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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 435202705
Report Date: 12/01/2025
Date Signed: 12/01/2025 04:18:17 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
11/21/2025 and conducted by Evaluator Audrey Jeung
PUBLIC
COMPLAINT CONTROL NUMBER: 26-AS-20251121154338
FACILITY NAME:CRESCENT OAKSFACILITY NUMBER:
435202705
ADMINISTRATOR:JOSHUA LAMBENGCOFACILITY TYPE:
740
ADDRESS:147 CRESCENT AVETELEPHONE:
(408) 730-4004
CITY:SUNNYVALESTATE: CAZIP CODE:
94087
CAPACITY:44CENSUS: DATE:
12/01/2025
UNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Bernadette Kang and Connor ZariTIME COMPLETED:
04:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
- Staff failed to prevent client from pushing another client
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
LPA Jeung met with resident care coordinator and acting administrator, interviewed staff, and reviewed client files and staff training records. Copies of relevant documents are provided. An incident occurred on 10/31/25--and Unusual Incident Reports were submitted to CCLD, reporting that client #1 pushed client #2 to the floor, sustaining a closed head injury. Names of staff involved were not included in Report; this information is provided to LPA today.
On that day, there were 4 caregivers on work schedule, plus a med tech and housekeeper. LPA interviewed 3 staff who worked on 10/31/25. Staff were unable to prevent client from harming another resident. When client's adverse behavior was observed, staff reacted appropriately to intervene and try to prevent anyone from harm.
Based on review of facility and other reports and interviews with staff, this allegation is determined to be unsubstantiated. Although the allegation may have occurred or is valid, there is not enough evidence to prove the alleged violation did or did not occur.
Updated Personnel Report (LIC500) is requested to be sent to CCLD BY 12/5/25.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Cowan April
LICENSING EVALUATOR NAME: Audrey Jeung
LICENSING EVALUATOR SIGNATURE:

DATE: 12/01/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2025
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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