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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 435294258
Report Date: 10/02/2025
Date Signed: 10/02/2025 11:47:36 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: 6DATE:
10/02/2025
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Licensees Yu Zhang & Xi-Hua LuoTIME COMPLETED:
12:00 PM
ALLEGATION(S):
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Facility staff using storage shed in the backyard as habitual space.
Facility staff not safeguarding resident's personal items.
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPAs) Marcella Tarin and Manuel Monter conducted an unannounced visit to deliver the complaint findings and met with Administrator (ADM) Julia Luo. LPA stated the purpose of the visit.

On January 15, 2025 the Department received a complaint alleging facility staff using storage shed in the backyard as habitual space.

On January 15, 2025, the Department interviewed W1. W1 stated there is a staff, S2, who lives in the storage shed in the back. W1 stated he/she has seen S2's personal belongings in the shed.

On January 24, 2025, LPA Dolores interviewed Staff S1. S1 denied the allegation that the shed being used as a living space for staff. S1 stated the shed is being used for storage to store extra beds.
Page 1 of 3
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Jin Jackie
LICENSING EVALUATOR NAME: Marcella Tarin
LICENSING EVALUATOR SIGNATURE:

DATE: 10/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/02/2025
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 6
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: 10/02/2025
NARRATIVE
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LPA Kabariti interviewed ADM. ADM stated she could not open the shed. ADM called her husband/licensee and placed her husband on speaker phone. The Licensee refused to open the shed. LPAs observed the shed was locked. The windows were black therefore LPAs could not see what was inside the shed. The shed had a power line that was running from the facility to the shed. ADM denied staff living in the shed. ADM states the shed is used for gardening supplies and only the gardener and owner has a key to the shed.

On July 17, 2025 LPA Tarin interviewed ADM. ADM 1 stated staff did not live in the shed.

On 9/25/2025, LPAs inspected the back yard. LPA Monter and LPA Marcella observed Staff S2 seated on a chair next to the storage shed in the back yard. LPA Monter asked S2 what’s inside the storage shed. S2 stated it’s a staff’s bedroom. LPA Monter asked S2 who’s bedroom does the shed belong to. S2 then clarified that he/she doesn’t know. LPA Tarin asked if LPAs could look inside the shed. S2 then stated the shed is locked and he/she doesn’t have the keys. LPA Tarin told S2, that the shed door is slightly ajar. S2 then went to check and acknowledged the shed was open. LPA Monter and Tarin observed the inside of the shed, which contained the following, but not limited to items: a mini fridge, bed (with blankets & pillows), an ignited lamp night stand, dresser with phone charger on top of it, grooming products, and other personal items. (LPA took photographs of the inside contents of the shed.) S2 then clarified that the storage shed was a sleeping area for other employees, not just him/her.

LPA’s interviewed staff S2 and S3. S2 states no staff live in the backyard shed. S2 states he/she only uses the shed when he/she's on break. S2 states it's a 'staff room." S3 states no staff live in the backyard shed.

On October 2, 2025, LPA Tarin and Monter interviewed ADM. ADM stated no staff sleep in the shed or use the shed as a staff room. ADM stated the shed is a storage space.

Based on review of the facility sketch and the facility fire clearance dated 10/6/2008, the backyard shed is part of the facility and is not listed as a staff bedroom or sleeping area.

Based on interviews and documents review the preponderance of evidence standard has been met therefore the above allegations is found to be SUBSTANTIATED.

Page 2 of 3

SUPERVISORS NAME: Jin Jackie
LICENSING EVALUATOR NAME: Marcella Tarin
LICENSING EVALUATOR SIGNATURE:

DATE: 10/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/02/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 6
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: 10/02/2025
NARRATIVE
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Facility staff not safeguarding resident's personal items.
On 1/15/2025 the Department received a complaint alleging Facility staff not safeguarding resident's personal items.

On January 15, 2025, the Department interviewed Witness W1. W1 stated S2 has stolen (R1) shoes. W1 stated when he/she had asked about R1's shoes, staff S2 brought them out from his/her room (storage shed).

On January 24,2025, LPA Dolores interviewed Staff S1. S1 denied staff using resident's personal items. Staff denied observing other staff use a resident's personal items.

On January 24 and July 17, 2025, the department interviewed ADM. ADM stated a caregiver used residents shoes because his/her shoes got wet when bathing a resident. S2 borrowed shoes to obtain dry shoes from his/her car. ADM immediately corrected S2 and apologized to R1. ADM stated she has never had issues with resident's personal belongings until the incident with staff S2 using R1’s shoes.

On 9/25/2025 the Department interviewed staff S2 to S3. S2 states he/she has never worn a resident's personal belonging such as clothes or shoes. S2 stated he/she has never worn another residents shoes or personal belongings. S3 stated he/she is not aware of any staff using/wearing a residents shoes or personal belongings.

Based on review of an Employee Individual Consultation document dated 6/18/2025, S2 was given a written warning by ADM, the document is signed by S2.

Based on interviews and documents review the preponderance of evidence standard has been met therefore the above allegations is found to be SUBSTANTIATED.

Licensee stated if the complaint report involved the backyard shed, he would not sign the report.

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SUPERVISORS NAME: Jin Jackie
LICENSING EVALUATOR NAME: Marcella Tarin
LICENSING EVALUATOR SIGNATURE:

DATE: 10/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/02/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 6
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: 10/02/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/03/2025
Section Cited
CCR
87468.1(a)(1)
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87468.1 Personal Rights of Residents in All Facilities (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (1) To be accorded dignity in their personal relationships with staff, residents, and other persons.
This is not met as evidenced by:
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ADM will submit a statement of understanding regarding the regulation cited. ADM will conduct an in-service training for staff regarding resident's personal rights. ADM will submit documentation of in-service training to CCL by POC due date 10/3/2025.
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Based on interviews and documentation reviewed, the licensee did not comply with the section cited above. ADM stated a staff used a residents shoes, and S2 was given a written warning by ADM. This poses/posed a potential health, safety or personal rights risk to persons in care.
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Type A
10/03/2025
Section Cited
CCR
87202(a)
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(a) All facilities shall maintain a fire clearance approved by the city,... fire department... and obtain an appropriate fire clearance approved by the city, county, or city and county fire department ...

This is not met as evidenced by:
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ADM will send photo documentation showing the storage area is no longer being used as a sleeping area. ADM stated she will also send a letter of understanding stating no staff or
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Based on investigation, LPAs observed a shed in the backyard being used as a staff sleeping area. Fire Clearance/Facility Sketch does not note the shed as a staff room/sleeping area. This poses/posed a potential health, safety or personal rights risk to persons in care.
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any individual is allowed to sleep in the following areas without building permit and fire clearance such as but not limited to; the sheds, living room, and garage.
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: Jin Jackie
LICENSING EVALUATOR NAME: Marcella Tarin
LICENSING EVALUATOR SIGNATURE:

DATE: 10/02/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/02/2025
LIC9099 (FAS) - (06/04)
Page: 6 of 6
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: 6DATE:
10/02/2025
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Licensees Yu Zhang & Xi-Hua LuoTIME COMPLETED:
12:00 PM
ALLEGATION(S):
1
2
3
4
5
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9
Facility staff are not able to communicate to resident and cannot speak English.
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPAs) Marcella Tarin and Manuel Monter conducted an unannounced visit to deliver the complaint findings and met with Administrator (ADM) Julia Luo. LPA stated the purpose of the visit.

On 1/15/2025 the Department received a complaint alleging Facility staff are not able to communicate to resident and cannot speak English.

On June 24, 2025, the Department interviewed Staff S1. Staff S1 was interviewed regarding the complaint investigation. Staff S1 was able to understand the questions that were posed by LPA’s. Staff S1 was able to provide responses to all questions posed.

Page 1 of 2

Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Jin Jackie
LICENSING EVALUATOR NAME: Marcella Tarin
LICENSING EVALUATOR SIGNATURE:

DATE: 10/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/02/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 6
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: 10/02/2025
NARRATIVE
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On September 25, 2025, LPA Tarin interviewed Staff S2 and S3. Both staff interviewed were asked questions regarding this complaint investigation. Both staff were able to understand the questions that were posed by LPA’s and were able to provide responses to all questions posed.

LPAs interviewed Resident R1 to R3. 3 Out of 3 Residents were did not provide responses to questions posed during interview.

On October 2, 2025, LPA interviewed staff S1-S3, ADM 1 and ADM 2. S1 to S3, ADM 1 and ADM 2 were able to respond to LPAs questions regarding emergency procedures, evacuation routes, and general care questions.

This agency has investigated the complaint alleging facility staff are not able to communicate to resident and cannot speak English. We have found that the complaint was UNFOUNDED, meaning that the allegation was false, could not have happened and/or is without a reasonable basis.
SUPERVISORS NAME: Jin Jackie
LICENSING EVALUATOR NAME: Marcella Tarin
LICENSING EVALUATOR SIGNATURE:

DATE: 10/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/02/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 6