Complaint Investigation Report

306005901-4-3-2026-22-AS-APAO-DSY3LB-20260408182029

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-20240522095807

Facility failed to follow residents prescribed diet.

Facility failed to follow medical orders resulting in residents tooth falling out.

Staff failed to report residents medical condition.

Staff speak limited English and can't communicate with residents.

Resident was not sent to the hospital after having an unwitnessed fall and complaining of pain.

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.