Walnut Creek Senior Living

Type of visit: Case Management - Other

On 07/16/2026, at 10:30 AM, Licensing Program Analyst (LPA) James Sampair arrived unannounced to conduct the 10-day opening of four complaint investigations. During that visit, additional deficiencies were identified. Upon entry, the LPA informed Caregiver Danilo Daniles of the reason for the visit. The Administrator (ADM) Donald Hay arrived at approximately 12:15 PM and departed at approximately 02:30 PM. Civil Penalties totaling $1,250 were issued for repeat violations. Deficiencies are cited per Title 22 California Code of Regulations and listed on LIC 809-D. Failure to submit Proof of Corrections (POCs) by plan of correction due date and/or any repeat deficiencies within a 12-month period may result in civil penalties. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, Jul 16, 2026

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87204(a) · Plan of correction due date: Aug 6, 2026

87204 Limitations - Capacity and Ambulatory Status (a) A licensee shall not operate a facility beyond the conditions and limitations specified on the license, including specification of the maximum number of persons who may receive services at any one time. . . This requirement is not met as evidenced by: Based on observation, the licensee did not comply with the section cited above. 9 residents are residing at the facility, which poses an immediate health and safety risk to persons in care.the state’s words, verbatim · CDSS document, Jul 16, 2026

Plan of correction: The Licensee has agreed to reduce the number of residents to 8 on or before the due date. An Immediate Civil Penalty of $1,000 was assessed.

From the deficiency page — Deficiency type: Type B · Section cited: CCR87468(c)(2)(A) · Plan of correction due date: Jul 23, 2026

87468 Personal Rights of Residents (c) Licensees shall prominently post personal rights, nondiscrimination notice, and complaint information in areas accessible to residents, representatives, and the public. (2) Information on the appropriate reporting agency in case of a complaint or emergency, including procedures for filing confidential complaints, shall be posted as follows: (A) Licensees may use the Residential Care Facility for the Elderly (RCFE) Complaint Poster (PUB 475) or may develop their own poster as provided in this section. A poster developed by the licensee shall contain the same content as the PUB 475. The poster that is posted shall be 20” x 26” in size and be posted in the main entryway of the facility. PUB 475 may be accessed, downloaded, and printed from the www.ccld.ca.gov website. This requirement is not met as evidenced by: Based on observation, the licensee did not comply with the section cited above by having a 12" by 18" complaint poster displayed, which poses a potential personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Jul 16, 2026

Plan of correction: On or before the due date, the Licensee has agreed to obtain and display the 20 x 26 inch Residential Care Facility for the Elderly (RCFE) Complaint Poster (PUB 475). It shall be posted in the main entryway of the facility. A Civil Penalty of $250 was assessed.

Type of visit: Case Management - Deficiencies

On 3/2/2026 at 9:30 AM, Licensing Program Analyst (LPA) James Sampair arrived unannounced to conduct this Case Management - Deficiencies inspection. Upon entry, the LPA stated the purpose of the visit to Caregiver Blessilda Luna. At approximately 10:30 AM Licensee / Administrator Donald Hay arrived. The LPA reviewed facility documents, toured the facility, and interviewed Administrator Donald Hay. Citation was issued for the following violation: Administrator - Qualifications and Duties Deficiencies are cited per Title 22 California Code of Regulations and listed on LIC 809-D. Failure to submit Proof of Corrections (POCs) by plan of correction due date and/or any repeat deficiencies within a 12-month period may result in civil penalties. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, Mar 2, 2026

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87405(a) · Plan of correction due date: Mar 23, 2026

87405 Administrator - Qualifications and Duties (a) All facilities shall have a qualified and currently certified administrator. . .The Department may require that the administrator devote additional hours in the facility to fulfill his/her responsibilities when the need for such additional hours is substantiated by written documentation. This requirement is not met as evidenced by: Based on record review, the licensee did not comply with the section cited above. The Administrator is not certified as an administrator, which poses a potential health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Mar 2, 2026

Plan of correction: On or before the due date, the Licensee shall notify LPA Sampair that they have completed and passed the Administrator certification test.

Type of visit: Case Management - Other

On 3/2/2026 at 9:30 AM, Licensing Program Analyst (LPA) James Sampair arrived unannounced to conduct this Case Management - Other inspection concerning the change in capacity. Upon entry, the LPA stated the purpose of the visit to Caregiver Blessilda Luna. At approximately 10:30 AM Licensee / Administrator Donald Hay arrived. The Contra Costa County Fire Protection District conducted the Fire Safety Inspection on 02/19/2026 and increased the capacity to 12 nonambulatory residents. The LPA toured the facility and interviewed Administrator Donald Hay and met Co-Administrator Robert Hay. The facility is adequately staffed and equipped for the increase to 12 nonambulatory residents. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, Mar 2, 2026

Type of visit: POC

**** Licensing Program Analyst James Sampair made an error. This meeting was conducted at different facility, AARON'S ADVANCE CARE HOME INC. 075601497.**** On 2/20/2026 at 9:00 AM, Licensing Program Analyst (LPA) James Sampair arrived unannounced to conduct this Plan of Correction (POC) Inspection. Upon entry, the LPA stated the purpose of the visit to Caregiver Nikkon Acabo. Administrator Kaitlin Chang arrived at approximately 9:30 AM. During the inspection, the LPA was able to clear 2 of the 2 citations issued on 2/12/2026. Clearance letters for the citations were issued to Administrator Chang. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, Feb 20, 2026

Type of visit: POC

On 2/9/2026 at 3:00 PM, Licensing Program Analyst (LPA) James Sampair arrived unannounced to conduct this Plan of Correction (POC) Inspection. Upon entry, the LPA stated the purpose of the visit to Caregiver Pamie Palpallatoc. At approximately 4:00 PM Licensee / Administrator Donald Hay arrived. The LPA reviewed facility documents, toured the facility, interviewed the Administrator, and Staff S1 and S2. Citations and civil penalties were issued for the following violations: Failure to Correct: Not conducting quarterly emergency / disaster drills. - $500 Repeat violation of operating a facility beyond the 8 resident limit to 9 residents, - $1,000 Caregiver Background Check: Allowing S1 to work without a criminal record clearance or exemption. $3,000 Civil penalties in total of $4,500 issued. Deficiencies are cited per Title 22 California Code of Regulations and listed on LIC 809-D. Failure to submit Proof of Corrections (POCs) by plan of correction due date and/or any repeat deficiencies within a 12-month period may result in civil penalties. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, Feb 9, 2026

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87355(e)(2) · Plan of correction due date: Feb 10, 2026

87355 Criminal Record Clearance (e) All individuals subject to a criminal record review . . . shall prior to working . . . in a licensed facility: (2) Obtain a California clearance or a criminal record exemption as required by the Department. This requirement is not met as evidenced by: Based on record review, the licensee did not comply with the section cited above. Staff S1 was not fingerprint cleared, which poses an immediate health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Feb 9, 2026

Plan of correction: The Licensee shall immediately remove S1 from the facility and not allow them to return until they are fingerprint cleared and associated with this facility.

From the deficiency page — Deficiency type: Type A · Section cited: CCR87204(a) · Plan of correction due date: Feb 10, 2026

87204 Limitations - Capacity and Ambulatory Status (a) A licensee shall not operate a facility beyond the conditions and limitations specified on the license, including specification of the maximum number of persons who may receive services at any one time. . . This requirement is not met as evidenced by: Based on observation, the licensee did not comply with the section cited above. 9 residents are residing at the facility, which poses an immediate health and safety risk to persons in care.the state’s words, verbatim · CDSS document, Feb 9, 2026

Plan of correction: The Licensee shall reduce the number of residents to 8 as soon as possible.

Type of visit: POC

On 1/29/2026, at 10:00 AM, Licensing Program Analyst (LPA) James Sampair arrived unannounced to conduct a Plan of Correction (POC) visit. Upon arrival, the LPA stated the purpose of the visit to Caregiver Blessilda Luna and Licensee Donald Hay by phone. LPA cleared 2 of the deficiencies from the 1/23/2025 visit. No citation was issued during this visit. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, Jan 30, 2026

Type of visit: Case Management - Deficiencies

On 1/30/2026, at 10:00 AM, Licensing Program Analyst (LPA) James Sampair arrived unannounced to conduct a Case Management - Deficiencies visit. Upon arrival, the LPA stated the purpose of the visit to Caregiver Blessilda Luna and Licensee Donald Hay by phone. The LPA had observed deficiencies concerning the Personal Rights of persons in care on 1/29/2026 where the Licensee restricted the movement of residents: Restriction of Resident R1 from exiting the building by locking the front door from the interior of the facility. Restriction of Resident R2 by placing her in a lounge chair with the leg rest propped up. Additionally, Staff S1 propped up the leg rest beyond its highest point with a chair that further blocked R2's ability to exit the lounge chair. Neither position was safe for R2. 2 Type A citations were issued during this visit. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, Jan 30, 2026

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87202(a) · Plan of correction due date: Jan 31, 2026

87202 Fire Clearance (a) All facilities shall maintain a fire clearance approved by the city, county, or city and county fire department, or district providing fire protection services, or the State Fire Marshal . . . This requirement is not met as evidenced by: Front door, an exit door, was locked from the interior, which which poses an immediate personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Jan 30, 2026

Plan of correction: Interior front door lock removed during inspection. $500 immediate fine issued.

From the deficiency page — Deficiency type: Type A · Section cited: CCR87468.2(a)(4) · Plan of correction due date: Jan 31, 2026

87468.2 Additional Personal Rights . . . (a) In addition to the rights listed in Section 87468.1 . . . residents . . . shall have all of the following personal rights: (4) To care, supervision, and services that meet their individual needs and are delivered by staff that are sufficient in numbers, qualifications, and competency to meet their needs. This requirement is not met as evidenced by: (1) locking the front door from the interior of the facility to restrict R1 from exiting the building and (2) R2 placed in a lounge chair with the leg rest propped up. Additionally, Staff S1 further increased height and blocked safe exit from chair by adding a chair at the end of the foot rest.the state’s words, verbatim · CDSS document, Jan 30, 2026

Plan of correction: On or before due date, the Licensee shall speak with the Responsible Party to move R2 to an appropriate location as soon as possible. $500 immediate fine issued.

Type of visit: Case Management - Annual Continuation

On 1/30/2026 at 1:15 PM, Licensing Program Analyst (LPA) James Sampair arrived unannounced to conduct this Case Management Annual Continuation Inspection. Upon entry, the LPA stated the purpose of the visit to Caregiver Blessilda Luna. Licensee Donald Hay arrived at approximately 1:30 PM. The LPA briefly toured the facility and reviewed facility documents. On or before 2/6/2026, the Licensee will send LPA Sampair: Updated LIC 500 Personnel Report Copy of Liability Insurance policy No citations issued during this inspection. The Required Annual Inspection is complete. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, Jan 30, 2026

Type of visit: POC

On 1/29/2026, at 10:00 AM, Licensing Program Analyst (LPA) James Sampair arrived unannounced to conduct a Plan of Correction (POC) visit. Upon arrival, the LPA stated the purpose of the visit to Caregiver Pamie Palpallatoc and spoke with Licensee Donald Hay by phone about the purpose of the visit. On 1/23/2025, the LPA conducted a Required 1-Year inspection of the facility during which 1 A Type deficiency with a due date of 1/24/2026 was issued. This citation was cleared during this visit. No citation was issued during this visit. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, Jan 29, 2026

Type of visit: Case Management - Annual Continuation

On 1/29/2026 at 11:45 AM, Licensing Program Analyst (LPA) James Sampair arrived unannounced to conduct this Case Management Annual Continuation Inspection. Upon entry, the LPA stated the purpose of the visit to Caregiver Pamie Palpallatoc. Shortly thereafter, the LPA stated the purpose of the visit to Administrator Donald Hay by phone. The LPA briefly toured the facility, reviewed facility documents, and reviewed 5 staff records. 3 Type A citations, 6 Type B citations, and $1,000 in civil penalties issued during the inspection. Deficiencies are cited per Title 22 California Code of Regulations and listed on LIC 809-D. Failure to submit Proof of Corrections (POCs) by plan of correction due date and/or any repeat deficiencies within a 12-month period may result in civil penalties. The Required Annual Inspection is not complete. The LPA will return unannounced to complete the annual inspection. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, Jan 29, 2026

Type of visit: Required - 1 Year

On 1/23/2026 at 11:30 AM, Licensing Program Analyst (LPA) James Sampair arrived unannounced to conduct this Required Annual Inspection. Upon entry, the LPA stated the purpose of the visit to Administrator Donald Hay. The LPA toured the facility including but not limited to residents’ rooms, bathrooms, kitchen, common areas and the backyard. The LPA observed adequate lighting for the comfort and safety of residents in all rooms. Inside and outside areas are free of obstruction and no bodies of water. The temperature in the dining room was measured at 70.3 degrees Fahrenheit at 1:11 PM. The maximum hot water temperature was 124.7 degrees Fahrenheit, above the safe range of 105 to 120 degrees Fahrenheit. The residents’ bathrooms are equipped with grab bars and slip-resistant mats. There is more than the minimum of a one week supply of nonperishable foods and 2 days of perishable foods. Centrally stored medications, sharps, and toxic cleaners were not made inaccessible in the kitchen to residents in care. The fire extinguishers were fully charged, but had not been serviced or replaced within the past 12 months. They were last serviced on 2/26/2024. The required postings, the Residential Care Facility for the Elderly Complaint Poster ("If you see something, say something"), Personal Rights posters, and the Theft and Loss Policy were not posted as required. Continued on LIC 809-C . . . . . . Continued from LIC 809 The LPA reviewed 9 resident records. 1 A Type and 12 B Type citations were issued during the inspection. Deficiencies are cited per Title 22 California Code of Regulations and listed on LIC 809-D. Failure to submit Proof of Corrections (POCs) by plan of correction due date and/or any repeat deficiencies within a 12-month period may result in civil penalties. The Required Annual Inspection is not complete. The LPA will return to complete it unannounced at a future date and time. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, Jan 23, 2026

Type of visit: Case Management - Licensee Initiated

On 10/10/2025, at 11:15 AM, Licensing Program Analyst (LPA) James Sampair arrived for this announced visit of the facility. Upon entry, the LPA verified the purpose of the visit with Administrator (ADM) Donald Hay. The LPA and ADM met concerning the fire inspection required for the change in capacity of this facility after the expansion of the facility. To request the required inspection, the LPA submitted an STD 850 to the Contra Costa County Fire Protection District at 12:15 PM. During a tour of the facility at approximately 12:00 PM, the LPA observed 9 residents living in the facility. This puts them over capacity by 1 resident for which they have been cited. The Licensee will submit a written plan on or before 10/17/2025 concerning the way in which staff will safely care for residents in case of an emergency or disaster until the licensed capacity of their facility has been increased to 12 residents in accordance with their 6/17/2025 request to the Community Care Licensing Department. 1 Type-B citation was issued during this inspection. Deficiencies are cited from Title 22 California Code of Regulations (refer to LIC 809-D). Failure to submit proof of correction may result in civil penalties being issued. Exit interview conducted and a copy of the Appeal Rights, and this report provided.the state’s words, verbatim · CDSS document, Oct 10, 2025

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87204(a) · Plan of correction due date: Oct 17, 2025

87204 Limitations - Capacity and Ambulatory Status (a) A licensee shall not operate a facility beyond the conditions and limitations specified on the license, including specification of the maximum number of persons who may receive services at any one time. This requirement is not met as evidenced by: Based on observation, the licensee did not comply with the section cited above. They are licensed for 8 residents and 9 residents are living at the facility, which poses a potential safety risk to persons in care.the state’s words, verbatim · CDSS document, Oct 10, 2025

Plan of correction: On or before the due date, the Licensee will submit a written plan to LPA Sampair concerning the way in which staff will safely care for residents in case of an emergency or disaster until the licensed capacity of their facility has been increased to 12 residents.

Type of visit: POC

On January 31, 2025 at 12:30 PM, Licensing Program Analyst (LPA) James Sampair arrived for this unannounced Plan of Correction (POC) visit. Upon entry to the facility, the LPA informed Caregiver Blessilda Luna of the purpose of the visit. Licensee Donald Hay arrived at approximately 1:15 PM. The LPA reviewed the documentation in progress with the Licensee that was related to the 5 POCs. 1 of the POCs was cleared. Due to the progress being made by the Licensee on completing the other 4 POCs, the LPA gave an extension to February 28, 2025 for them to be completed. No citations issued. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, Jan 31, 2025

Type of visit: Case Management - Annual Continuation

On 1/31/2025 at 12:30 PM, Licensing Program Analyst (LPA) James Sampair arrived for this unannounced Case Management visit to complete the Required 1 Year Inspection began on 1/23/2025. Upon entry to the facility, the LPA informed Caregiver Blessilda Luna of the purpose of the visit. Licensee Donald Hay arrived at approximately 1:15 PM. The LPA completed the review of facility files and 6 staff files. 4 Type-B citations issued (refer to LIC 809-D). Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, Jan 31, 2025

Type of visit: Required - 1 Year

On 1/23/2025 at 8:00 AM, Licensing Program Analyst (LPA) James Sampair arrived for this unannounced Required 1 Year Inspection. Upon entry to the facility, the LPA informed Caregiver Danilo Danilesof the purpose of the visit. Licensee Donald Hay arrived at approximately 1:25 PM. The LPA toured the facility inside and outside. The LPA inspected the kitchen, common areas, bedrooms, bathrooms, and the exterior of the facility. The facility was clean, appropriately furnished, and well lit. More than the 2 days of perishable and 7 days of nonperishable food supplies were available. No body of water is on the facility grounds. . Medications are centrally stored. Bathrooms and showers were observed to be fully functioning and clean. Carbon monoxide and smoke detectors were operational. The fire extinguisher was last serviced on 02/26/2024. Inside temperature was 71 degrees Fahrenheit and the hot water temperature was 110 degrees Fahrenheit. The LPA reviewed 5 resident files. 5 Type-B citations issued (refer to LIC 809-D). The inspection is incomplete and the LPA will return unannounced at a different date and time to complete the full inspection. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, Jan 23, 2025

Type of visit: Required - 1 Year

On 1/29/2024 at 9:30 AM, Licensing Program Analyst (LPA) J. Sampair arrived unannounced to conduct the Required Annual Inspection of the facility. Upon arrival, LPA stated the purpose of the visit to Caregiver Pamie Palpallatoc. Licensee Donald Hay arrived at approximately 1:00 PM. The LPA toured facility inside and outside, inspected the kitchen, living room, bathrooms, and bedrooms. All indoor and outdoor passageways were free of obstruction. LPA observed a 7 day supply of nonperishable and 2 day supply of perishable foods on hand. The LPA reviewed records of 7 residents. 2 Type-A and 1 Type-B citations were issued (for details refer to LIC809-D). By 2/5/2024, Licensee will send updated forms to LPA: · LIC500 - Personnel Report · LIC308 - Designation of Facility Responsibility · LIC610E - Emergency/Disaster Plan · Evidence of Liability Insurance Required Annual Inspection incomplete. LPA shall return unannounced to complete the inspection at a later date and time. Exit interview conducted and a copy of this report provided via email to the Licensee.the state’s words, verbatim · CDSS document, Jan 29, 2024