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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 071440596
Report Date: 11/20/2024
Date Signed: 11/20/2024 04:10:02 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND ASC, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/02/2024 and conducted by Evaluator Alona Gomez
COMPLAINT CONTROL NUMBER: 15-AS-20240502154143
FACILITY NAME:ROUNDHILL CARE HOMES, INC.FACILITY NUMBER:
071440596
ADMINISTRATOR:PEDRO D. ZAMORAFACILITY TYPE:
740
ADDRESS:3053 ROUNDHILL ROADTELEPHONE:
(925) 837-0599
CITY:ALAMOSTATE: CAZIP CODE:
94507
CAPACITY:6CENSUS: 1DATE:
11/20/2024
UNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Administrator, Ana BreenTIME COMPLETED:
04:30 PM
ALLEGATION(S):
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Facility is in disrepair.
Staff did not ensure facility is clean and sanitized.
Facility did not follow proper reporting requirements.
INVESTIGATION FINDINGS:
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On 11/19/2024 at 3:00 pm, Licensing Program Analyst (LPA) A Gomez arrived unannounced to deliver amended report findings in regard to the allegations above. LPA met with Administrator, Ana Breen and explained the purpose of the visit.

On the allegation of "Facility is in disrepair," LPA conducted multiple visits to assess the condition of the facility. During the initial visit on 5/09/2024, LPA observed a slow drip from the kitchen sink, which had a bucket placed underneath to catch the water. However, the sink was still operational, and the slow drip did not interfere with the facility’s daily operations.

Report Continues on LIC9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Yvonne Flores-LariosTELEPHONE: (510) -28-0517
LICENSING EVALUATOR NAME: Alona GomezTELEPHONE: 510-239-1306
LICENSING EVALUATOR SIGNATURE:

DATE: 11/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/20/2024
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 2
Control Number 15-AS-20240502154143
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND ASC, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
FACILITY NAME: ROUNDHILL CARE HOMES, INC.
FACILITY NUMBER: 071440596
VISIT DATE: 11/20/2024
NARRATIVE
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The Administrator confirmed that the leak had been ongoing for approximately a week and was actively working to repair it. LPA also inspected the rest of the facility, including bathrooms, common areas, and the front and back yards, and found no other issues of disrepair. On 8/01/2024, during a follow-up visit, LPA confirmed that the kitchen sink had been fully repaired and no longer required a bucket to catch the water.

On the allegation of "Staff did not ensure the facility is clean and sanitized," LPA conducted inspections on 5/09/2024 and 8/01/2024. During both visits, LPA observed that the facility was clean, well-maintained, and free from any visible signs of unsanitary conditions. The bathrooms, kitchen, common areas, and both the front and back yards were all in satisfactory condition with no issues regarding cleanliness or sanitation. There were no reports or evidence of pests or contamination during the visits.

On the allegation of "Facility did not follow proper reporting requirements," during the initial visit on 5/09/2024 LPA spoke with the Administrator who stated that the kitchen sink had a slow drip for less than a week before LPA conducted the initial visit. LPA requested plumber invoices/quotes by 5/16/2024. The facility subsequently submitted the requested documents, and LPA reviewed them before the follow-up visit on 8/01/2024. The reports showed that the facility had gotten a quote for repair on 5/4/2024. During the visit on 8/01/2024, LPA also confirmed that the kitchen sink had been fully repaired and no longer required a bucket to catch the water. The facility was within their reporting time frame when LPA conducted the visit on 5/09/2024.

LPA was unable to receive any proof from RP to substantiate the above allegations.

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

SUPERVISOR'S NAME: Yvonne Flores-LariosTELEPHONE: (510) -28-0517
LICENSING EVALUATOR NAME: Alona GomezTELEPHONE: 510-239-1306
LICENSING EVALUATOR SIGNATURE:

DATE: 11/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/20/2024
LIC9099 (FAS) - (06/04)
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