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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306003842
Report Date: 08/06/2025
Date Signed: 08/06/2025 01:14:51 PM

Substantiated


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
08/01/2025 and conducted by Evaluator Celine Rodriguez
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20250801112910
FACILITY NAME:GILBERT CARE HOME-MILANFACILITY NUMBER:
306003842
ADMINISTRATOR:ROSANNA MAGKAWASFACILITY TYPE:
735
ADDRESS:322 N. MILAN PLACETELEPHONE:
(714) 484-1880
CITY:ANAHEIMSTATE: CAZIP CODE:
92801
CAPACITY:6CENSUS: 4DATE:
08/06/2025
UNANNOUNCEDTIME BEGAN:
07:00 AM
MET WITH:Licensee - Noel Villegas TIME COMPLETED:
01:40 PM
ALLEGATION(S):
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Facility failed to provide care and supervision resulting in client engaging in unsafe acts
Facility did not follow Day Staff Ratio implemented by RCOC
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Celine Rodriguez conducted an unannounced 10-day visit to the facility for the complaint and to deliver the findings. LPA Rodriguez explained the purpose of today's visit, was greeted, and granted entry by staff on duty, who contacted licensee (LE) Noel Villegas about visit.

During the investigation, LPA Rodriguez toured the physical plant of the facility, conducted interviews, and requested copies of pertinent records reviewed.

It was alleged that facility failed to provide care and supervision resulting in client engaging in unsafe acts. LPA Rodriguez conducted 4 out of 4 interviews with staff, of which all 4 interviews did not corroborate with the allegation. Per Regional Center Individual Program Plan dated for 7/30/2024, client 1’s (C1) IPP states that C1 “has no sense of danger”, “will refuse to comply with staff”, and has “no safety awareness”. Per record review, Regional Center issued the facility a New Referral Moratorium on July 28, 2025, regarding C1 climbing up a chair to access a cupboard, of which this was substantiated.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Celine Rodriguez
LICENSING EVALUATOR SIGNATURE:

DATE: 08/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2025
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 3
Control Number 22-AS-20250801112910
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: GILBERT CARE HOME-MILAN
FACILITY NUMBER: 306003842
VISIT DATE: 08/06/2025
NARRATIVE
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It was alleged that facility did not follow Day Staff Ratio implemented by RCOC. LPA Rodriguez conducted 4 out of 4 interviews with staff, of which all 4 interviews did not corroborate with the allegation. Per staff interviews, client 1 (C1) required 1:1 supervision, however was placed on a 2:1 supervision as of 4/10/2024. During the tour of the facility, and upon LPAs entrance of the facility, LPA observed a total of 4 staff members on duty, of which 2 staff members were specifically attending to C1. Per review of the facility LIC500 dated for April 2025, there are a total of 4 caregivers scheduled from 8:00AM-2:00PM, 4 caregivers from 2:00PM-10:00PM, and three caregivers from 10:00PM-8:00AM, along with 4 administrators who are on-call 24-hours. Per record review, Regional Center issued the facility a New Referral Moratorium on July 28, 2025, of which the allegation for insufficient staffing from 1/28/2025, was substantiated.

Based on LPA’s interviews which were conducted, review of documents obtained, and observations, the preponderance of evidence standard has been met, therefore the allegation is SUBSTANTIATED.

An exit interview was conducted with LE Villegas.

A copy of this report was explained, and appeal rights were provided during the visit.
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Celine Rodriguez
LICENSING EVALUATOR SIGNATURE:

DATE: 08/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 22-AS-20250801112910
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: GILBERT CARE HOME-MILAN
FACILITY NUMBER: 306003842
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/06/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type B
08/06/2025
Section Cited
CCR
80078(a)
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80078 Responsibility for Providing Care and Supervision
(a) The licensee shall provide care and supervision as necessary to meet the client's needs.
This requirement is not met as evidence by:
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Licensee is to provide proof of understanding of the regulation cited to the assigned LPA on or by 8/6/2025.
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Based on LPAs review of documents, observations and interviews, Regional Center issued the facility a New Referral Moratorium on July 28, 2025, of which the allegation for insufficient staffing, resulting in client climbing up a chair and accessing a cupboard was substantiated. This poses an immediate health and safety risk to clients in care.
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Request Denied
Type B
08/07/2025
Section Cited
CCR
85065.5(a)(1)
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85065.5 Day Staff-Client Ratio
(a) ...The following minimum staffing requirements shall be met:
(1) For Regional Center clients, staffing shall be maintained...
This requirement is not met as evidence by:
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Licensee is to provide proof of understanding of the regulation cited to the assigned LPA on or by 8/6/2025.
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Based on LPAs review of documents, observations and interviews, Regional Center issued the facility a New Referral Moratorium on July 28, 2025, of which the allegation for insufficient staffing, was substantiated. This poses an immediate health and safety risk to clients in care.
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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.
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Celine Rodriguez
LICENSING EVALUATOR SIGNATURE:

DATE: 08/06/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3