Complaint Investigation Report

306005815-1-28-2026-22-AS-APAO-DR784U-20260210211142

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

01/22/2026 and conducted by Evaluator Samer Haddadin

COMPLAINT CONTROL NUMBER: 22-AS-20260122080653

Facility lacks sufficient staffing to meet resident's needs

Licensing Program Analyst (LPA) Samer Haddadin conducted an announced visit to the facility to complete the 10-day visit and deliver the findings. Upon arrival, LPA Haddadin was granted entry and greeted by the caregiver on duty, Elma Ilaggan.

It was alleged that “Facility lacks sufficient staffing to meet resident's needs.” At the time of the visit, LPA Haddadin observed four residents in care and two caregivers on duty. The facility’s current capacity is six. LPA Haddadin conducted three resident interviews and two staff interviews; all interviewees denied the allegation. One resident could not be interviewed because the resident was non-verbal and medically unable to provide a reliable statement. During record review of the caregiver schedule, LPA Haddadin observed staffing that reflected two caregivers on duty during the day shift and one caregiver on duty during the night shift. Based on interviews, observations, and record review, the preponderance of evidence standard could not be met. Therefore, the allegation “Facility lacks sufficient staffing to meet resident's needs” is unsubstantiated. An exit interview was conducted, and a copy of this report was provided to facility staff.