306003529-10-27-2021-22-AS-SSAS-CPH2Q6-20230228163525

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306003529
Report Date: 10/27/2021
Date Signed: 10/27/2021 12:53:42 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
10/19/2021 and conducted by Evaluator Michelle Reed

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20211019091710

FACILITY NAME:	GUARDIAN ANGELS HOMES I		FACILITY NUMBER:	306003529
ADMINISTRATOR:	SONIA GARCIA		FACILITY TYPE:	740
ADDRESS:	18021 E. SANTA CLARA AVENUE		TELEPHONE:	(714) 269-7307
CITY:	SANTA ANA	STATE: CA	ZIP CODE:	92705
CAPACITY:	6	CENSUS: 6	DATE:	10/27/2021
		UNANNOUNCED	TIME BEGAN:	10:15 AM
MET WITH:	Administrators Sonia Garcia and Kelly Francia		TIME COMPLETED:	01:00 PM

ALLEGATION(S):

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Staff denied resident from receiving mail
Staff denied resident from receiving phone calls

INVESTIGATION FINDINGS:

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Licensing Program Analysts Michelle Reed and Beverly Thompson Gracia arrived at the facility to discuss the complaint allegations. Upon arrival, LPAs met with Staff Arnell Lopez and Stephanie Magana. Administrators Sonia Garcia and Kelly Francia arrived a shortly after LPAs. Resident #1(R1) was admitted into the facility on 10/14/21. Records were reviewed and interviews with staff, R1 and witnesses. R1 has a cell phone available for use as well as a landline at the facility. R1 disclosed that she talks to all her family and friends as she so chooses. She also has a phone list with all family members names, phone numbers, relationship and their location. Sometimes the cell phone reception is not reliable and calls may be dropped. R1 does not have a landline in her room however on today's date the Licensee was having ethernet installed in R1's room. R1 will have her own phone number and the phone number will be shared with all family members. When asked about mail service R1 stated that she is allowed to receive mail but at this time her Daughter(POA) handles all her mail. Based upon interviews and a review of records the allegations are unsubstantiated, meaning that although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violations occurred. An exit interview was conducted with Sonia Garcia and a copy of this report was provided.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Sheila Santos	TELEPHONE: (714) 703-2857
LICENSING EVALUATOR NAME: Michelle Reed	TELEPHONE: (714) 743-4958
LICENSING EVALUATOR SIGNATURE:	DATE: 10/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/27/2021

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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