306002915-10-13-2025-22-AS-APAO-DMGVSF-20251015164127

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306002915
Report Date: 10/13/2025
Date Signed: 10/13/2025 12:13:54 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
10/10/2025 and conducted by Evaluator Samer Haddadin

COMPLAINT CONTROL NUMBER: 22-AS-20251010101254

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: 108	DATE:	10/13/2025
		UNANNOUNCED	TIME BEGAN:	11:55 AM
MET WITH:	Troy Byington		TIME COMPLETED:	11:56 AM

ALLEGATION(S):

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Facility served contaminated food to residents.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Samer Haddadin conducted an unannounced visit to the facility on October 13, 2025, to deliver findings regarding the above-mentioned allegation. Upon arrival, LPA Haddadin was greeted by Administrator (AD) Troy Boyington, who granted access to the facility. The purpose of the visit was explained.
The allegation investigated was that the “Facility served contaminated food to residents.” Community Care Licensing (CCL) received a telephone report from the Orange County Health Care Agency (OCHCA). The complainant relayed information from the Public Health Nurse with the Communicable Disease Control Division, indicating that a resident (R1) at the facility tested positive for a foodborne illness identified as Salmonella Newport. LPA conducted interviews with five (5) residents and five (5) staff members. All interviewees denied the allegation. Residents interviewed stated they enjoyed the meals provided at the facility and had never become ill from the food served. {***CONTINUE 9099C***}

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Samer Haddadin
LICENSING EVALUATOR SIGNATURE:	DATE: 10/13/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/13/2025

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-20251010101254

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: 10/13/2025

NARRATIVE

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Staff interviews revealed that employees also consumed the same food as residents and reported no incidents of illness or concern regarding food safety.
An interview with R1 indicated uncertainty as to whether the illness originated from food prepared at the facility, noting that R1 frequently eats meals outside the facility. R1’s roommate confirmed that they did not become ill and were unsure whether meals consumed outside the facility contributed to R1’s condition. None of the residents interviewed reported symptoms or illness related to food served at the facility.
An interview with OCHCA confirmed that while R1 tested positive for Salmonella, there was no verification that the food consumed at the facility was the source. OCHCA staff advised that, as mandated reporters, the agency submitted the report to CCL as required.
On October 13, 2025, LPA Haddadin observed residents eating breakfast and lunch, both of which were prepared and served by facility staff. The meals appeared properly prepared and presented. LPA observed food preparation areas, storage, and handling practices to be clean, organized, and consistent with Title 22 regulations. No health or safety violations were observed.
Based on the information obtained, there is insufficient evidence to prove or disprove the allegation. Therefore, the allegation that the “Facility served contaminated food to residents.” is deemed UNSUBSTANTIATED, meaning that although the allegation may have occurred or is valid, there is not a preponderance of evidence to prove that the alleged violation occurred.
An exit interview was conducted, and a copy of this report was provided to the Administrator.

SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Samer Haddadin
LICENSING EVALUATOR SIGNATURE:	DATE: 10/13/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/13/2025

LIC9099 (FAS) - (06/04)

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