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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 415201849
Report Date: 05/28/2021
Date Signed: 05/28/2021 10:53:31 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
This is an official report of an unannounced visit/investigation of a complaint received in our office on
07/24/2020 and conducted by Evaluator Jaime Vado
PUBLIC
COMPLAINT CONTROL NUMBER: 14-AS-20200724170452
FACILITY NAME:EAST WEST CARE REDWOOD CITY IIFACILITY NUMBER:
415201849
ADMINISTRATOR:CYNTHIA ADVINCULAFACILITY TYPE:
740
ADDRESS:1018 CLINTON STREETTELEPHONE:
(650) 261-3593
CITY:REDWOOD CITYSTATE: CAZIP CODE:
94061
CAPACITY:8CENSUS: 7DATE:
05/28/2021
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Evangeline PanglinanTIME COMPLETED:
11:15 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Illegal eviction
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On May 28, 2020 at 1000 LPA Jaime Vado conducted an unannounced complaint
inspection visit to deliver findings regarding the allegation recieved. LPA met with staff person Evangeline Panlinan and explained purpose of today's inspection.

During the course of the investigation LPA interviewed staff, family, and reveiwed documents regarding the resident. The facility initally issued an eviction notice due to the pandemic situation and it relating to the resident needing off site physical therapy that was stopped due to the ongoing pandemic. It was found that the facility rescinded the eviction notice after working out the physical therapy needs, medication needs, and care details for the residnet. According to administrator interview the eviction notice was taken back and the resident remains in care. LPA observed that the resident is in the facility on this date and confirmed that the resident is recieving the previous level of care with the assistance of the family of the resident.

Based on these observations, the above allegations are UNSUBSTANTIATED.
Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the above allegations are unsubstantiated at this time.


Report is discussed with Evangeline.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Julio Montes
LICENSING EVALUATOR NAME: Jaime Vado
LICENSING EVALUATOR SIGNATURE:

DATE: 05/28/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/28/2021
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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