Complaint Investigation Report

306006005-5-18-2026-22-AS-APAO-DUR862-20260604221338

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

07/19/2022 and conducted by Evaluator Kerry Hiratsuka

COMPLAINT CONTROL NUMBER: 22-AS-20220719163319

Tammie Sampedro, Regional Operations Specialist

-Facility staff failed to provide meals to resident

-Facility staff failed to administer medication to resident as prescribed

On May 18, 2026, Licensing Program Analyst (LPA) Hiratsuka, contacted the facility via phone and email to deliver final findings regarding a complaint that was received on 07/19/2022. The time frame of the allegations is prior to the complaint received by the department

Based on the information obtained during the course of the investigation, the Department is unable to determine the validity of the allegations listed above. Therefore, the allegations above are

A finding that a complaint allegation is unsubstantiated means that, although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.