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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 435200727
Report Date: 05/20/2026
Date Signed: 05/20/2026 11:49:45 AM

Unfounded


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
02/11/2026 and conducted by Evaluator Simranjit Rai
COMPLAINT CONTROL NUMBER: 26-AS-20260211082354
FACILITY NAME:CARLTON PLAZA OF SAN JOSEFACILITY NUMBER:
435200727
ADMINISTRATOR:SHANTELA YADAOFACILITY TYPE:
740
ADDRESS:380 BRANHAM LANETELEPHONE:
(408) 972-1400
CITY:SAN JOSESTATE: CAZIP CODE:
95136
CAPACITY:183CENSUS: 96DATE:
05/20/2026
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Administrator, Shantela YadaoTIME COMPLETED:
12:00 PM
ALLEGATION(S):
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Facility overcharged resident.
Facility staff did not safeguard resident's personal belongings.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Simi Rai conducted an unannounced visit to conclude the complaint investigation. LPA Rai met with Administrator, Shantela Yadao and stated the purpose of today’s visit.

On 02/11/2026, the Department received a complaint with the above allegations. On 02/18/2026, the Department conducted an initial investigation at the facility.

Continuation on LIC 9099-C, Page 1 of 3.
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Romeo Manzano
LICENSING EVALUATOR NAME: Simranjit Rai
LICENSING EVALUATOR SIGNATURE:

DATE: 05/20/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2026
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 3
Control Number 26-AS-20260211082354
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: CARLTON PLAZA OF SAN JOSE
FACILITY NUMBER: 435200727
VISIT DATE: 05/20/2026
NARRATIVE
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Page 2 of 3.
Facility overcharged resident.
It was alleged that the facility is charging resident $1,400 for the month of December, when resident passed away on 12/2/2025 and family removed resident’s items from the room on 12/04/2025.

On 02/18/2026, the Department conducted an interview with Executive Assistant (EA) Yoliana Sanchez-Cruz. EA stated resident passed away in December 2025 and resident’s family removed resident’s items from the room on 12/04/2025.

Based on review of R1’s Admission Agreement page 11 out of 18 signed by resident R1 on 07/17/2025, “Your estate (or person or entity responsible for payment of fees under the Residence and Service Agreement) will continue to be responsible for all outstanding fees due at the time of your death and for fees accruing until your personal property is removed from your Apartment.” Based on Invoice dated 12/2025, resident was charged for rent and care from 12/1/2025 – 12/31/2025 for $6,680 and Apartment Room Service for the amount $540. For the dates of 12/1-12/4/2025, when resident R1 was charged for the rent and care until personal property was removed from the Apartment, the amount due to the facility was $1401.93.

Based on facility’s records of checks received from resident R1, the last check was processed on 12/5/2025 for the amount due in November 2025 and facility staff did not receive check from R1 for the dates 12/1-12/4/2025, which is the amount due of $1401.93. Based on review of resident's charges, Executive Director did decide for facility to not invoice the resident's family the amount of $1401.93 and the resident's family does not owe any amount to the facility.

Facility staff did not safeguard resident’s personal belongings.
It was alleged that the facility allowed resident’s family member FM2 to enter resident’s room and take resident’s belongings.

On 02/18/2025, the Department conducted an interview with Executive Assistant (EA) Yoliana Sanchez-Cruz. EA stated Executive Director had sent an email on 12/03/2025, 1 day after resident passed away that no one was allowed to enter R1’s room. EA stated the only person that visited the resident and/or resident’s room from 12/1/2025-12/4/2025 was resident’s family FM1 who removed resident’s personal property.
SUPERVISORS NAME: Romeo Manzano
LICENSING EVALUATOR NAME: Simranjit Rai
LICENSING EVALUATOR SIGNATURE:

DATE: 05/20/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 26-AS-20260211082354
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: CARLTON PLAZA OF SAN JOSE
FACILITY NUMBER: 435200727
VISIT DATE: 05/20/2026
NARRATIVE
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Page 3 of 3.

Based on review of R1’s Admission Agreement page 11 out of 18 signed by resident R1 on 07/17/2025, R1 designated FM2 to remove personal property from the apartment upon death.

During today's visit, LPA Rai interviewed 5 residents (R1-R5). 4 Out of 5 residents (R2-R5) refused to speak with LPA Rai. R1 stated she/he has not heard about R1's personal belongings being missing or misplaced at the facility. R1 stated their personal belongings have not been missing or misplaced at the facility. R1 stated she/he has not heard about other resident's personal belongs being missing or misplaced at the facility.

During today's visit, LPA Rai interviewed 5 staff (S1-S5). 5 Out of 5 staff stated it is the process for the facility management to lock the resident's room when the resident is in the process of moving out and only resident's authorized representative is able to enter the room and give authorization to the facility staff and management to enter resident's room. 5 Out of 5 staff stated they are not aware of R1's personal belongings being missing or misplaced in the resident's room. They stated they have not seen or heard, in general, regarding resident's personal belongings being missing or misplaced in the facility. They stated they have not seen or heard, in general, staff stealing or misplacing resident's personal belongings in the facility.

During the investigation, LPA Rai reached out to FM2 to conducted an interview but FM2 was not available.

The Department has completed the investigation of the above allegations. Based on interviews conducted and record reviews, the Department has found that the above allegations were UNFOUNDED, meaning that the allegations were false, could not have happened and/or are without a reasonable basis.

No deficiencies cited from California Code of Regulations, Title 22. Exit interview conducted with Administrator, Shantela Yadao and a copy of the report was provided.
SUPERVISORS NAME: Romeo Manzano
LICENSING EVALUATOR NAME: Simranjit Rai
LICENSING EVALUATOR SIGNATURE:

DATE: 05/20/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3