306000889-3-2-2026-22-AS-APAO-DRWTFN-20260306134149

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306000889
Report Date: 03/02/2026
Date Signed: 03/02/2026 11:02:47 AM

Unfounded

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
02/25/2026 and conducted by Evaluator Kimberly Lyman

COMPLAINT CONTROL NUMBER: 22-AS-20260225105026

FACILITY NAME:	SENIOR LIVING COMMUNITY FOR THE EASTERN STAR IN CA		FACILITY NUMBER:	306000889
ADMINISTRATOR:	KAT FARRIS		FACILITY TYPE:	741
ADDRESS:	16850 E. BASTANCHURY ROAD		TELEPHONE:	(714) 577-9281
CITY:	YORBA LINDA	STATE: CA	ZIP CODE:	92886
CAPACITY:	76	CENSUS: 30	DATE:	03/02/2026
		UNANNOUNCED	TIME BEGAN:	08:00 AM
MET WITH:	Lita Spicer and Kat Farris		TIME COMPLETED:	11:20 AM

ALLEGATION(S):

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9

Staff overmedicated a resident

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Kimberly Lyman conducted an unannounced complaint visit to initiate an investigation into the above allegation. LPA was greeted and granted entry into the facility and explained the reason for the visit.
During the course of the investigation, LPA toured the facility and interviewed staff and resident as well as reviewed and obtained pertinent documentation such as medication administration record (MAR). Regarding the allegation that staff overmedicated a resident, the investigation revealed the following: Interview with Resident 1 (R1) showed the resident had a lack of awareness of which medications are prescribed. Medication orders show R1 is prescribed Hydrocodone (Norco) 10/325mg twice daily and Trazadone HCL 50mg at bedtime. Review of MAR indicates resident has been receiving the medications as prescribed. Per physician report dated 12/16/2025, R1 is diagnosed with Mild Cognitive Impairment with disorientation. Based on interviews conducted and record review, the allegation is deemed UNFOUNDED, meaning the allegation was false, could not have happened and/or is without a reasonable basis. Exit interview conducted and a copy of this report was provided to facility representative.

Unfounded

Estimated Days of Completion:

SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Kimberly Lyman
LICENSING EVALUATOR SIGNATURE:	DATE: 03/02/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2026

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 2

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
02/25/2026 and conducted by Evaluator Kimberly Lyman

COMPLAINT CONTROL NUMBER: 22-AS-20260225105026

FACILITY NAME:	SENIOR LIVING COMMUNITY FOR THE EASTERN STAR IN CA		FACILITY NUMBER:	306000889
ADMINISTRATOR:	KAT FARRIS		FACILITY TYPE:	741
ADDRESS:	16850 E. BASTANCHURY ROAD		TELEPHONE:	(714) 577-9281
CITY:	YORBA LINDA	STATE: CA	ZIP CODE:	92886
CAPACITY:	76	CENSUS: 30	DATE:	03/02/2026
		UNANNOUNCED	TIME BEGAN:	08:00 AM
MET WITH:	Lita Spicer and Kat Farris		TIME COMPLETED:	11:20 AM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff threatened a resident

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA) Kimberly Lyman conducted an unannounced complaint visit to initiate an investigation into the above allegations. LPA was greeted and granted entry into the facility and explained the reason for the visit.
During the course of the investigation, LPA toured the facility and interviewed staff and residents. Regarding the allegation that staff threatened a resident, the investigation revealed the following: Six out of six staff deny threatening Resident 1 (R1) and state the resident directs inappropriate language at staff. Interview with R1 indicated a threatening statement was made by staff one time only. Four out of four residents deny threatening or inappropriate language and state satisfaction with the facility. Based on interviews conducted, LPA is unable to corroborate the allegation. Therefore, the allegation is deemed unsubstantiated, meaning that although the allegation may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. An exit interview was conducted and a copy of this report was provided.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Kimberly Lyman
LICENSING EVALUATOR SIGNATURE:	DATE: 03/02/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2026

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

LIC9099 (FAS) - (06/04)

Page: 2 of 2