Eastbay Villas

Type of visit: Required - 1 Year

On 08/24/26 at 1:30PM, Licensing Program Analyst (LPA) D Panlilio arrived unannounced to conduct an annual required inspection. LPA met with administrator (ADM) and explained the purpose of the visit. LPA observed administrator has current RCFE certificate #7033719740 which expires 12/27/2027. At 2PM, LPA toured the facility including but not limited to the front entrance, screening station, kitchen, bathrooms, bedrooms and common areas. There is one central entry point for universal screening for staff, clients and visitors. A sign-in policy, visitor’s logs, no touch thermometer, additional face masks and hand sanitizer were observed at the screening station. Emergency Disaster Plan, Complaint poster, Personal rights, Cough/sneeze etiquette, proper hand-washing signs were observed posted in common areas. Facility has a sufficient 2-day perishable and 7-day non-perishable food supply. Facility has a 30-day supply of PPEs, paper, medications locked in cabinets. Comfortable temperature is maintained at 74 deg F. Hot water temperature was measured at 113 deg F. Facility has a mitigation plan in place and the infection control leader is the administrator. Inside and outside pathways were free of obstruction and fire hazards. Fire extinguisher was observed fully charged and purchased 03/05/26. Smoke and Carbon monoxide detectors were operational. LPA reviewed 3 staff and 4 resident files. Updated copies of the following documents were obtained for facility file:  LIC500- Personnel Report  Resident Roster  LIC308- Designation of Facility Responsibility  LIC610E- Emergency/Disaster Plan including infection control plans  Evidence of Liability Insurance No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, Aug 24, 2026

Allegation investigated: Staff Person engaged in conduct inimical

On 03/18/26 at 3:58PM, Licensing Program Analyst (LPA) D Panlilio conducted a subsequent visit and met with administrator (ADM) to deliver the findings of above allegation. LPA explained the purpose of the visit with ADM. During investigation, the Department obtained the following documents from administrator – Personnel record (LIC500), Administrator Certification, Employee job application. Health & safety check conducted see LIC 809 dated 05/14/25. Continued on next page, LIC 9099-C Unsubstantiated Allegation: Staff person engaged in conduct inimical Investigation Finding: Unsubstantiated During investigation, the Department conducted interviews of residents (R1, R2, R3, R4, R5, R6), responsible parties (W1, W2, W3, w4, W5, W6), facility staff (ADM, S1, S2, S3, S4, S5), Regional Center of the East Bay Case Managers (CM1, CM2) and reviewed facility documents. On 07/28/25, residents’ families and Regional Center of the East Bay (RCEB) case managers reported during their interviews that the residents’ families make financial decisions on the resident’s behalf. However, all residents’ monthly Personal and Incidental (P&I) funds go directly to Eastbay Villas facility. Administrator (ADM) and Direct Support Professional (DSP1) manage their funds. DSP staff were interviewed and said they do not have access or manage resident’s money. ADM cashes resident’s checks and gives DSP1 the cash monthly to record in the P&I binder. All funds are tracked with receipts and bank statements and are kept locked and inaccessible from residents and staff. Staff were unaware of any staff, including ADM, of stealing residents’ money. ADM denied stealing current resident’s money and denied any involvement in stealing her former resident’s money. On 05/14/25, ADM showed email communications between herself, her attorney and Plaintiff attorneys with Trustee which showed that in exchange for her testimony of her knowledge of certain conduct and actions by another defendant, there would be a Stipulation for the dismissal of the litigation against her in the matter. Although the allegation may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. Therefore, the allegation that staff person engaged in conduct inimical is unsubstantiated. No deficiency cited during visit. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, Mar 18, 2026 · control 15-AS-20250512090437

Type of visit: Required - 1 Year

On08/21/25 at 1:30PM, Licensing Program Analyst (LPA) D Panlilio arrived unannounced to conduct an annual required inspection. LPA met with administrator (ADM) and explained the purpose of the visit. LPA observed administrator has current RCFE certificate #7033719740 which expires 12/27/25. At 2PM, LPA toured the facility including but not limited to the front entrance, screening station, kitchen, bathrooms, bedrooms and common areas. There is one central entry point for universal screening for staff, clients and visitors. A sign-in policy, visitor’s logs, no touch thermometer, additional face masks and hand sanitizer were observed at the screening station. Emergency Disaster Plan, Complaint poster, Personal rights, Cough/sneeze etiquette, proper hand-washing signs were observed posted in common areas. Facility has a sufficient 2-day perishable and 7-day non-perishable food supply. Facility has a 30-day supply of PPEs, paper, medications locked in cabinets. Comfortable temperature is maintained at 76 deg F. Hot water temperature was measured at 115 deg F. Facility has a mitigation plan in place and the infection control leader is the administrator. Inside and outside pathways were free of obstruction and fire hazards. Fire extinguisher was observed fully charged and purchased 03/07/25. Smoke and Carbon monoxide detectors were operational. LPA reviewed 3 staff and 5 resident files. Updated copies of the following documents were obtained for facility file:  LIC500- Personnel Report  Resident Roster  LIC308- Designation of Facility Responsibility  LIC610E- Emergency/Disaster Plan including infection control plans  Evidence of Liability Insurance No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, Aug 21, 2025

Type of visit: Case Management - Health Checks

On 05/14/25 at 5PM, Licensing Program Analyst (LPA) D Panlilio conducted an unannounced Health and Safety check due to the department receiving a priority 1 complaint. During the health and safety check, LPA observed a total of 3 staff members and 6 residents at the facility. LPA toured facility with staff, including but not limited to bedrooms, kitchen, bathroom, and common areas. Residents in care appear to be safe and there are no imminent health/safety concerns on today's date. No deficiencies cited during the health and safety check. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, May 14, 2025

Type of visit: Prelicensing

On 08/06/24 at 111:30 AM. Licensing Program Analyst (LPA) Daisy Panlilio arrived announced to conduct a pre-licensing inspection. LPA met with Administrator (ADM) and explained the purpose of the visit. The facility currently has no residents. ADM has a current RCFE certificate # 7033719740 which expires 12/27/25. At 12PM, LPA toured the facility with ADM including but not limited to the residents' bedrooms, common areas, kitchen, and outdoor area. LPA observed a screening station near the front entrance with a no touch temperature probe, visitors' log and hand sanitizer. Facility has adequate lighting. Indoor and outdoor passageways were observed free of obstruction. There were no bodies of water observed. LPA advised ADM that hot water temperature should be maintained between 105 degrees F and 120 degrees F. LPA observed 2 days supply of perishable and one week supply of non-perishable foods. Towels, sheets, activity supplies and hygiene products were observed available. The facility has 3 full bathrooms. LPA observed the shower area has non-skid floor mats. Facility has flashlights available for emergency use. LPA observed sufficient emergency supplies stored inside the garage. There is sufficient lighting throughout facility. First-aid kit was observed to be complete. Smoke detectors and carbon monoxide were operational. Fire extinguisher was observed fully charged and last inspected on 04/19/24. Proper hand-washing signs, Emergency/Disaster plans/contact information, personal rights were observed posted in common areas. LPA observed no deficiencies during inspection. LPA observed that facility is ready to be licensed. This report will be submitted to the Central Applications Unit (CAU) and a final review of the application will be conducted. This facility is not yet licensed and is subject to final approval by CAU. Additional requirements may still be required. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, Aug 6, 2024

Type of visit: Case Management - Other

On 08/06/24 while at the facility for another reason, Licensing Program Analyst (LPA) D Panlilio conducted a component III presentation with administrator (ADM)/ applicant. LPA discussed the common deficiencies that residential care facilities for the elderly are cited on, Title 22 regulations on infection control, physical plant, personnel requirements on clearances and associations, training, emergency/disaster/food requirements, etc. ADM agrees to comply with Title 22 regulations. ADM was reminded of the statute that requires CCL to be notified within 5 business days of admitting their first resident. This notification may be done by phone, by mail, or by fax. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, Aug 6, 2024