<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306000106
Report Date: 05/20/2026
Date Signed: 05/20/2026 04:38:34 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/27/2023 and conducted by Evaluator Brandon Lopez
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20231027100758
FACILITY NAME:PROMISES GUEST VILLAGEFACILITY NUMBER:
306000106
ADMINISTRATOR:DANTE ENCARNACIONFACILITY TYPE:
735
ADDRESS:1315-1321 ANAHEIM BLVD.TELEPHONE:
(714) 774-1544
CITY:ANAHEIMSTATE: CAZIP CODE:
92805
CAPACITY:40CENSUS: 40DATE:
05/20/2026
UNANNOUNCEDTIME BEGAN:
03:30 PM
MET WITH:Office Staff Maria Rizza EngresoTIME COMPLETED:
05:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff does not keep an accurate log of residents money.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On May 20, 2026, Licensing Program Analyst (LPA) Brandon Lopez made an unannounced visit to the facility to deliver the complaint findings. LPA was greeted and granted entry into the facility by staff after explaining the purpose for the visit. Administrator Dante Encarnacion was notified via telephone but was unable to assist with today's inspection.

During the course of the investigation, the Department interviewed ten clients and four staff. The Department also reviewed and obtained pertinent documents to this complaint such as client personal and incidental (P&I) expense monies records. Regarding the allegation, staff does not keep an accurate log of residents money, the following has been concluded: The Department reviewed the P&I records for ten current clients of the facility. The Department observed that the facility did not document descriptions of each transaction that was made in any of the ten clients ledgers as required. The facility was also unable to provide any receipts for the documented transactions made for any of the ten clients as required. The Department conducted ten client interviews. CONTINUED ON LIC9099-C
Substantiated
Estimated Days of Completion: 90
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Brandon Lopez
LICENSING EVALUATOR SIGNATURE:

DATE: 05/20/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 7
Control Number 22-AS-20231027100758
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME: PROMISES GUEST VILLAGE
FACILITY NUMBER: 306000106
VISIT DATE: 05/20/2026
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Ten out of ten clients interviewed corroborated the allegation and stated that they have not been asked to provide any receipts to the facility for purchases that they have made in the past. One client also reported that their P&I has been mismanaged in the past. Two staff interviewed also corroborated the allegation and confirmed that the facility does not have any receipts for past purchases made by the ten clients.

Based on the evidence gathered during this investigation, the Department obtained sufficient evidence to substantiate the allegation that, staff does not keep an accurate log of residents money. The preponderance of evidence standards has been met; therefore, the above allegation is SUBSTANTIATED. A deficiency is being cited on the attached LIC9099-D page. An exit interview was conducted with an authorized facility representative. A copy of the report and appeal rights were provided to the facility at time of visit.
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Brandon Lopez
LICENSING EVALUATOR SIGNATURE:

DATE: 05/20/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 7
Control Number 22-AS-20231027100758
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

FACILITY NAME: PROMISES GUEST VILLAGE
FACILITY NUMBER: 306000106
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/20/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/30/2026
Section Cited
CCR
80026(h)(1)
1
2
3
4
5
6
7
80026 Safeguards for Cash Resources, Personal Property, and Valuables of Residents: (h) Each licensee shall maintain accurate records of accounts of cash resources.. (1) Records of clients' cash resources .. Supporting receipts for purchases..
1
2
3
4
5
6
7
The designated staff stated that she will conduct an in service training with staff regarding the regulation and will complete a statement of understanding. The designated staff agreed to provide LPA proof of training and the statement of understanding via email or fax by POC due date.
8
9
10
11
12
13
14
This requirement was not evidenced by: Based on interviews and records reviewed, the Licensee did not ensure that the facility maintained supporting receipts for purchases made by clients. This poses a potential health, safety, and personal risks risk to persons in care.
8
9
10
11
12
13
14
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Brandon Lopez
LICENSING EVALUATOR SIGNATURE:

DATE: 05/20/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 7
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/27/2023 and conducted by Evaluator Brandon Lopez
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20231027100758

FACILITY NAME:PROMISES GUEST VILLAGEFACILITY NUMBER:
306000106
ADMINISTRATOR:DANTE ENCARNACIONFACILITY TYPE:
735
ADDRESS:1315-1321 ANAHEIM BLVD.TELEPHONE:
(714) 774-1544
CITY:ANAHEIMSTATE: CAZIP CODE:
92805
CAPACITY:40CENSUS: 40DATE:
05/20/2026
UNANNOUNCEDTIME BEGAN:
03:30 PM
MET WITH:Office Staff Maria Rizza EngresoTIME COMPLETED:
05:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff neglect residents resulting in bedsores/infections.
Staff not maintaining residents hygiene.
Staff does not keep facility free from pests.
Staff not providing clean and sanitary environment.
Unqualified staff administered medications to residents.
Staff does not properly store medications.
Administrator is not present.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On May 20, 2026, Licensing Program Analyst (LPA) Brandon Lopez made an unannounced visit to the facility to deliver the complaint findings. LPA was greeted and granted entry into the facility by staff after explaining the purpose for the visit. Administrator Dante Encarnacion was notified via telephone but was unable to assist with today's inspection.

During the course of the investigation, the Department interviewed ten clients and four staff. The Department also conducted a tour of the facility's physical plant including areas such as the facility's staff offices, laundry/recreation room, kitchen, dining areas, living room, eight client bedrooms, eight bathrooms, garages, and the facility's exterior portions. The Department additionally reviewed and obtained pertinent documents to the complaint such as the facility's staffing schedule, client records, and staff records. Regarding the allegation, staff neglect residents resulting in bedsores/infections, the following has been concluded: The Department conducted ten client interviews. Ten out of ten clients interviewed denied any knowledge of a client suffering from a bedsore/infection. CONTINUED ON LIC9099-C
Unsubstantiated
Estimated Days of Completion: 90
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Brandon Lopez
LICENSING EVALUATOR SIGNATURE:

DATE: 05/20/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 7
Control Number 22-AS-20231027100758
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME: PROMISES GUEST VILLAGE
FACILITY NUMBER: 306000106
VISIT DATE: 05/20/2026
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
The clients interviewed also denied ever receiving any assistance with repositioning in bed and were not aware of any client at the facility that required assistance with repositioning in bed. The Department conducted four staff interviews. Four out of the four staff interviewed denied the allegation and stated that no client at the facility has ever had a bedsore/infection. The staff interviewed also stated that they have not had a client that required assistance with repositioning in bed. During the investigation, the Department was unable to identify any client that suffered from a bedsore/infection or required assistance with repositioning in bed.

Regarding the allegation, staff not maintaining residents hygiene, the following has been concluded: The Department reviewed the records for ten current clients of the facility. The Department observed that each client is considered ambulatory and is able to complete their activities of daily living (ADL) independently, including their bathing, dressing, and toileting needs. The Department conducted ten client interviews. Ten out of ten clients interviewed denied the allegation and stated that they are able to complete all of their hygiene needs independently and do not receive any assistance from the facility staff with them. The clients interviewed also stated that the facility only supplies them with hygiene supplies and that there has always been a sufficient supply on hand. The Department conducted four staff interviews. Four out of four staff interviewed denied the allegation and reported that they do not assist clients with hygiene needs since they are able to do them independently. The staff interviewed also stated that they only supply the clients with hygiene supplies and that there has always been sufficient hygiene supplies on hand. During the investigation, the Department observed the facility to have sufficient hygiene supplies on hand which are stored in the garages.

Regarding the allegation, staff does not keep facility free from pests, the following has been concluded: During the investigation, the Department conducted a tour of the physical plant of the facility. The Department inspected areas including the facility's staff offices, laundry/recreation room, kitchen, dining areas, living room, eight client bedrooms, eight bathrooms, garages, and the facility's exterior portions. The Department did not observe any signs of pest being present at the facility. The Department conducted ten client interviews. Nine out of the ten clients interviewed denied the allegation and denied ever observing any pest at the facility. However, one out of the ten clients interviewed reported seeing a few cockroaches at the facility in the past. The Department conducted four staff interviews. Four out of the four staff interviewed denied the allegation and denied ever observing any pest at the facility.
CONTINUED ON LIC9099-C
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Brandon Lopez
LICENSING EVALUATOR SIGNATURE:

DATE: 05/20/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2026
LIC9099 (FAS) - (06/04)
Page: 5 of 7
Control Number 22-AS-20231027100758
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME: PROMISES GUEST VILLAGE
FACILITY NUMBER: 306000106
VISIT DATE: 05/20/2026
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Regarding the allegation, staff not providing clean and sanitary environment, the following has been concluded: During the investigation, the Department conducted a tour of the physical plant of the facility. The Department inspected areas including the facility's staff offices, laundry/recreation room, kitchen, dining areas, living room, eight client bedrooms, eight bathrooms, garages, and the facility's exterior portions. The Department observed each area to be clean and free of any hazards. The Department reviewed the facility's staffing schedule and observed that there is a housekeeper scheduled each day to clean the facility. The Department conducted ten client interviews. Ten out of the ten clients interviewed denied the allegation and reported that they were satisfied with the cleanliness of the facility. The Department conducted four staff interviews. Four out of the four staff interviewed also denied the allegation and reported no issues with the cleanliness of the facility.

Regarding the allegation, unqualified staff administered medications to residents, the following has been concluded: The Department reviewed the facility's personnel report and observed that there are four medication technicians currently employed at the facility. The Department reviewed the records for the four medication technicians, including their training records. The Department observed that each of the four medication technicians have received initial medication training and are qualified to assist with the client's medication. The Department conducted ten client interviews. Ten out of the ten clients interviewed reported that they have only received assistance with their medication from the medication technicians. The clients interviewed also reported no issues with receiving their medication. The Department conducted four staff interviews. Four out of the four staff interviewed also denied the allegation and stated that the medication technicians are the only staff that are allowed to assist with clients' medications.

Regarding the allegation, staff does not properly store medications, the following has been concluded: During the investigation, the Department observed that the facility centrally stores their medication in a medication cart located in the kitchen. The Department observed the medication cart to be kept locked and inaccessible to clients in care. The Department conducted ten client interviews. Ten out of the ten clients interviewed denied the allegation and reported that they have not seen medication left in the open where they were accessible to other clients in care. The Department conducted four staff interviews. Four out of the four staff interviewed also denied and reported no issues with medication being accessible to clients in care.

CONTINUED ON LIC9099-C
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Brandon Lopez
LICENSING EVALUATOR SIGNATURE:

DATE: 05/20/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2026
LIC9099 (FAS) - (06/04)
Page: 6 of 7
Control Number 22-AS-20231027100758
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME: PROMISES GUEST VILLAGE
FACILITY NUMBER: 306000106
VISIT DATE: 05/20/2026
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Regarding the allegation, administrator is not present, the following has been concluded: The Department reviewed the facility's staffing schedule and observed that the facility Administrator is scheduled to work at the facility Monday through Saturday, from 8 AM to 5 PM. The Department conducted ten clients interviewed. Ten out of the ten clients interviewed denied the allegation and reported that the Administrator is present at the facility every week. The Department conducted four staff interviews. Four out of the four staff interviewed also denied the allegation and reported that the Administrator is present at the facility multiple days each week.

Based on the evidence gathered during the investigation, the Department is unable to ascertain if the allegations occurred as reported. Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove or refute the alleged violation occurred; therefore, the seven allegations are deemed UNSUBSTANTIATED. An exit interview was conducted with an authorized facility representative and a copy of the report was provided to the facility at time of visit.
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Brandon Lopez
LICENSING EVALUATOR SIGNATURE:

DATE: 05/20/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2026
LIC9099 (FAS) - (06/04)
Page: 7 of 7