306004295-3-27-2025-22-AS-AJLO-DFETMF-20250404145105

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306004295
Report Date: 03/27/2025
Date Signed: 03/27/2025 08:26:21 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
06/02/2022 and conducted by Evaluator Sean Haddad

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20220602161208

FACILITY NAME:	NELDYS ADULT RESIDENTIAL CARE HOME		FACILITY NUMBER:	306004295
ADMINISTRATOR:	JON NEIL CASTRO		FACILITY TYPE:	735
ADDRESS:	11411 STANFORD AVENUE		TELEPHONE:	(714) 539-5151
CITY:	GARDEN GROVE	STATE: CA	ZIP CODE:	92840
CAPACITY:	6	CENSUS: 4	DATE:	03/27/2025
		UNANNOUNCED	TIME BEGAN:	07:40 AM
MET WITH:	Myrna Cabaneros		TIME COMPLETED:	08:40 AM

ALLEGATION(S):

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Staff hit resident while in care.

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 allegation. LPA met with staff Myrna Cabaneros and explained the reason for today’s inspection. Administrator (AD) Jon Castro was not present during the inspection.

The investigation into the allegation that staff hit resident while in care revealed the following: During the course of the investigation, LPA inspected the facility, interviewed AD, clients, and staff, and obtained and reviewed copies of the client roster and staff roster.

CONTINUED

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Sean Haddad
LICENSING EVALUATOR SIGNATURE:	DATE: 03/27/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/27/2025

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-20220602161208

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

FACILITY NAME: NELDYS ADULT RESIDENTIAL CARE HOME	FACILITY NUMBER: 306004295
	VISIT DATE: 03/27/2025

NARRATIVE

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It was alleged that a staff hit Client #1 (C1) on their feet multiple times, C1 began to cry, and the facility claimed the reason this was done was because C1 had been trying to elope. LPA inspected the facility, conducted health and safety checks on the clients present, and observed no health and safety issues. LPA interviewed three staff who were unable to provide information regarding the allegation. LPA interviewed AD who stated that during this incident, C1 had removed the stick from the windowsill that was used to keep the window closed, C1 was trying to elope and was agitated, and Staff #1 (S1) took the stick and used it to tap on the ground to get C1’s attention as part of redirecting C1. AD denied that any staff hit any client during this incident. LPA attempted to interview C1, but C1 is non-verbal. LPA conducted a health and safety check on C1 and observed no health and safety issues. LPA interviewed the four other clients, all of whom denied the allegation and stated that staff do not hit clients at the facility. Two of these clients were physically present during the alleged incident and stated it did not occur as reported. S1 no longer works at the facility and multiple attempts to interview S1 were unsuccessful. Per AD, during the facility’s investigation into the incident, S1 denied hitting C1 with the stick.

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.

SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Sean Haddad
LICENSING EVALUATOR SIGNATURE:	DATE: 03/27/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/27/2025

LIC9099 (FAS) - (06/04)

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