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Complaint Investigation Report

Lincoln Villa, Fremont05/30/2025Licence 019201025

Census68
Date signed05/30/2025 02:55:46 PM
The inspector’s account

Based on interviews conducted on 04/17/2025 and 05/30/2025, ADM confirmed with LPAs that the facility did not submit an SOC 341 to Ombudsman regarding the incident that occurred on 3/22/2025 between R1 and R2.

All staffs that LPAs interviewed stated that all unusual incidents get verbally reported to the supervisor and then recorded in the communication log. However, staff admitted to not having completed an SOC 341. The above allegation is substantiated.

Based on interviews conducted, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED . California Code of Regulations (Title 22, Division 6, Chapter 8), is being cited on the attached LIC 9099D.

Exit interview conducted with Fernandez. Appeal rights and copy of this report provided.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction