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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306003764
Report Date: 05/14/2026
Date Signed: 06/25/2026 08:51:47 AM

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
05/06/2026 and conducted by Evaluator Sean Haddad
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20260506155811
FACILITY NAME:GOLDEN ANGEL OF LA HABRA IIFACILITY NUMBER:
306003764
ADMINISTRATOR:LORNITA S. PANISFACILITY TYPE:
740
ADDRESS:1250 VIVIWOOD PLACETELEPHONE:
(714) 449-9819
CITY:LA HABRASTATE: CAZIP CODE:
90631
CAPACITY:6CENSUS: 5DATE:
05/14/2026
UNANNOUNCEDTIME BEGAN:
03:12 PM
MET WITH:Lornita S. PanisTIME COMPLETED:
04:45 PM
ALLEGATION(S):
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Facility staff is rough with resident's in care resulting in bruising
INVESTIGATION FINDINGS:
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This is an amended report

This unannounced inspection is being conducted by Licensing Program Analyst (LPA) Sean Haddad for the purpose of delivering findings for the investigation into the above identified complaint allegation. LPA met with Administrator (AD) Lornita S. Panis and explained the reason for today’s inspection.

The investigation into the allegation that facility staff is rough with resident's in care resulting in bruising revealed the following: During the course of the investigation, LPA inspected the facility, interviewed AD, staff, and residents, and obtained and reviewed copies of the resident roster, staff roster, and a photograph of Resident #1 (R1).
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Sean Haddad
LICENSING EVALUATOR SIGNATURE:

DATE: 06/25/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/25/2026
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 5
Control Number 22-AS-20260506155811
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: GOLDEN ANGEL OF LA HABRA II
FACILITY NUMBER: 306003764
VISIT DATE: 05/14/2026
NARRATIVE
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It was alleged that a staff was rough with a resident resulting in bruising. LPA inspected the facility, conducted health and safety checks on residents, and observed no health and safety issues. LPA interviewed the four other residents and did not obtain information corroborating the allegation. LPA interviewed AD and three staff who denied the allegation. LPA reviewed a photograph of R1 which does show a small, superficial, finger-sized bruise on R1’s leg allegedly caused by rough handling by Staff #1 (S1) and noted that by the time of today’s inspection, the bruise had resolved, indicating that it was indeed a bruise and not a permanent mark. However, S1 denied causing the bruise and the information obtained did not confirm the cause of the bruise.

Based on the information gathered during the investigation and review of all documents obtained, the Department is unable to ascertain if the above 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 violation occurred; therefore, this allegation is deemed Unsubstantiated. An exit interview was conducted and a copy of this report was discussed with and provided to facility representative.

This is an amended report
SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Sean Haddad
LICENSING EVALUATOR SIGNATURE:

DATE: 06/25/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/25/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 22-AS-20260506155811
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: GOLDEN ANGEL OF LA HABRA II
FACILITY NUMBER: 306003764
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/14/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/15/2026
Section Cited
CCR
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This is an amended report.
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This is an amended report.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Sean Haddad
LICENSING EVALUATOR SIGNATURE:

DATE: 06/25/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/25/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 5
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
05/06/2026 and conducted by Evaluator Sean Haddad
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20260506155811

FACILITY NAME:GOLDEN ANGEL OF LA HABRA IIFACILITY NUMBER:
306003764
ADMINISTRATOR:LORNITA S. PANISFACILITY TYPE:
740
ADDRESS:1250 VIVIWOOD PLACETELEPHONE:
(714) 449-9819
CITY:LA HABRASTATE:CAZIP CODE:
90631
CAPACITY:6CENSUS: 5DATE:
05/14/2026
UNANNOUNCEDTIME BEGAN:
03:12 PM
MET WITH:Lornita S. PanisTIME COMPLETED:
04:45 PM
ALLEGATION(S):
1
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Facility staff does not respond to resident's in a timely manner
Facility staff does not change resident in a timely manner
INVESTIGATION FINDINGS:
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This unannounced inspection is being conducted by Licensing Program Analyst (LPA) Sean Haddad for the purpose of delivering findings for the investigation into the above identified complaint allegations. LPA met with Administrator (AD) Lornita S. Panis and explained the reason for today’s inspection.

The investigation into the allegations that facility staff does not respond to resident's in a timely manner and facility staff does not change resident in a timely manner revealed the following: During the course of the investigation, LPA inspected the facility, interviewed AD, staff, and residents, and obtained and reviewed copies of the resident roster and staff roster.

CONTINUED
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Sean Haddad
LICENSING EVALUATOR SIGNATURE:

DATE: 05/14/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 22-AS-20260506155811
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: GOLDEN ANGEL OF LA HABRA II
FACILITY NUMBER: 306003764
VISIT DATE: 05/14/2026
NARRATIVE
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It was alleged that staff do not respond to a resident’s calls for assistance timely at night. LPA inspected the facility, conducted health and safety checks on residents, and observed no health and safety issues. LPA interviewed the four other residents and did not obtain information corroborating the allegation. LPA interviewed AD and three staff who denied the allegation, stating that while staff sleep at night, they wake up and provide care when they hear residents’ request assistance, and in response to a resident needing additional night care, an additional staff was added to address that resident’s needs at night.

It was alleged that staff leave a resident in soiled diapers for extended periods of time. LPA interviewed the four other residents and did not obtain information corroborating the allegation. LPA interviewed AD and three staff who denied the allegation.

Based on the information gathered during the investigation and review of all documents obtained, the Department is unable to ascertain if the above allegations occurred as reported. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove or refute the alleged violations occurred; therefore, these allegation are deemed Unsubstantiated. An exit interview was conducted and a copy of this report was discussed with and provided to facility representative.
SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Sean Haddad
LICENSING EVALUATOR SIGNATURE:

DATE: 05/14/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2026
LIC9099 (FAS) - (06/04)
Page: 5 of 5