306001407-10-27-2025-22-AS-SSAS-DMWVBE-20251029161726

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306001407
Report Date: 10/27/2025
Date Signed: 10/27/2025 10:27:01 AM

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
11/23/2021 and conducted by Evaluator Brandon Lopez

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20211123123942

FACILITY NAME:	EMERALD COURT		FACILITY NUMBER:	306001407
ADMINISTRATOR:	PATRICIA GIRAY-GUSTIN		FACILITY TYPE:	740
ADDRESS:	1731 MEDICAL CENTER		TELEPHONE:	(714) 778-5100
CITY:	ANAHEIM	STATE: CA	ZIP CODE:	92801
CAPACITY:	299	CENSUS: 238	DATE:	10/27/2025
		UNANNOUNCED	TIME BEGAN:	08:00 AM
MET WITH:	Executive Director Dillon Cagulada		TIME COMPLETED:	10:30 AM

ALLEGATION(S):

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Staff did not ensure that resident was adequately fed
Resident was not provided services in the resident's Admission Agreement
Staff provided resident with THC

INVESTIGATION FINDINGS:

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On October 27, 2025, Licensing Program Analyst (LPA) Brandon Lopez made an unannounced visit to the facility to deliver the complaint findings for the allegations listed above. LPA was greeted and granted entry into the facility by staff after explaining the purpose for the visit. Executive Director (ED) Dillon Cagulada was present and assisted on today's visit.

Regarding the allegation that, staff did not ensure that resident was adequately fed, the following has been concluded: It was alleged that Resident #1 (R1) was not fed at times. The Department reviewed R1's Physician's Report dated, April 4, 2021. which stated that R1 was able to feed herself. The Department also reviewed R1's Care Plan dated July 12, 2021, which stated that two meals would be delivered to R1's apartment daily due to her physical limitations. The Deparment was unable to interview R1 for this complaint. The Department conducted eight staff interviews. Eight out of eight staff interviewed denied the allegation and confirmed that R1 always received food to her apartment. The Department also conducted six resident interviews. CONTINUED ON LIC9099-C

Unsubstantiated

Estimated Days of Completion: 90

SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Brandon Lopez
LICENSING EVALUATOR SIGNATURE:	DATE: 10/27/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/27/2025

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-20211123123942

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: EMERALD COURT	FACILITY NUMBER: 306001407
	VISIT DATE: 10/27/2025

NARRATIVE

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Six out of six residents interviewed denied any issues with accessing food. The residents interviewed also expressed that they were satisfied with the quality, the portions, and the variety of food provided to them.

Regarding the allegation that, resident was not provided services in the resident's Admission Agreement, the following has been concluded: It was alleged that R1 paid extra to have caregiver support four times per week which has not been provided. The Department reviewed R1's Admission Agreement dated April 12, 2021. Per R1's Admission Agreement, R1 required, and agreed to pay for a level three care which remained the same until she moved out of the facility on September 30, 2025. The Department reviewed R1's Care Plan dated July 12, 2021. Per R1's Care Plan, R1 received assistance in bathing twice a week, assistance with transferring, assistance with toileting, assistance with escorts as needed, and received housekeeping services on a daily basis. The Department was unable to interview R1 for this complaint. The Department conducted eight staff interviews. Eight out of the eight staff interviewed confirmed that R1 was receiving the services agreed upon and that R1 was receiving appropriate care. The Department also interviewed six residents. Six out of the six residents interviewed confirmed that they are receiving the services and level of care they agreed upon with the facility. The residents interviewed also expressed that they all enjoy living at the facility and that the staffing is appropriate.

Regarding the allegation that, staff provided resident with THC, the following has been concluded: It was alleged that a unknown staff provided R1 with THC gummies. The Department reviewed R1's list of prescribed medications dated September 28, 2025. The Department confirmed that THC gummies were not a medication that was prescribed to R1. The Department conducted six resident interviews. Six out of six resident interviews denied staff ever trying to provide them with THC gummies, or any medication that was not prescribed to them. The Department also conducted eight staff interviews. Eight out of the eight staff interview denied observing or witnessing a staff trying to provide THC gummies to R1, or any other residents'. The staff interviewed also stated that providing unprescribed medications to residents would be against the facility's policy.

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 three allegations are deemed UNSUBSTANTIATED. An exit interview was conducted with Executive Director Dillon Cagulada and a copy of the report was provided.

SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Brandon Lopez
LICENSING EVALUATOR SIGNATURE:	DATE: 10/27/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/27/2025

LIC9099 (FAS) - (06/04)

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