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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 435202196
Report Date: 05/08/2026
Date Signed: 06/05/2026 10:08:52 AM

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
12/31/2025 and conducted by Evaluator Maria Partoza
COMPLAINT CONTROL NUMBER: 26-AS-20251231134530
FACILITY NAME:ELWYN NC - LA ALAMEDAFACILITY NUMBER:
435202196
ADMINISTRATOR:JOCELYN CANOSAFACILITY TYPE:
734
ADDRESS:15470 LA ALAMEDA DRTELEPHONE:
(408) 779-5353
CITY:MORGAN HILLSTATE: CAZIP CODE:
95037
CAPACITY:5CENSUS: 2DATE:
05/08/2026
UNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Jocelyn Canosa - Interim AdministratorTIME COMPLETED:
05:00 PM
ALLEGATION(S):
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Staff did not ensure resident's dietary needs were met
Staff did not dispense medications as prescribed
INVESTIGATION FINDINGS:
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This page is being amended due for identying information and additional information received by the department.

Licensing Program Analyst (LPA) Maria (Mita) Partoza, conducted an unannounced visit to deliver the finding of the complaint investgation filed with the Department on 12/31/2025. LPA met with current interim Administrator Jocelyn Canosa.

On 12/31/2025, the Department received a complaint with the above allegations. On 01/06/2026, LPA continued with the investigation and gathered documents and interviewed staff. On 04/16/2026, LPA conducted additional staff interviews and gathered additional information.

page 1 of 3 - see LIC 9099C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Romeo Manzano
LICENSING EVALUATOR NAME: Maria Partoza
LICENSING EVALUATOR SIGNATURE:

DATE: 06/05/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2026
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 3
Control Number 26-AS-20251231134530
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: ELWYN NC - LA ALAMEDA
FACILITY NUMBER: 435202196
VISIT DATE: 05/08/2026
NARRATIVE
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This page is being amended due to identifying and additional information received by the Department.
Allegation 1: Staff did not ensure resident’s dietary needs were met.
On 02/06/2026, LPA interviewed reporting party 1 (RP1), who reported concerns that while resident 1 (R1) resided at the facility, staff provided canned, frozen, pre-packaged, and restaurant foods rather than meals consistent with R1’s dietary needs.

On 01/06/2026 and 04/16/2026, LPA interviewed six staff (S1, S2, S3, S4, S5, and S6). S1 to S6 stated that meals were prepared and offered to R1 consistent with the facility meal plan, R1’s dietary needs, and nutritionist recommendations; however, R1 frequently refused the prepared meals and requested alternative food choices when R1 did not like the food offered. S1 to S6 stated that when R1 refused prepared meals, staff would ask R1 what he/she would like to eat to encourage food intake. S1 to S5 stated that staff would take R1, with the responsible party, to purchase grocery items at least once a week based on R1’s preferred food choices that met R1’s dietary needs. S1 stated that R1 may request to order outside food, which was paid for by the facility. R1 had discharged from the facility on 12/31/2025. On 01/06/2026, LPA attempted to interview R2 and R3; however, R2 and R3 were non-verbal, non-ambulatory, and tube fed, and were unable to participate in interviews.

Based on record and document review conducted on 02/09/2026, records documented that R1 has documented medical conditions requiring specialized medical care need device and dietary management. A nutrition assessment dated 08/06/2025 documented that R1 was able to express wants and dislikes and frequently requested restaurant foods. Facility provided proof of purchase dated 02/18/2025 through 10/01/2025 for various restaurant and grocery food purchases for R1. S6 stated that the facility met with R1’s responsible party on 08/26/2025 due to concerns that R1’s refusal of facility prepared meals and frequent outside food requests could impact R1’s dietary plan. Record review documented that R1 did not maintain incidental funds at the facility.

see LIC 9099C
page 2 of 3
SUPERVISORS NAME: Romeo Manzano
LICENSING EVALUATOR NAME: Maria Partoza
LICENSING EVALUATOR SIGNATURE:

DATE: 06/05/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 26-AS-20251231134530
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: ELWYN NC - LA ALAMEDA
FACILITY NUMBER: 435202196
VISIT DATE: 05/08/2026
NARRATIVE
1
2
3
4
5
6
7
8
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This page is being amended for identifying information.

Allegation 2: Staff did not dispense medications as prescribed

On 02/06/2026, LPA interviewed RP1, who reported concerns regarding prescribed medication availability, including metabolic health medication.

On 01/06/2026 and 04/16/2026, LPA interviewed S1, S2, S3, S4, S5, and S6. S1 to S6 stated that medications are routinely monitored, ordered approximately one week in advance, and picked up when available. S6 stated that on one occasion, R1’s prescribed metabolic health medication was not immediately available because no refills had been authorized by the primary care provider (PCP).

S6 stated they scheduled a medical follow-up for R1 and obtained the medication the following day. S6 stated that the medication was given to R1 when R1 was brought to urgent care while a new authorization to refill the medication is obtained from R1s PCP. S6 stated R1 did not miss a dose of his/her medication. Based on review of facility documentation, staff brought R1 to urgent care for the medication to be administered and to obtain the prescription for the metabolic health medication.

Although the allegation(s) may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated.

No deficiencies were cited during today's visit based on the California Code of Regulations (CCR) Title 22 and a copy of the report was provided to interim administrator Jocelyn Canosa.

end of report - page 3 of 3
SUPERVISORS NAME: Romeo Manzano
LICENSING EVALUATOR NAME: Maria Partoza
LICENSING EVALUATOR SIGNATURE:

DATE: 06/05/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3