306003971-7-10-2025-22-AS-APAO-DJN857-20250716221215

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306003971
Report Date: 07/10/2025
Date Signed: 07/10/2025 01:05:59 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
11/07/2022 and conducted by Evaluator Celine Rodriguez

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20221107171030

FACILITY NAME:	NANCITA HOME		FACILITY NUMBER:	306003971
ADMINISTRATOR:	AARON RESURRECCION		FACILITY TYPE:	735
ADDRESS:	713 N. NANCITA STREET		TELEPHONE:	(714) 220-2657
CITY:	ANAHEIM	STATE: CA	ZIP CODE:	92801
CAPACITY:	6	CENSUS: 5	DATE:	07/10/2025
		UNANNOUNCED	TIME BEGAN:	11:16 AM
MET WITH:	Facility Administrator - Analouise "Louise" Igisaiar		TIME COMPLETED:	01:10 PM

ALLEGATION(S):

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Client was hit by staff causing injury

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Celine Rodriguez conducted an unannounced continuation 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 facility administrator (AD) Analouise "Louise" Igisaiar about visit. For this visit, LPA Rodriguez met with AD Igisaiar.

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

It was alleged that client was hit by staff causing injury. LPA Rodriguez conducted a total of 5 interviews that consisted of clients and staff, of which all 5 interviews did not corroborate with the allegation. Interviews conducted with clients denied that staff would hit clients and cause injury and described staff as "nice". Per record review and observations client 1 (C1) was admitted to the facility on 3/1/2009.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Celine Rodriguez
LICENSING EVALUATOR SIGNATURE:	DATE: 07/10/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2025

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-20221107171030

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: NANCITA HOME	FACILITY NUMBER: 306003971
	VISIT DATE: 07/10/2025

NARRATIVE

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Per behavioral notes, progress notes and quarterly reviews, C1 had a history of making false accusations, property destruction, eloping, physical aggressions, and engages in behaviors to seek attention by contacting law enforcement and making false statements such as people hurting C1, having injuries (such as bruises, black eyes, scratches), making false statements about medical diagnoses, or when having delusions.

Per review of reports, on 6/2/22, staff 1 (S1) and C1 went out for activities and utilized the facility van. The facility van was parked on a downhill slope, and C1's arm got caught on the door due to door closing on its own by the way the car was parked. S1 immediately conducted a body check and no bruises or scratches were sustained. S1 also obtained medical attention, however C1 denied of wanting to be evaluated. Per record review, staff 1 (S1) is background cleared, and is associated to the facility via Guardian. S1 has been trained on mandated reporting, direct service professional, crisis prevention interventions and supervision.

Based on LPA’s interviews which were conducted, review of documents obtained, and observations, LPA is unable to ascertain if the 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 with AD Igisaiar.

A copy of this report was provided and explained.

SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Celine Rodriguez
LICENSING EVALUATOR SIGNATURE:	DATE: 07/10/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2025

LIC9099 (FAS) - (06/04)

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