306003423-5-4-2026-22-AS-KSGH-DUGLU5-20260527090322

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306003423
Report Date: 05/04/2026
Date Signed: 05/04/2026 12:34:53 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
04/28/2026 and conducted by Evaluator Jerome Haley

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20260428154616

FACILITY NAME:	FLORES ADULT RESIDENTIAL HOME		FACILITY NUMBER:	306003423
ADMINISTRATOR:	ZOILA FLORES		FACILITY TYPE:	735
ADDRESS:	2229 N. FOREST AVENUE		TELEPHONE:	(714) 542-3468
CITY:	SANTA ANA	STATE: CA	ZIP CODE:	92706
CAPACITY:	6	CENSUS: 0	DATE:	05/04/2026
		UNANNOUNCED	TIME BEGAN:	09:10 AM
MET WITH:	Zoila Flores		TIME COMPLETED:	12:45 PM

ALLEGATION(S):

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Facility did not treat client with respect and dignity.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Jerome Haley made an unannounced visit to the begin the investigation in to the complaint allegation listed above. LPA explained the purpose of the visit upon entry. The complaint investigation consisted of interviews and document review.

Regarding the allegation: Facility did not treat the client with respect and dignity

0 of 9 individuals were not able to provide any corroborating information or evidence that supports the complaint allegation. During the investigation six individuals and documents review disclosed information that directly contradicts the complaint allegation. According to one individual who was interviewed, they explained there are no concerns about the care at the facility. Another individual who was interviewed said the same thing, and denied there are any concerns about the care at the facility.

Continued on LIC9099C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Kevin Saborit-Guasch
LICENSING EVALUATOR NAME: Jerome Haley
LICENSING EVALUATOR SIGNATURE:	DATE: 05/04/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/04/2026

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-20260428154616

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: FLORES ADULT RESIDENTIAL HOME	FACILITY NUMBER: 306003423
	VISIT DATE: 05/04/2026

NARRATIVE

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In addition to denying there are concerns about the care at the facility, the individual said some very good things about the Licensee/Administrator Zoila Flores and the care she has provided. The individual provided details about what Licensee Flores has done for their loved one while under her care.

During the investigation documents were reviewed and the information reviewed did not support the complaint allegation. According page four and five of Client 1’s (C1) Individualized Program Plan (IPP) dated June 24, 2025, C1 has maintained good health status without any major illnesses, injuries, or hospitalization. It was documented in the June 24, 2025, IPP that C1 expressed they’re happy living in the home, happy with the current placement, and does not wish to move out.

Based on the information gathered during the investigation through interviews and document review, the department is unable to ascertain if the allegation occurred as reported. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove or refute the alleged violations occurred; therefore, the allegation is deemed unsubstantiated.

An exit interview was conducted, and a copy of this report was provided.

SUPERVISORS NAME: Kevin Saborit-Guasch
LICENSING EVALUATOR NAME: Jerome Haley
LICENSING EVALUATOR SIGNATURE:	DATE: 05/04/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/04/2026

LIC9099 (FAS) - (06/04)

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