079200294-4-16-2026-15-AS-BFOG-DVAV67-20260622160903

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 079200294
Report Date: 04/16/2026
Date Signed: 04/16/2026 02:43:57 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
01/12/2026 and conducted by Evaluator Alona Gomez

COMPLAINT CONTROL NUMBER: 15-AS-20260112112454

FACILITY NAME:	SUNRISE ASSISTED LIVING OF DANVILLE		FACILITY NUMBER:	079200294
ADMINISTRATOR:	KIRSTEN KORFHAGE		FACILITY TYPE:	740
ADDRESS:	1027 DIABLO RD		TELEPHONE:	(925) 831-1740
CITY:	DANVILLE	STATE: CA	ZIP CODE:	94526
CAPACITY:	89	CENSUS: 77	DATE:	04/16/2026
		UNANNOUNCED	TIME BEGAN:	11:25 AM
MET WITH:	Sr General Manager, Abbie Apolinario		TIME COMPLETED:	03:00 PM

ALLEGATION(S):

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Facility in disrepair
Facility not following residents care plan
Facility staff are making false claims

INVESTIGATION FINDINGS:

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On 4/16/2026 at 11:25AM, Licensing Program Analyst (LPA) A. Gomez arrived unannounced to deliver findings for the above allegations. LPA met with Sr General Manager, Abbie Apolinario and explained the purpose of the visit.

During the course of the investigation LPA toured facility, conducted interviews, reviewed facility records, and resident records.

report continues on LIC9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Yvonne Flores-Larios
LICENSING EVALUATOR NAME: Alona Gomez
LICENSING EVALUATOR SIGNATURE:	DATE: 04/16/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/16/2026

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 15-AS-20260112112454

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: SUNRISE ASSISTED LIVING OF DANVILLE	FACILITY NUMBER: 079200294
	VISIT DATE: 04/16/2026

NARRATIVE

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On the allegation Facility in disrepair LPA observed that in room 242 the pull cord in the bathroom was not working properly, alerting staff, or recording the alerts on the computer system. However at the time of the visit the facility and Maintenance were actively working to resolve the issues. During the annual inspection LPA was also made aware that they were continuously testing that particular rooms call button. LPA also interviewed S3 who cooperated that the facility was aware of the pull cord issues and was continuously testing it. Pull cord is now fully operational. Therefore the allegation is Unsubstantiated.

On the allegation Facility not following residents care plan LPA reviewed a sample of residents care plans and care notes and observed that all residents care plans are being followed. LPA interviewed residents who all expressed that they are happy with the level of care they are receiving. LPA was unable to identify a resident who's care needs are not being met and their care plan is not being followed. Therefore the allegation is Unsubstantiated.

On the allegation Facility staff are making false claims LPA conducted interviews and reviewed records. LPA was unable to cooperate that a care partner was instructed to make false claims in regards to the function of the call button in room 242. LPA did observe that there was not an alert recorded in the computer system for the alleged incident however LPA interviewed S2 and S3 and reviewed text messages and phone call logs. LPA did not observe any communications on the alleged date to the staff on duty and was unable to obtain any additional information from the reporting party to support the allegation therefore the allegation 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 allegation is UNSUBSTANTIATED.

Exit interview conducted and a copy of this report provided.

SUPERVISORS NAME: Yvonne Flores-Larios
LICENSING EVALUATOR NAME: Alona Gomez
LICENSING EVALUATOR SIGNATURE:	DATE: 04/16/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/16/2026

LIC9099 (FAS) - (06/04)

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