306002915-6-3-2025-22-AS-APAO-DHJUAP-20250611152505

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306002915
Report Date: 06/03/2025
Date Signed: 06/03/2025 03:59:45 PM

Unfounded

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
02/19/2025 and conducted by Evaluator Jessica Cho

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20250219113315

FACILITY NAME:	BROOKDALE ANAHEIM		FACILITY NUMBER:	306002915
ADMINISTRATOR:	TROY BYINGTON		FACILITY TYPE:	740
ADDRESS:	200 N DALE ST		TELEPHONE:	(714) 761-5771
CITY:	ANAHEIM	STATE: CA	ZIP CODE:	92801
CAPACITY:	140	CENSUS: 101	DATE:	06/03/2025
		UNANNOUNCED	TIME BEGAN:	03:30 PM
MET WITH:	Troy Byrington- Executive Director		TIME COMPLETED:	04:20 PM

ALLEGATION(S):

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Unlawful eviction.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Jessica Cho arrived unannounced for the purpose of delivering the findings into the above allegation. LPA met with Executive Director (ED) Troy Byrington and explained the reason for the visit.

During the course of the investigation, LPA successfully interviewed five out of six residents and three staff, and obtained pertinent documentation which includes Resident/Personnel Rosters, Personnel Reports, Staff Contacts, Facility Sketch, Eviction Notice dated January 21, 2025, Residents’ Face Sheets, Physician’s Report, Progress Note, Community Policy Violation Warnings dated November 14 & 18, 2024, Residency Agreement, Theft and Loss Policy and Procedure, and Resident Personal Property and Valuables.

The investigation revealed the following:

Unfounded

Estimated Days of Completion:

SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Jessica Cho
LICENSING EVALUATOR SIGNATURE:	DATE: 06/03/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/03/2025

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 4

Control Number 22-AS-20250219113315

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: BROOKDALE ANAHEIM	FACILITY NUMBER: 306002915
	VISIT DATE: 06/03/2025

NARRATIVE

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Regarding the allegation of unlawful eviction, it was reported that Resident #1 (R1) is being unlawfully evicted. Per review of the eviction notice, R1 is being evicted for a qualifying reason, and the notice included all elements required per Title 22 eviction procedures. R1 confirmed the rent was unpaid thus R1 is in breach of the Residency Agreement which states under I(1), Rule and Regulation Compliance, that resident “must pay all fees and charges” owed to the facility.

Therefore, this agency has investigated the complaint and based on the interviews which was conducted and the records that were reviewed, the following allegation, Unlawful eviction, is deemed UNFOUNDED. We have found that the complaint was unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. We have therefore dismissed the complaint.

An exit interview was conducted with Executive Director Troy Byrington, and a copy of this report was provided at exit.

SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Jessica Cho
LICENSING EVALUATOR SIGNATURE:	DATE: 06/03/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/03/2025

LIC9099 (FAS) - (06/04)

Page: 4 of 4

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
02/19/2025 and conducted by Evaluator Jessica Cho

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20250219113315

FACILITY NAME:	BROOKDALE ANAHEIM		FACILITY NUMBER:	306002915
ADMINISTRATOR:	TROY BYINGTON		FACILITY TYPE:	740
ADDRESS:	200 N DALE ST		TELEPHONE:	(714) 761-5771
CITY:	ANAHEIM	STATE: CA	ZIP CODE:	92801
CAPACITY:	140	CENSUS: 101	DATE:	06/03/2025
		UNANNOUNCED	TIME BEGAN:	03:30 PM
MET WITH:	Troy Byrington- Executive Director		TIME COMPLETED:	04:20 PM

ALLEGATION(S):

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Facility failed to safeguard residents personal items.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Jessica Cho arrived unannounced for the purpose of delivering the findings into the above allegations. LPA met with Executive Director (ED) Troy Byrington and explained the reason for the visit.

During the course of the investigation, LPA successfully interviewed five out of six residents and three staff, and obtained pertinent documentation which includes Resident/Personnel Rosters, Personnel Reports, Staff Contacts, Facility Sketch, Eviction Notice dated January 21, 2025, Residents’ Face Sheets, Physician’s Report, Progress Note, Community Policy Violation Warnings dated November 14 & 18, 2024, Residency Agreement, Theft and Loss Policy and Procedure, and Resident Personal Property and Valuables (LIC621).

The investigation revealed the following:

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Jessica Cho
LICENSING EVALUATOR SIGNATURE:	DATE: 06/03/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/03/2025

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 4

Control Number 22-AS-20250219113315

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: BROOKDALE ANAHEIM	FACILITY NUMBER: 306002915
	VISIT DATE: 06/03/2025

NARRATIVE

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Regarding the allegation, Facility failed to safeguard resident’s personal items, it is alleged that cameras that belong to Resident #1 (R1) have gone missing. R1 confirmed losing 3 professional cameras, watches, black sunglasses, and many other valuable items. Based on LPA’s observations of R1’s room, the room was unorganized and full of clutter. During the walk through, LPA observed the three items listed on the LIC621 inventory such as a television, 4 watches, and sunglasses and other items. All personal property observed during the walk through was not inventoried upon admission as per the Theft and Loss Policy. Three out of three facility staff indicated that R1 moved in with a few personal belongings and had started to bring in more items that were hard to track and confirm the existence of such items. Additionally, five out of six residents denied experiencing theft.

Therefore, based on the observations made, interviews which were conducted, and the records that were reviewed, although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the following allegation, Facility failed to safeguard resident’s personal items, is deemed UNSUBSTANTIATED.

An exit interview was conducted with Executive Director Troy Byrington, and a copy of this report was provided at exit.

SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Jessica Cho
LICENSING EVALUATOR SIGNATURE:	DATE: 06/03/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/03/2025

LIC9099 (FAS) - (06/04)

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