<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 236804088
Report Date: 04/03/2026
Date Signed: 04/03/2026 11:35:22 AM

Substantiated


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
02/23/2026 and conducted by Evaluator Christopher Arnhold
COMPLAINT CONTROL NUMBER: 21-AS-20260223193121
FACILITY NAME:OCEANSIDE CARE HOME LLCFACILITY NUMBER:
236804088
ADMINISTRATOR:VALESIA COLEFACILITY TYPE:
740
ADDRESS:550 S. FRANKLIN STREETTELEPHONE:
(614) 747-3443
CITY:FORT BRAGGSTATE: CAZIP CODE:
95437
CAPACITY:5CENSUS: 2DATE:
04/03/2026
UNANNOUNCEDTIME BEGAN:
08:15 AM
MET WITH:Staff Jermaine StuartTIME COMPLETED:
11:45 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff do not have required training
Time between dinner and breakfast is more than 15 hours
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
At approximately 8:15AM, Licensing Program Analyst (LPA) Chris Arnhold arrived at this facility unannounced, to conduct an investigation into the above allegations. LPA met with Staff Jermaine Stuart and reviewed records. Based on a review of records, LPA observed 2 of 2 staff did not have documentation of the required 40 hours of initial training. The New Employee training log covers a total of 30 hours of training in topics such as Nutrition, Personal Care Services, Dementia Training and Medication training. The training logs were signed by Administrator Valesia Cole, however the Administrator has not been a certified Administrator for two years. LPA was not able to find training materials onsite. LPA was informed the training was completed via video. There were no staff on site with valid First Aid/CPR training during this visit.
Based on interviews conducted and observations made, the evening meal was served at 5PM on 04/02/2026. LPA arrived at approximately 8:15AM on this date and observed the morning meal was not served until 8:58AM. This is beyond the 15 hour maximum between evening meal and first meal.
Based on the Departments investigation, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED.
Deficiencies are cited from the California Code of Regulations (CCRs), and/or the Health and Safety Code. Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
This report was reviewed with Jermaine Stuart and Appeal rights were given.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kimberley Mota
LICENSING EVALUATOR NAME: Christopher Arnhold
LICENSING EVALUATOR SIGNATURE:

DATE: 04/03/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2026
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 4
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
02/23/2026 and conducted by Evaluator Christopher Arnhold
COMPLAINT CONTROL NUMBER: 21-AS-20260223193121

FACILITY NAME:OCEANSIDE CARE HOME LLCFACILITY NUMBER:
236804088
ADMINISTRATOR:VALESIA COLEFACILITY TYPE:
740
ADDRESS:550 S. FRANKLIN STREETTELEPHONE:
(614) 747-3443
CITY:FORT BRAGGSTATE: CAZIP CODE:
95437
CAPACITY:5CENSUS: DATE:
04/03/2026
UNANNOUNCEDTIME BEGAN:
08:15 AM
MET WITH:Staff Jermaine StuartTIME COMPLETED:
11:45 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Personal Rights
Non-Nutrional meals being served to residents
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
At approximately 8:15AM, Licensing Program Analyst (LPA) Chris Arnhold arrived at this facility unannounced, to conduct an investigation into the above allegations. LPA met with Staff Jermaine Stuart and reviewed records. Based on a review of records and interviews conducted LPA was not able to find evidence that residents personal rights were violated. Staff, S2, recently quit employment at the facility with no reason given.
During the course of this investigation, LPA observed breakfast and lunch being served. Breakfast was waffles, sausage, fruit and oatmeal. Lunch was tuna sandwiches with soup and salad. The food supplies in the kitchen appeared to be of good quality and stored properly. LPA did not observe ready cook microwave meals in the food supplies. Meals appear to be created with store bought ingrediants and prepared at the time of each meal.

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.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kimberley Mota
LICENSING EVALUATOR NAME: Christopher Arnhold
LICENSING EVALUATOR SIGNATURE:

DATE: 04/03/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 21-AS-20260223193121
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: OCEANSIDE CARE HOME LLC
FACILITY NUMBER: 236804088
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/03/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
04/04/2026
Section Cited
HSC
1569.618(c)(3)
1
2
3
4
5
6
7
1569.618 Administration and management of residential care facilities; substituted qualifications; employee scheduling:(3) Ensure that at least one staff member who has cardiopulmonary resuscitation (CPR) training and first aid training is on duty and on the premises at all times. This requirement is
1
2
3
4
5
6
7
Licensee shall ensure at least one staff is on duty and on the premises who has a valid First aid/CPR certification. Licensee shall schedule CPR training for S1 and submit the scheduled date to CCL by 04/04/2026.
8
9
10
11
12
13
14
not met as evidenced by: Based on records reviewed, there were no staff present with CPR training. This poses an immediate Health, Safety or Personal Rights risk to persons in care.
8
9
10
11
12
13
14
Type B
04/17/2026
Section Cited
HSC
1569.625(b)(2)
1
2
3
4
5
6
7
1569.625 Staff training; legislative findings; contents:(2) In addition to paragraph (1), training requirements shall also include an additional 20 hours annually...This requirement is not met as evidenced by: Based on records reviewed, S1 did not have documented evidence of completed 40 hours
1
2
3
4
5
6
7
Licensee shall ensure all staff receive at least 40 hours of training in the first 4 weeks of employment and at least 20 hours of training every 12 months. Licensee shall submit self certification of completed training to CCL by 04/17/2026.
8
9
10
11
12
13
14
of initial training and did not have evidence of the 20 hours of annual training. This poses a potential Health, Safety or Personal Rights risk to persons in care.
8
9
10
11
12
13
14
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Kimberley Mota
LICENSING EVALUATOR NAME: Christopher Arnhold
LICENSING EVALUATOR SIGNATURE:

DATE: 04/03/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 21-AS-20260223193121
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: OCEANSIDE CARE HOME LLC
FACILITY NUMBER: 236804088
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/03/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/17/2026
Section Cited
CCR
87555
1
2
3
4
5
6
7
87555 General Food Service Requirements:(1) Where all food is provided by the facility arrangements shall be made so that each resident has available at least three meals per day...Not more than fifteen (15) hours shall elapse between the third and first meal.
1
2
3
4
5
6
7
Licensee agrees to submit self certification they have read and understood regulation 87555, General Food Service Requirements.

Licensee shall submit self certification of completion to CCL by 04/17/2026.
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Kimberley Mota
LICENSING EVALUATOR NAME: Christopher Arnhold
LICENSING EVALUATOR SIGNATURE:

DATE: 04/03/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2026
LIC9099 (FAS) - (06/04)
Page: 4 of 4