306000873-10-4-2025-22-AS-APAO-DME55Y-20251012193956

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306000873
Report Date: 10/04/2025
Date Signed: 10/04/2025 12:40:39 PM

Unsubstantiated

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
11/03/2023 and conducted by Evaluator Samer Haddadin

COMPLAINT CONTROL NUMBER: 22-AS-20231103072829

FACILITY NAME:	BATES FAMILY HOME III		FACILITY NUMBER:	306000873
ADMINISTRATOR:	RANDALL & SANDRA BATES		FACILITY TYPE:	735
ADDRESS:	26631 ESTRADA CIRCLE		TELEPHONE:	(949) 458-9315
CITY:	MISSION VIEJO	STATE: CA	ZIP CODE:	92691
CAPACITY:	6	CENSUS: 4	DATE:	10/04/2025
		UNANNOUNCED	TIME BEGAN:	08:45 AM
MET WITH:			TIME COMPLETED:	04:03 PM

ALLEGATION(S):

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Facility did not report the incident of the client's brusing as a mandated reporter.
Client sustained unexplained bruises on the thighs.

INVESTIGATION FINDINGS:

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On this date, Licensing Program Analyst (LPA) Samer Haddadin conducted an unannounced visit to the facility. The purpose of this visit was to deliver findings regarding two allegations under investigation. Upon arrival, LPA Haddadin was greeted and granted entry by the facility’s Administrator (AD), Randall Bates. The investigative process included a comprehensive facility tour, interviews with three staff members and three residents, and a thorough review of relevant client records to evaluate the facts surrounding the allegations. The first allegation investigated was that the "Facility did not report the incident of the client’s bruising as a mandated reporter." Interviews were conducted with three facility staff members, all of whom denied the allegation. A subsequent review of documentation confirmed that the facility fulfilled its mandated reporting responsibilities. {***CONTINUE 9099C***}

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Samer Haddadin
LICENSING EVALUATOR SIGNATURE:	DATE: 10/04/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/04/2025

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 22-AS-20231103072829

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: BATES FAMILY HOME III	FACILITY NUMBER: 306000873
	VISIT DATE: 10/04/2025

NARRATIVE

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Records indicated that on October 19, 2023, the facility reported that Client 1 (C1) had been transported to Kaiser Permanente after staff observed C1 spending an unusual and extended period in the restroom on October 18, 2023. Documentation confirmed that C1 was ambulatory and independent in personal care and hygiene, making it unlikely that staff would have observed bruising located on C1’s inner thigh prior to the transport. The facility’s prompt action to seek medical evaluation led to a diagnosis of a urinary tract infection (UTI). Based on the totality of evidence obtained from interviews and record review, the allegation that the facility failed to report the incident as a mandated reporter is deemed unsubstantiated.
The second allegation investigated was that the "Client sustained unexplained bruises on the thighs." LPA Haddadin conducted interviews with three staff members, all of whom denied the allegation, consistent with findings from the first investigation. Record review and interviews clarified that the bruising was initially discovered by Vocational Visions (VV), a separate licensed day program (Facility No. 306005250) providing one-on-one care services. The bruising was therefore observed during care provided at VV, not at the residential facility. Given C1’s independence and the absence of one-on-one assistance at the residence, facility staff were appropriately unaware of the bruising due to both the client’s high level of independence and the private nature of the affected area. Based on the evidence obtained from interviews and documentation, the allegation that "Client sustained unexplained bruises on the thighs" is also deemed unsubstantiated.
Although the above allegations may have occurred or be valid, there is not a preponderance of evidence to prove that the alleged violations did or did not occur. Therefore, at this time, both allegations are determined to be unsubstantiated.
An exit interview was conducted with Administrator Randall Bates. A physical copy of this report, detailing the unsubstantiated findings for both allegations, was provided to the Administrator at the conclusion of the visit.

SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Samer Haddadin
LICENSING EVALUATOR SIGNATURE:	DATE: 10/04/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/04/2025

LIC9099 (FAS) - (06/04)

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