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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306003933
Report Date: 10/24/2025
Date Signed: 10/24/2025 03:27:05 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
02/09/2022 and conducted by Evaluator Kevin Saborit-Guasch
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20220209112439
FACILITY NAME:CHATEAU ST. MARK HOMES 1FACILITY NUMBER:
306003933
ADMINISTRATOR:ANICIA LOPEZFACILITY TYPE:
735
ADDRESS:9671 RANDOM DRIVETELEPHONE:
(714) 635-7732
CITY:ANAHEIMSTATE: CAZIP CODE:
92804
CAPACITY:6CENSUS: 6DATE:
10/24/2025
UNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Martin Lopez, administrator (via phone)TIME COMPLETED:
03:40 PM
ALLEGATION(S):
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Staff hit resident.
INVESTIGATION FINDINGS:
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On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility in order to follow up on the investigation of the allegation listed above. LPA was greeted and granted entry by facility staff after introducing himself, explaining the purpose of the visit and listing the allegation investigated. Administrator Martin Lopez was notified via phone and explained the findings.

An initial complaint investigation visit was conducted on February 16, 2022. During the visit, licensing staff obtained resident's records including IPP and nursing reports for client C1. LPA interviewed two staff members as well as C1. Additional witness interviews were conducted during the investigation.

During the present visit, LPA obtained the facility's current staff roster and client census and conducted or attempted additional staff and client interviews. There are five clients present and one client is hospitalized.
CONTINUED ON FORM LIC9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Kevin Saborit-Guasch
LICENSING EVALUATOR SIGNATURE:

DATE: 10/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/24/2025
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 2
Control Number 22-AS-20220209112439
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: CHATEAU ST. MARK HOMES 1
FACILITY NUMBER: 306003933
VISIT DATE: 10/24/2025
NARRATIVE
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CONTINUED FROM FORM LIC9099
Regarding the allegation that Staff hit resident, the following has been concluded: Client C1 was admitted to the facility on April 20, 2001 with a primary diagnosis of Severe Mental Disability, Seizure disorder, Impulsive control disorder, Autism spectrum disorder, Diabetes Mellitus 2 and Hypothyroidism. An interview with C1 was attempted during the initial complaint visit as well as during the present visit but were unsuccessful due to C1's non-verbal condition. C1 has documented aggressive and/or self-injurious behavior and is stated to require a high level of care per their Individual Program Plan. The circumstances of the allegation were not specified and no evidence in interviews and records reviewed was of a nature to corroborate the allegation.

Based on the evidence gathered during interviews and review of records, the allegation is found to be Unsubstantiated, meaning that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur.

An exit interview was conducted and a copy of this report was provided to a facility representative.
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Kevin Saborit-Guasch
LICENSING EVALUATOR SIGNATURE:

DATE: 10/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/24/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2