415601026-12-5-2025-14-AS-BCHN-DQA9Y5-20260112224631

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 415601026
Report Date: 12/05/2025
Date Signed: 12/05/2025 04:01:50 PM

Unfounded

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
06/05/2025 and conducted by Evaluator Grace Donato

PUBLIC

COMPLAINT CONTROL NUMBER: 14-AS-20250605212144

FACILITY NAME:	EARLY HORIZONS HOME CARE		FACILITY NUMBER:	415601026
ADMINISTRATOR:	ROGAYAN, YOLANDA		FACILITY TYPE:	740
ADDRESS:	2800 SHANNON DR		TELEPHONE:	(650) 255-5418
CITY:	S SAN FRANCISCO	STATE: CA	ZIP CODE:	94080
CAPACITY:	6	CENSUS: 5	DATE:	12/05/2025
		UNANNOUNCED	TIME BEGAN:	01:42 PM
MET WITH:	Irene Mehta		TIME COMPLETED:	04:15 PM

ALLEGATION(S):

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Staff threatened illegal eviction

INVESTIGATION FINDINGS:

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On 12/5/2025, LPA Grace Donato conducted an unannounced complaint investigation visit to deliver findings. LPA met with Administrator, Irene Mehta and explained the purpose of this visit.

Regarding the allegation that Staff threatened illegal eviction, RP stated that ADM called a case worker (CW1) to start an eviction process for R1. This has now been put on hold and the resident is attending the Adult Day program and there is no eviction in process.

According to ADM, R1 was having behavioral issues and an email was sent to CW1 regarding these changes. ADM also mentioned that the behaviors were just grounds for eviction but never said that the resident will be evicted. ADM even suggested additional counselling from the social worker (SW) that works with R1.

Based on records review, the department has determined that the allegation was false, could not have happened and/or is without a reasonable basis, therefore the allegation is UNFOUNDED.

No deficiencies cited today. Report is reviewed and copy is provided.

Unfounded

Estimated Days of Completion:

SUPERVISORS NAME: Brenda Chan
LICENSING EVALUATOR NAME: Grace Donato
LICENSING EVALUATOR SIGNATURE:	DATE: 12/05/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2025

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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