435202894-8-13-2026-26-AS-RMAO-DXJ8J7-20260901223302

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 435202894
Report Date: 06/02/2026
Date Signed: 08/13/2026 03:40:09 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131

This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/17/2026 and conducted by Evaluator Maria Partoza

COMPLAINT CONTROL NUMBER: 26-AS-20260317093638

FACILITY NAME:	FAMILY FEELS RESIDENTIAL CARE 3		FACILITY NUMBER:	435202894
ADMINISTRATOR:	GARCIA, RITA		FACILITY TYPE:	740
ADDRESS:	770 PRONTO DR		TELEPHONE:	(408) 440-2916
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95123
CAPACITY:	6	CENSUS: 6	DATE:	06/02/2026
		UNANNOUNCED	TIME BEGAN:	01:27 PM
MET WITH:	Philipp Perez		TIME COMPLETED:	03:00 PM

ALLEGATION(S):

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Staff did not safeguard resident's belongings.
Staff did not properly address pests in the facility resulting to infestation.

INVESTIGATION FINDINGS:

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This report is being amended due to new information for the 2nd allegation. See new LIC9099 for the amended report.

Licensing Program Analyst (LPA) Maria (Mita) Partoza, conducted an unannounced complaint investigation visit and met with designated administrator (DADM) Philipp Perez. LPA stated the purpose of the visit. Licensee/Administrator (LIC/ADM) David Devries was not available at the time of the LPAs visit due to prior commitment.

On 03/17/2026, the Department received a complaint with the above allegation(s). On 03/25/2026 the Department conducted an initial investigation visit at the facility and conducted interviews, inspection of the facility and requested for documents.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Romeo Manzano
LICENSING EVALUATOR NAME: Maria Partoza
LICENSING EVALUATOR SIGNATURE:	DATE: 08/13/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2026

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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Control Number 26-AS-20260317093638

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131

FACILITY NAME: FAMILY FEELS RESIDENTIAL CARE 3	FACILITY NUMBER: 435202894
	VISIT DATE: 06/02/2026

NARRATIVE

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On 03/25/2026, LPA interviewed S1, S2, and S3. S1 stated pest-control services were performed on 03/24/2026 and reported that cockroaches may remain visible following treatment. S2 stated small cockroaches were observed after returning to employment on 02/02/2026 and reported pest-control treatment was performed. S2 stated spiders had not been observed and S2 was not aware of a resident sustaining a spider bite. S3 stated a resident reported observing a black spider but stated it is not a black widow spider, it was observed outside near the garden area and stated S3 was not aware of a resident sustaining a spider bite.

On 03/26/2026, LPA received documentation indicating pest-control services were obtained on 01/29/2026, with treatment performed on 02/02/2026 and 03/24/2026.

On 04/24/2026, W1 reported that R1 continued to report the presence of cockroaches and spiders within the facility and reported another resident had allegedly sustained a spider bite several years earlier. No documentation regarding the reported spider bite was provided to LPA.

Based on interviews, observations, and records reviewed, R1 stated the phone remained in R1's possession. R1, W1, W2, S1, S2, and S3 did not provide information identifying an individual who used R1's phone. LPA observed cockroaches within the facility and reviewed documentation showing pest-control services were obtained on 01/29/2026, with treatment performed on 02/02/2026 and 03/24/2026. LPA reviewed R2's records and did not observe documentation indicating R2 sustained a spider bite or received hospital services related to a spider bite.

Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are unsubstantiated.

No deficiencies were cited during today's visit based on the California Code of Regulations (CCR) Title 22. An exit interview was conducted and a copy of the report was provided to Designated Administrator (DADM) Philipp Perez.

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SUPERVISORS NAME: Romeo Manzano
LICENSING EVALUATOR NAME: Maria Partoza
LICENSING EVALUATOR SIGNATURE:	DATE: 06/02/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/02/2026

LIC9099 (FAS) - (06/04)

Page: 3 of 3

Control Number 26-AS-20260317093638

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131

FACILITY NAME: FAMILY FEELS RESIDENTIAL CARE 3	FACILITY NUMBER: 435202894
	VISIT DATE: 06/02/2026

NARRATIVE

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On 03/25/2026, LPA interviewed 3 staff (S1, S2, and S3). S1 stated that resident 1 (R1)'s cellular phone remained in R1's possession and stated that staff has their own cell phones and residents uses the house phone. S2 stated R1 previously had a cellular phone, reported the phone service was discontinued by a sibling, and stated R1 uses the facility telephone. S3 stated R1 previously had a cellular phone, reported the phone service was discontinued by a family member, and stated residents generally use the facility telephone. S2 and S3 stated they did not have information regarding the reported phone activity, and S3 stated no residents were observed using R1's cellular phone. S2 and S3 both stated they have their own cell phone.

On 03/25/2026, LPA interviewed resident 1 (R1). R1 presented the cellular phone identified in the complaint and stated the phone remained in his/her possession. R1 stated the phone was used to communicate with family members, healthcare providers, government agencies, and financial institutions. R1 stated no staff or residents used the phone. R1 stated the increase involved usage minutes rather than additional calls and stated the telephone numbers on the device were familiar to R1.

On 04/05/2026, 04/22/2026, and 04/24/2026, W1 reported concerns regarding increased phone activity and stated a phone carrier investigation remained pending. W1 did not provide documentation identifying unauthorized phone usage or the individual who allegedly used the phone.

On 04/22/2026, LPA interviewed witness 2 (W2). W2 stated conversations with R1 may last one to two hours and did not identify an individual who allegedly used R1's phone.

Allegation 2: Staff did not properly address pests in the facility resulting in infestation.
-This allegation is being amended due to new information . See new LIC 9099.

On 03/25/2026, LPA conducted a facility inspection. During the inspection, LPA observed cockroaches in the food pantry, Room #3, and the staff room. LPA did not observe spiders during the inspection.

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SUPERVISORS NAME: Romeo Manzano
LICENSING EVALUATOR NAME: Maria Partoza
LICENSING EVALUATOR SIGNATURE:	DATE: 06/02/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/02/2026

LIC9099 (FAS) - (06/04)

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