<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 430707868
Report Date: 03/17/2025
Date Signed: 03/17/2025 05:40:39 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
Lookup Error,
, CA
This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/16/2022 and conducted by Evaluator Jason Lund
COMPLAINT CONTROL NUMBER: 26-AS-20220816145953
FACILITY NAME:FLORENCE RESIDENTIAL CARE HOME #2FACILITY NUMBER:
430707868
ADMINISTRATOR:PERLA DIMALANTA ZEIJNALIFACILITY TYPE:
735
ADDRESS:135 NORTH 8TH STREETTELEPHONE:
(408) 293-0362
CITY:SAN JOSESTATE: CAZIP CODE:
95112
CAPACITY:10CENSUS: 9DATE:
03/17/2025
UNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Care Staff Winnie Rodriquez TIME COMPLETED:
04:15 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff do not prevent a client from mistreating another client while in care
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Jason Lund arrived unannounced to complete a complaint investigation regarding the above allegation. LPA Lund met with Care Staff Winnie Rodriquez who called Administrator Perla Zeijnali. LPA Lund explained the reason for the visit to Administrator Perla Zeijnali who gave permission to Care Staff Winnie Rodriquez to sign required paperwork. Census: 9
Staff do not prevent a client from mistreating another client while in care - LPA Lund interviewed staff, and clients in care. Based interviews with current staff and clients in care. Staff have prevented client from mistreating each other while at the facility.
Based on interviews with current staff and clients in care, on the information provided, it was unclear if staff do not prevent a client from mistreating another client while in care, therefore the allegation was deemed UNSUBSTANTIATED.
As a result of this investigation, this Department finds the allegation to be UNSUBSTANTIATED. A complaint allegation finding of Unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. Exit interview conducted and report left.
Unsubstantiated
Estimated Days of Completion: 90
SUPERVISORS NAME: Stephenie Doub
LICENSING EVALUATOR NAME: Jason Lund
LICENSING EVALUATOR SIGNATURE:

DATE: 03/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2025
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