430707868-2-25-2026-26-AS-CKAI-DS429A-20260311171134

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 430707868
Report Date: 02/25/2026
Date Signed: 02/25/2026 03:12:54 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131

This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/19/2025 and conducted by Evaluator Marcela Yanez

COMPLAINT CONTROL NUMBER: 26-AS-20250619142304

FACILITY NAME:	FLORENCE RESIDENTIAL CARE HOME #2		FACILITY NUMBER:	430707868
ADMINISTRATOR:	PERLA DIMALANTA ZEIJNALI		FACILITY TYPE:	735
ADDRESS:	135 NORTH 8TH STREET		TELEPHONE:	(408) 293-0362
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95112
CAPACITY:	10	CENSUS:	DATE:	02/25/2026
		UNANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	Rodelito Perez, Lead staff		TIME COMPLETED:	03:20 PM

ALLEGATION(S):

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Resident left the facility unsupervised
Staff did not prevent resident from engaging in a physical altercation with another resident

INVESTIGATION FINDINGS:

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On 02/25/26 Licensing Program Analyst (LPA) Marcela Yanez conducted an unannounced complaint investigation visit to deliver findings. LPA announced the purpose of the visit and met with Rodelito Perez, lead staff.

On 06/19/25 the department received a complaint with the allegation of Resident left the facility unsupervised and Staff did not prevent resident from engaging in a physical altercation with another resident.

During the investigation the department interviewed 7 residents and 4 staff. On 06/16/25 Resident R1 was observed by staff to have behavior with Resident R2 regarding a belonging. 2 out of 7 residents stated that the facility does not intervene when residents have an altercation. 2 out of 7 residents stated that he/she has not observed any fighting in the facility. 2 out of 7 residents stated that the facility does intervene when residents have an altercation. S1 and S2 stated they did not observe R1 & R2 in an altercation on 06/16/25.
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Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Christine Kabariti
LICENSING EVALUATOR NAME: Marcela Yanez
LICENSING EVALUATOR SIGNATURE:	DATE: 02/25/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/25/2026

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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Control Number 26-AS-20250619142304

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131

FACILITY NAME: FLORENCE RESIDENTIAL CARE HOME #2	FACILITY NUMBER: 430707868
	VISIT DATE: 02/25/2026

NARRATIVE

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S1 and S2 stated that R1 did not want to eat and was not interacting like normal. S1 and S2 stated that R1 ran out of the house on 06/16/25 and S1 followed R1 to the grocery store located 3 blocks from the facility.
S1 stated he/she lost sight of R1 at the grocery store. S1 stated he/she called the Administrator (ADM) and he/she stated to go back to the facility and meet with local law enforcement. S1 returned to the facility and informed local law enforcement with the details of what happened with R1. Local law enforcement began searching for R1 and could not locate him/her.

R1 returned to facility on 06/17/25. ADM stated on the day of the altercation R1 had attempted to take Resident R2s belonging from him/her and R2 refused to give R1 his/her belonging. ADM stated the facility policy regarding resident altercations is to immediately stop the altercation from continuing and separate both residents and take them to different rooms and to de-escalate the situation.

Based on interviews conducted, observations, and records reviewed, although the allegations listed above 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 allegations are unsubstantiated.

No deficiency was cited as per California Code of Regulations Title 22. This report was reviewed with Rodelito Perez and a copy of this report was provided.

SUPERVISORS NAME: Christine Kabariti
LICENSING EVALUATOR NAME: Marcela Yanez
LICENSING EVALUATOR SIGNATURE:	DATE: 02/25/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/25/2026

LIC9099 (FAS) - (06/04)

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