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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 435294258
Report Date: 12/04/2025
Date Signed: 12/04/2025 10:54:05 AM

Substantiated


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
01/15/2025 and conducted by Evaluator Marcella Tarin
COMPLAINT CONTROL NUMBER: 26-AS-20250115102820
FACILITY NAME:BECK CARE HOMEFACILITY NUMBER:
435294258
ADMINISTRATOR:ZHANG, YU & LUO, XI-HUAFACILITY TYPE:
740
ADDRESS:1681 BECK DRIVETELEPHONE:
(408) 866-7858
CITY:SAN JOSESTATE: CAZIP CODE:
95130
CAPACITY:6CENSUS: 5DATE:
12/04/2025
UNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:License Xi-Hua 'Julia' LuoTIME COMPLETED:
11:00 AM
ALLEGATION(S):
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Facility staff using resident's room as hallway to get to the backyard.
INVESTIGATION FINDINGS:
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On 12/4/2025 Licensing Program Analysts (LPAs) Marcella Tarin and David Marrufo arrived unannounced to deliver an amended complaint finding from unsubstantiated to substantiated.

On 1/15/2025 the Department received a complaint alleging facility staff using resident's room as hallway to get to the backyard

On 8/4/2025, LPA Tarin interviewed Reporting Party(RP). RP stated he/she has told staff S2 not to walk through R1’s room. RP stated he/she was visiting R1 in his/her bedroom, when S2 entered R1’s bedroom to access the backyard of the facility. RP stated the door was closed and S2 did not knock. RP did not provide additional information regarding this incident.

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Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Christine Kabariti
LICENSING EVALUATOR NAME: Marcella Tarin
LICENSING EVALUATOR SIGNATURE:

DATE: 12/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/04/2025
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 3
Control Number 26-AS-20250115102820
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: BECK CARE HOME
FACILITY NUMBER: 435294258
VISIT DATE: 12/04/2025
NARRATIVE
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On 1/24/2025, the Department interviewed staff S1. S1 stated they sometimes use the resident's room to go to the backyard because it has an exit door. S1 stated staff knows they should go around through the siding door of the living room or garage.

On 7/17/2025, LPA Tarin interviewed ADM. ADM states she has not observed staff using a residents room as a hallway to get to the backyard.

On 9/25/2025 LPAs interviewed S2 to S3. Staff S2 stated he/she has never used or observed a staff used a resident’s room to exit to the backyard. Staff S3 stated he/she has never seen staff use a resident’s room to exit to the backyard.

On 9/25/2025, LPAs interviewed 3 Residents R2 to R4. 3 Out of 3 (R2-R4) residents did not provide answers to questions LPAs posed regarding this allegation. On 10/9/2025, LPA interviewed Resident R4. R4 state he/she has no issues.

Based on LPAs observations and interviews which were conducted and record review(s), the preponderance of evidence standard has been met, therefore the above allegation(s) is found to be SUBSTANTIATED, perCalifornia Code of Regulations, Title 22 a deficiency is being cited on the attached LIC 9099D. Appeals right were provided.

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END OF REPORT

SUPERVISORS NAME: Christine Kabariti
LICENSING EVALUATOR NAME: Marcella Tarin
LICENSING EVALUATOR SIGNATURE:

DATE: 12/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/04/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3
Control Number 26-AS-20250115102820
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: BECK CARE HOME
FACILITY NUMBER: 435294258
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/04/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/11/2025
Section Cited
CCR
87307(C)
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87307 Personal Accommodations and Services (C) No bedroom of a resident shall be used as a passageway to another room, bath or toilet.

This was not met as evidenced by:
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Licensee states she will submit a plan of correction on how she will provide additional staff training on resident's personal rights to include residents privacy and not using a resident's room as a passageway. Licensee will submit POC to CCL by POC due date 12/11/2025.
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Based on interviews, S1 stated they sometimes use the resident's room to go to the backyard because it has an exit door. Continue to next section.
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Continuation from previous section...S1 stated staff knows they should go around through the siding door of the living room or garage, which poses a potential health, safety and personal rights risk to residents.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Christine Kabariti
LICENSING EVALUATOR NAME: Marcella Tarin
LICENSING EVALUATOR SIGNATURE:

DATE: 12/04/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/04/2025
LIC9099 (FAS) - (06/04)
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