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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 019201610
Report Date: 08/18/2026
Date Signed: 08/18/2026 03:09:10 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
08/12/2026 and conducted by Evaluator Patricia Manalo
COMPLAINT CONTROL NUMBER: 15-AS-20260812092917
FACILITY NAME:ARBOR AT BERKELEY, THEFACILITY NUMBER:
019201610
ADMINISTRATOR:LEE, MAUREENFACILITY TYPE:
740
ADDRESS:2100 SAN PABLO AVE.TELEPHONE:
(510) 788-1333
CITY:BERKELEYSTATE: CAZIP CODE:
94702
CAPACITY:120CENSUS: 57DATE:
08/18/2026
UNANNOUNCEDTIME BEGAN:
09:50 AM
MET WITH:Maureen Lee, Executive Director TIME COMPLETED:
01:55 PM
ALLEGATION(S):
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Staff is overcharging resident.
INVESTIGATION FINDINGS:
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On 08/18/2026 at 9:50 AM, Licensing Program Analyst (LPA) P. Manalo arrived unannounced to conduct the initial 10-day visit and deliver the findings on the above allegation. LPA met with Assistant Executive Director (AED) Quaid Holder and Executive Director (ED), Maureen Lee, and explained the purpose of the visit.

During the visit, LPA obtained and reviewed the following documents included but not limited to Progress Notes, Service Plan, Physician Report, Resident Roster, Staff Schedule, Staff Contact Information, Monthly Statement, Level of Care Determination Tool, Functional Evaluation, and Service Plan Agreement. LPA interviewed AED, Staff 1 (S1), 1 witness, and 1 resident.

Continue to LIC9099-C...
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Yvonne Flores-Larios
LICENSING EVALUATOR NAME: Patricia Manalo
LICENSING EVALUATOR SIGNATURE:

DATE: 08/18/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/18/2026
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-20260812092917
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: ARBOR AT BERKELEY, THE
FACILITY NUMBER: 019201610
VISIT DATE: 08/18/2026
NARRATIVE
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Continued from LIC9099...

Allegation: Staff is overcharging resident.

It was alleged that staff is overcharging resident. LPA interviewed Witness 1 (W1) who stated that R1 is being charged for additional cost on services that R1 does not need. LPA reviewed R1’s Service Plan Agreement effective on 04/22/2025 that stated that R1 is being charged an Assisted Living (AL) Care Services for an additional monthly charge of $960.48 for R1’s care and R1 signed the Service Plan Agreement on 05/13/2025. LPA reviewed R1’s service plan and Level of Care Determination Tool dated 09/24/2025 and interviewed S1 who stated that R1’s assessment did not show any change in condition and R1’s level of care remains the same as the assessment conducted on 04/22/2025. LPA reviewed R1’s monthly statement dated 07/31/2025, 09/30/2025, and 07/28/2026 and interview with AED stated that since there was no change in condition after R1’s assessment on 09/24/2025, R1’s monthly rate stayed the same as what the previous owner was previously charging R1 for.

Based on interviews and record review conducted, the above allegation that staff is overcharging resident is unsubstantiated. Although the allegation 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 allegations are unsubstantiated.

There is no deficiency noted.

Exit interview was conducted with Holder and Lee, and a copy of this report was provided.
SUPERVISORS NAME: Yvonne Flores-Larios
LICENSING EVALUATOR NAME: Patricia Manalo
LICENSING EVALUATOR SIGNATURE:

DATE: 08/18/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/18/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2