486803808-9-10-2026-21-AS-VBEI-DXYUD6-20260916152901

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 486803808
Report Date: 09/10/2026
Date Signed: 09/10/2026 11:21:45 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405

This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/02/2026 and conducted by Evaluator Elias Magdaleno

COMPLAINT CONTROL NUMBER: 21-AS-20260902164445

FACILITY NAME:	COGIR OF VALLEJO HILLS		FACILITY NUMBER:	486803808
ADMINISTRATOR:	MENDOZA, ALLISON		FACILITY TYPE:	740
ADDRESS:	350 LOCUST DRIVE		TELEPHONE:	(707) 553-2698
CITY:	VALLEJO	STATE: CA	ZIP CODE:	94591
CAPACITY:	80	CENSUS: 49	DATE:	09/10/2026
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Richard Breitkreutz, Executive Director		TIME COMPLETED:	11:40 AM

ALLEGATION(S):

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Ice machine is unsanitary

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Magdaleno arrived unannounced to initiate a 10-day complaint investigation and deliver findings regarding the above allegations and met with Executive Director, Richard Breitkreutz.

LPA made observations, gathered documents, and conducted interviews.

Ice machine is unsanitary – Reporting Party (RP) alleges that facility ice machine has visible mold growth and is not being properly cleaned/sanitized. Review of submitted photographs showed an ice machine with visible black staining coming into contact with ice cubes. A further image indicates an Ice Machine Cleaning Log from Cogir of Vallejo Hills dated 2026 with no entries from January to current. Interviews with management indicated that a new log is being used to log staff cleaning and ice machine receives quarterly professional cleaning from a third-party company. Further interviews with management indicated that there was build up reported on upper interior portion of ice machine that is separated from the ice basin by a covering.
Continued LIC9099C...

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Victoria Bertozzi
LICENSING EVALUATOR NAME: Elias Magdaleno
LICENSING EVALUATOR SIGNATURE:	DATE: 09/10/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2026

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 21-AS-20260902164445

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405

FACILITY NAME: COGIR OF VALLEJO HILLS	FACILITY NUMBER: 486803808
	VISIT DATE: 09/10/2026

NARRATIVE

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Continued from LIC9099...

Interviews with staff indicated that during a cleaning, staff noticed dark flakes and removed the plate separating the upper portion of the machine from the ice and noticed the build-up. Management was immediately notified and took the machine out of commission, removed and disposed of all the ice, and purchased bags of ice for use. The third-party contracted to clean the machine was contacted and took the machine apart for a thorough cleaning and sanitization. During this, management discovered that the third-party cleaners had missed a quarterly cleaning which may have led to the build-up in the top portion of the machine not normally accessible to staff. Cleaning was conducted same day, however, machine was kept out of commission for several days and bagged ice was used to ensure sanitization. LPA observed the ice machine to be clean with no build-up. Management removed the plate separation and LPA observed that the top portion of the machine was also clean and free of build-up. Review of cleaning logs indicated that some cleanings are being marked, however, management indicated staff occasionally forget to sign log. Review of third-party invoices and field reports indicate visits to check ice machine in July, August, and September of 2026. 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 allegation is unsubstantiated.

No deficiencies cited. Exit interview conducted with Executive Director, whose signature on form confirms receipt.

SUPERVISORS NAME: Victoria Bertozzi
LICENSING EVALUATOR NAME: Elias Magdaleno
LICENSING EVALUATOR SIGNATURE:	DATE: 09/10/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2026

LIC9099 (FAS) - (06/04)

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