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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306006352
Report Date: 08/20/2026
Date Signed: 08/20/2026 02:24:03 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/14/2026 and conducted by Evaluator RoseMarie Ruppert
COMPLAINT CONTROL NUMBER: 22-AS-20260814161818
FACILITY NAME:HILLS OF HAYWARD, THEFACILITY NUMBER:
306006352
ADMINISTRATOR:NEPOMUCENO, MARICELFACILITY TYPE:
740
ADDRESS:835 S HAYWARD STREETTELEPHONE:
(714) 827-1016
CITY:ANAHEIMSTATE: CAZIP CODE:
92804
CAPACITY:6CENSUS: 1DATE:
08/20/2026
UNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Licensee (LE) Allen MedinaTIME COMPLETED:
02:30 PM
ALLEGATION(S):
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Licensee is disseminating false statements
Licensee failed to provide residents written notice of intent to sell
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Rose Ruppert made an unannounced visit to investigate a complaint that was received in the Regional Office. LPA was greeted and granted entry by staff and LPA spoke with Licensee (LE) Allen Medina and Administrator Heddy "Girlie" Mae Oyson over the phone regarding the purpose of the visit.

It was alleged that Licensee is disseminating false statements. Currently the Licensees for the Hills of Hayward are in legal proceedings with the California Department of Social Services (CDSS). The Department received documentation that, as of July 13, 2026, the Licensees received stipulation and agreement with Sacramento and CDSS legal division. Currently there are no settlement stipulations or waivers with the Department at this time and the Licensees will be cited for False Statements. An immediate $250 Civil Penalty will be assessed for a Repeat Violation of False Claims on 6/18/2026.

(Continued on LIC 9099-C)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: RoseMarie Ruppert
LICENSING EVALUATOR SIGNATURE:

DATE: 08/20/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/20/2026
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 3
Control Number 22-AS-20260814161818
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

FACILITY NAME: HILLS OF HAYWARD, THE
FACILITY NUMBER: 306006352
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/20/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/31/2026
Section Cited
CCR
87207
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87207 False Claims. No licensee, officer or employee of a licensee shall make or disseminate any false or misleading statement regarding the facility or any of the services provided by the facility. This requirement is not met as evidenced by:
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Licensees are to provide information to residents, staff, vendors and families that are not misleading statements that misrepresent the Department. The Department is in legal proceedings and there are no agreements agreed upon between CDSS and licensees at this time.
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(cont'd) The Regional Office received documentation that misrepresent the Department. This poses a potential health and safety risk for residents in care.
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Licensee (LE) Allen Medina stated families, vendors and staff will be provided 60 day notice stating the Hills is transitioning business operations. Documents are to be emailed to LPA for review by 9/30/2026.
Type B
08/31/2026
Section Cited
CCR
87224(a)(5)(A)(1)
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87224 Eviction Procedures (a) The licensee may evict a resident for ....(5) Change of use of the facility. (A) The licensee may, upon no less than sixty (60) days written notice, evict a resident due to change of use of the facility. 1. In addition to written notice to quit requirement specified in Section 87224(d),
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Licensee (LE) Allen Medina and Administrator Designee Heddy "Girlie" Mae Oyson will submit the sixty day notice to residents and responsible parties to the Department by the POC due date. Documents are to be emailed to LPA for review.
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(cont'd) written notice to evict due to change of use of the facility shall be made to the resident or the resident’s responsible person... This requirement was not met as evidenced by: Based on LPA document review and interview this was not provided for one of one resident in care.
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***This is an amended report.***
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: RoseMarie Ruppert
LICENSING EVALUATOR SIGNATURE:

DATE: 08/20/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/20/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 22-AS-20260814161818
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME: HILLS OF HAYWARD, THE
FACILITY NUMBER: 306006352
VISIT DATE: 08/20/2026
NARRATIVE
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(Continued from LIC 9099)

It was also alleged that Licensee failed to provide residents written notice of intent to sell. Per LPA file review and staff interviews conducted from 5/29-8/20/2026, residents, nor responsible parties were provided the sixty days written eviction notification of the facility change of use and the intent to sell. Emails were communicated to residents, families and vendors but were not provided per California Code of Regulations 87224(a)(5)(A)(1). A deficiency will be cited.

Based on LPA's interviews and file review the allegations that the: Licensee is disseminating false statements and the Licensee failed to provide residents written notice of intent to sell are Substantiated and the preponderance of the evidence standard has been met. An exit interview was conducted via phone with Allen Medina, Licensee (LE) and a copy of the unsigned report was provided to the facility, along with the LIC 9099-D, LIC421FC and Appeal Rights.
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: RoseMarie Ruppert
LICENSING EVALUATOR SIGNATURE:

DATE: 08/20/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/20/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3