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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306002916
Report Date: 08/14/2026
Date Signed: 08/14/2026 03:52:23 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
06/25/2024 and conducted by Evaluator Pang Lee
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20240625110839
FACILITY NAME:ARC FACILITY AT CAMINO 2FACILITY NUMBER:
306002916
ADMINISTRATOR:MICHAEL ADAMSFACILITY TYPE:
740
ADDRESS:2209 CAMINO DEL SOLTELEPHONE:
(714) 870-5830
CITY:FULLERTONSTATE: CAZIP CODE:
92833
CAPACITY:6CENSUS: 4DATE:
08/14/2026
UNANNOUNCEDTIME BEGAN:
02:21 PM
MET WITH:Michael AdamsTIME COMPLETED:
02:36 PM
ALLEGATION(S):
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Staff allowed residents to be left in soiled clothing for an extended period of time
INVESTIGATION FINDINGS:
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On 08/14/2026, Licensing Program Analyst (LPA) Pang Lee conducted a telephone meeting with Facility Designated Administrator (FDA) Michael Adams for the purpose of delivering the complaint finding regarding the allegation above. A brief interview was conducted with FDA Adams.

It was alleged that staff allowed residents to be left in soiled clothing for an extended period of time. During the course of the investigation, the Department conducted interviews and requested relevant facility records. FDA Adams denied the allegation and stated that facility staff provide residents with routine incontinence care, including changing and showering residents as needed. FDA Adams further stated that residents are routinely checked every two hours and stated that the facility does not document when residents are changed. The Department was able to interview two residents. One of the two residents denied the allegation and reported no concerns regarding care provided by facility staff.

CONTINUED LIC 9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Czarrina A Camilon-Lee
LICENSING EVALUATOR NAME: Pang Lee
LICENSING EVALUATOR SIGNATURE:

DATE: 08/14/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/14/2026
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-20240625110839
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: ARC FACILITY AT CAMINO 2
FACILITY NUMBER: 306002916
VISIT DATE: 08/14/2026
NARRATIVE
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 An outside agency was also contacted and stated that they did not recall the alleged incident. Attempts were made to contact the complainant; however, that attempt was unsuccessful. On 06/20/2026, LPA Lee emailed FDA Adams requesting facility records for review. On 07/31/2026, LPA Lee contacted FDA Adams by telephone to follow up regarding the requested records; however, the requested records were not provided to the Department. Based on interviews conducted and the information obtained during the investigation, there is insufficient evidence to establish that staff allowed residents to remain in soiled clothing for an extended period of time.

As a result of this investigation, this Department found the allegation to be UNSUBSTANTIATED. A complaint allegation finding of Unsubstantiated meant that although the allegation may have happened or was valid, there was not a preponderance of the evidence to prove that the alleged violation occurred. An Exit Interview was conducted with FDA Adams, and a copy of this report was provided to the facility via email. A certified copy will be sent to the facility mailing address.
SUPERVISORS NAME: Czarrina A Camilon-Lee
LICENSING EVALUATOR NAME: Pang Lee
LICENSING EVALUATOR SIGNATURE:

DATE: 08/14/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/14/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2