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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306003934
Report Date: 10/24/2025
Date Signed: 10/24/2025 12:40:34 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
06/11/2021 and conducted by Evaluator Kevin Saborit-Guasch
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20210611141332
FACILITY NAME:CHATEAU ST. MARK HOMES 3FACILITY NUMBER:
306003934
ADMINISTRATOR:ANICIA LOPEZFACILITY TYPE:
735
ADDRESS:1621 S. IVANHOE STREETTELEPHONE:
(714) 758-3655
CITY:ANAHEIMSTATE: CAZIP CODE:
92804
CAPACITY:6CENSUS: 6DATE:
10/24/2025
UNANNOUNCEDTIME BEGAN:
08:50 AM
MET WITH:Martin Lopez, administrator (via telephone)TIME COMPLETED:
12:45 PM
ALLEGATION(S):
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Facility staff physically abused a client
INVESTIGATION FINDINGS:
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On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility for the purpose of following up on the investigation of the allegation listed above. LPA was greeted and granted entry by facility staff after introducing himself, stating the purpose of the visit and listing the allegation investigated. Administrator Martin Lopez was notified of the visit via telephone and provided with the findings remotely. Administrator authorized caregiving staff to sign on his behalf.

The initial complaint investigation visit was conducted by licensing staff on June 18, 2021. During the visit, LPA interviewed staff, clients and reviewed documentation. Additional witness interviews were conducted over the course of the investigation.

During the present visit, LPA conducted additional staff and resident interviews.

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)
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Control Number 22-AS-20210611141332
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 3
FACILITY NUMBER: 306003934
VISIT DATE: 10/24/2025
NARRATIVE
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CONTINUED FROM FORM LIC9099
Regarding the allegation that Facility staff physically abused a client, the following has been concluded: Client C1 was admitted to the facility on April 1, 2016 with a primary diagnosis of mild intellectual disability and epilepsy. On or around May 20, 2021, C1 sustained a bruise on his arm and initially stated that the bruise was sustained as a result of an interaction with an unspecified care provider, potentially at the partial hospitalization program C1 attends on weekdays. The presence of the bruise was confirmed upon inspection by the facility's duty nurse. However, per a review of C1's assessments, C1 is an unreliable historian due to a diagnosis of auditory and visual hallucinations. Based on statements made by facility staff and witnesses, the origin of the bruise could not reliably be evidenced to be the result of inappropriate staff action. Additionally, C1 is noted to have a history of self-injurious behaviors.

As a result, 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)
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