435202725-5-7-2026-26-AS-RMAO-DTZUE2-20260512153023

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 435202725
Report Date: 05/07/2026
Date Signed: 05/07/2026 11:24:22 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
04/02/2026 and conducted by Evaluator Manuel Monter

COMPLAINT CONTROL NUMBER: 26-AS-20260402114257

FACILITY NAME:	WILLOW GLEN SENIOR LIVING		FACILITY NUMBER:	435202725
ADMINISTRATOR:	MARY ANN TRINIDAD		FACILITY TYPE:	740
ADDRESS:	2991 FAIRCLIFF CT		TELEPHONE:	(408) 914-1147
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95125
CAPACITY:	6	CENSUS: 6	DATE:	05/07/2026
		UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Administrator Mary Ann		TIME COMPLETED:	11:30 AM

ALLEGATION(S):

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Staff member consumes alcohol during work hours, impairing their ability to provide adequate care and supervision, which presents a risk to residents in care.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Monter conducted an unannounced complaint inspection to deliver the findings on the above allegation. LPA met with Administrator Mary Ann.

On April 2, 2026, the Department received a complaint alleging Staff member consumes alcohol during work hours, impairing their ability to provide adequate care and supervision, which presents a risk to residents in care.

On April 3 & 6, 2026, the Department interviewed Witness W1. W1 stated the staff member who allowed drinking events at the facility was the Administrator Mary Ann. W1 stated the ADM will invite staff over to come drink at the care home for events such as a care givers birthday party. LPA asked W1 if the staff members, including ADM Marry Ann, were drinking and also providing care to residents. W1 stated the staff who were drinking were not providing care. Page 1 Out of 3.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Romeo Manzano
LICENSING EVALUATOR NAME: Manuel Monter
LICENSING EVALUATOR SIGNATURE:	DATE: 05/07/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/07/2026

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-20260402114257

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: WILLOW GLEN SENIOR LIVING	FACILITY NUMBER: 435202725
	VISIT DATE: 05/07/2026

NARRATIVE

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On April 6, 2026, Licensing Program Analyst Manuel Monter interviewed residents R1-R5. R1 stated he/she faintly remembers a staff member who smelled like they were intoxicated. R1 stated he/she doesn’t remember when this happened, or if the staff who smelled intoxicated was providing care to him/her or to other residents.

4 Out of 6 residents interviewed (R2-R5) stated they have not observed any staff drinking alcohol at the facility. 4 Out of 6 residents interviewed (R2-R5) stated they have not observed any staff under the influence/drunk/intoxicated at the facility. R6 stated he/she declined to be interviewed.

On Apri 6, 2026, Licensing Program Analyst Manuel Monter interviewed staff S1 & S2. S1 and S2 stated they have never seen/heard about staff drinking (alcohol) inside the facility. S1 and S2 stated they have never drunk alcohol in the facility. S1 and S2 stated they have never seen staff working at the facility drunk/hungover/under the influence.

On April 6, 2026, Licensing Program Analyst Manuel Monter interviewed Administrator Mary Ann. ADM stated there have been times when the care staff at the home might drink a glass of wine during their time off, inside the staff room. ADM stated they might also drink a glass of wine in the back yard, away from the residents. ADM stated the staff, even herself might have a glass of wine, but they have never done so when they are on the clock. ADM stated there is always staff scheduled, providing care, who do not drink.

On April 17, 2026, Licensing Program Analyst Manuel Monter interviewed staff S3 and S4. Staff S3 and S4 stated they are not aware of any instance were staff were under the influence and providing care. S3 and S4 stated they are not aware of any instance where the ADM was drinking / under the influence and providing care to residents.

On April 17, 2026, Licensing Program Analyst Manuel Monter interviewed Licensee Irish Ladwig, referred to as LN. LN stated there hasn't been any instance where a staff member was providing care, was also under the influence.

Page 2 Out of 3.

SUPERVISORS NAME: Romeo Manzano
LICENSING EVALUATOR NAME: Manuel Monter
LICENSING EVALUATOR SIGNATURE:	DATE: 05/07/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/07/2026

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 26-AS-20260402114257

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: WILLOW GLEN SENIOR LIVING	FACILITY NUMBER: 435202725
	VISIT DATE: 05/07/2026

NARRATIVE

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On April 24 and May 4, 2026, Licensing Program Analyst Manuel Monter interviewed staff S5-S7. S5 and S6 stated there has been many instances where staff were drinking at the facility. S5 and S6 stated they have never seen staff members who were drinking and providing care.

S7 stated he/she has never seen other staff members drinking and providing care to residents. S7 stated he/she has never seen the ADM or staff members under the influence and providing care to residents.

The Department reviewed the facility’s policy update, dated April 8, 2026, subject regarding: Strict Policy on Noise, Parties, Alcohol and smoking. The policy stated effective immediately, the following policies must be observed by all staff: No parties or loud activities: such as parties, gathering, karaoke- noting loud music or noise may disturb residents, families or neighbors. Alcohol consumption is prohibited inside the facility, whether on duty or off duty.

Based on investigation, records reviewed, and interviews conducted, the Department found that the above allegations are UNSUBSTANTIATED. An unsubstantiated finding indicates that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the allegations did or did not occur.

Page 3 Out of 3. End of Report.

SUPERVISORS NAME: Romeo Manzano
LICENSING EVALUATOR NAME: Manuel Monter
LICENSING EVALUATOR SIGNATURE:	DATE: 05/07/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/07/2026

LIC9099 (FAS) - (06/04)

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