Complaint Investigation Report

306005901-4-3-2026-22-AS-APAO-DSY2GW-20260408172346

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

05/22/2024 and conducted by Evaluator Kerry Hiratsuka

COMPLAINT CONTROL NUMBER: 22-AS-20240522133044

Negligence by staff resulted in a resident being hospitalized.

Facility staff are unresponsive to resident family members.

Resident was not given privacy during incontinent care.

Staff failed to provide incontinent care.

Resident was isolated from other residents.

Dried feces and/or blood was present in a residents room for about a week.

Facility is not following prescribed diet.

On 04/03/2026, Licensing Program Analyst (LPA) HIratsuka, contacted the facility via phone and email to deliver final findings regarding a complaint that was received on 05/22/2024. 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.

Operatoins Director was advised the report is going to be emailed to him.