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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306001397
Report Date: 06/24/2026
Date Signed: 06/24/2026 10:34:04 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
11/02/2021 and conducted by Evaluator Jason Lund
COMPLAINT CONTROL NUMBER: 22-AS-20211102101402
FACILITY NAME:JONATHAN'S HOMEFACILITY NUMBER:
306001397
ADMINISTRATOR:PRISCILLA S. BUSTAMANTEFACILITY TYPE:
735
ADDRESS:1519 SHELTON STTELEPHONE:
(714) 754-7184
CITY:SANTA ANASTATE: CAZIP CODE:
92707
CAPACITY:6CENSUS: 0DATE:
06/24/2026
UNANNOUNCEDTIME BEGAN:
10:00 PM
MET WITH:TIME COMPLETED:
10:30 PM
ALLEGATION(S):
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Facility staff failed to follow doctor's orders
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Jason Lund delivered complaint findings via email to current Administrator Priscilla Bustamante for the following allegations above due to the facility having a census of zero and no contact.

Facility staff failed to follow doctor's orders- LPA Lund interviewed Reporting Party (RP). LPA Lund attempted to interview Administrator Priscilla Bustamante and any former clients in care. RP stated that she heard about all the above allegations from a former service coordinator but doesn’t have any knowledge of the allegation. Based on interview with RP and not being able to interview Administrator Priscilla Bustamante and any former clients in care, LPA Lund can’t verify if facility staff failed to follow doctor's orders. LPA Lund could not get any documentation from facility as of 8/28/2025, the facility has no clients in care. The facility phone number is discontented.
Unsubstantiated
Estimated Days of Completion: 90
SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Jason Lund
LICENSING EVALUATOR SIGNATURE:

DATE: 06/24/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2026
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
Control Number 22-AS-20211102101402
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: JONATHAN'S HOME
FACILITY NUMBER: 306001397
VISIT DATE: 06/24/2026
NARRATIVE
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Based on interviews with RP, and no interviews with Administrator Priscilla Bustamante and any former clients in care and no documentation from the facility on the information provided, it was unclear if facility staff failed to follow doctor's orders, therefore the allegation was deemed UNSUBSTANTIATED.

As a result of this investigation, this Department finds the allegation to be UNSUBSTANTIATED. A complaint allegation finding of Unsubstantiated means that although the allegation may have happened or is valid, there is no preponderance of the evidence to prove that the alleged violation occurred. Report emailed to the facility.

SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Jason Lund
LICENSING EVALUATOR SIGNATURE:

DATE: 06/24/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2