Complaint Investigation Report

306005513-6-9-2026-22-AS-APAO-DUW53B-20260609193539

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

ORANGE COUNTY RO , 770 THE CITY DR., SUITE 7100

This is an official report of an unannounced visit/investigation of a complaint received in our office on

03/20/2023 and conducted by Evaluator Arielle Pascua

COMPLAINT CONTROL NUMBER: 22-AS-20230320090137

Facility staff is withholding care and supervision from resident

This report is being amended to reflect signatures.

On 05/23/2026, Licensing Program Analyst (LPA) Arielle Pascua conducted a complaint visit via telephone call regarding the complaint allegations above.

It was alleged that the facility staff is withholding care and supervision from resident and have issued an unlawful eviction. LPA Pascua attempted to contact former staff from this facility to obtain additional information, however, LPA Pascua was unable to reach staff as they were no longer employed by this facility. In addition, contact with current staff deny or have not been employed by the facility during the time of the complaint. A review of the facility records were also conducted. Based on interviews conducted and observation, the allegations are found to be UNSUBSTANTIATED, meaning that although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violations occurred. An exit interview was conducted and a copy of this report was provided via email for signature.