14-AS-BCHN-DNAQSD-20251110112521

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 415600964
Report Date: 09/04/2025
Date Signed: 09/04/2025 02:42:01 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
06/20/2025 and conducted by Evaluator John Calandra

COMPLAINT CONTROL NUMBER: 14-AS-20250620155832

FACILITY NAME:	KENSINGTON PLACE REDWOOD CITY		FACILITY NUMBER:	415600964
ADMINISTRATOR:	ALBERTO GOLIA		FACILITY TYPE:	740
ADDRESS:	2800 EL CAMINO REAL		TELEPHONE:	(650) 363-9200
CITY:	REDWOOD CITY	STATE: CA	ZIP CODE:	94061
CAPACITY:	67	CENSUS: 55	DATE:	09/04/2025
		UNANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	April Vargas, Executive Director in Training		TIME COMPLETED:	02:45 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Facility staff did not provide a refund to resident's responsible person

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

On 9/4/2025, Licensing Program Analyst(LPA) John Calandra met with facility representative for this conclusionary complaint investigation. LPA Calandra explained the purpose of the visit.

Complaint alleged that the facility did not provide a refund to resident’s responsible party. Based on document review and interviews, S1 sent R1’s responsible party a refund check which could not be deposited due to a printing error. Thus, S1 sent a subsequent refund check to resident’s responsible party which they were able to deposit.

Based on the fact that the resident’s responsible party was refunded the allegation is unsubstantiated. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. Therefore the above allegation is unsubstantiated at this time.

No deficiencies cited during today's visit.

An exit interview was conducted. This report is reviewed with facility representative and a copy is provided.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Brenda Chan
LICENSING EVALUATOR NAME: John Calandra
LICENSING EVALUATOR SIGNATURE:	DATE: 09/04/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/04/2025

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 1