306004435-12-9-2025-22-AS-APAO-DPN5X6-20251223192011

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306004435
Report Date: 12/09/2025
Date Signed: 12/09/2025 02:36:07 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
11/21/2025 and conducted by Evaluator RoseMarie Ruppert

COMPLAINT CONTROL NUMBER: 22-AS-20251121155515

FACILITY NAME:	STONYBROOK RESIDENTAL CARE I		FACILITY NUMBER:	306004435
ADMINISTRATOR:	BRANDON PENALOSA		FACILITY TYPE:	735
ADDRESS:	9542 STONYBROOK DRIVE		TELEPHONE:	(657) 208-1902
CITY:	ANAHEIM	STATE: CA	ZIP CODE:	92804
CAPACITY:	5	CENSUS: 5	DATE:	12/09/2025
		UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Gladys Framo, House Manager		TIME COMPLETED:	03:00 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff physically abused client

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA) Rose Ruppert made an unannounced visit to the facility to deliver findings for a complaint investigation. LPA was greeted and granted entry by staff. LPA spoke with Administrator via phone who stated the House Manager is his Administrative Designee and could sign the report.

During the course of the investigation it was alleged that Staff physically abused client.

LPA reviewed the following documents for Client #1 (C1): Facesheet, Physician's Report, Individual Program Plan, Quarterly Progress Report from August 2025 and November 2025 and Individual Behavior Support Plan. LPA also reviewed the following documents for Staff #1 (S1): Personnel Report, Criminal Record Statement, Statement Acknowledging Requirement to Report Suspected Abuse of Dependent Adults and Elders and staff training documentation. LPA also reviewed Unusual Incident Report submitted by the facility to the Regional Office on November 22, 2025
(Continued on LIC 9099-C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: RoseMarie Ruppert
LICENSING EVALUATOR SIGNATURE:	DATE: 12/09/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2025

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-20251121155515

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: STONYBROOK RESIDENTAL CARE I	FACILITY NUMBER: 306004435
	VISIT DATE: 12/09/2025

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

(Continued from LIC 9099)

The Physician's Report reports C1 has a diagnosis of Intermittent Explosive Behaviors which include physical aggression towards self and staff. LPA also reviewed a Quarterly Assessment Report for C1 that was conducted on November 24, 2025. This report addressed the explosive behaviors exhibited by C1 and the goals and objectives for staff to assist C1 when client has behavior episodes. The report stated C1 has the following targets to meet: 1. Emotional Outbursts, 2: Physical Aggression, 3: Self injurious behaviors, 4: transferring behavior and #5: Throwing Objects. LPA also reviewed Staff #1's records. There are no disciplinary actions against S1 and training was current.

On November 25, 2025 LPA conducted a health and safety check for five of five clients in care. LPA interviewed four of five clients who reside in the home and inquired if they were physically abused by staff. Four of five denied this allegation. One client declined to interview. LPA interviewed six of six staff members. Six of six staff members denied the allegation that staff physical abused a client. Staff also stated the client in question did not have any markings or bruises from the incident; which was reported to have occurred on November 17, 2025. LPA interviewed three of three witnesses. Two of the three witnesses confirmed the allegation that Staff physically abused client. One of the three witnesses could not confirm, nor deny the allegation. Administrator (AD) stated staff member returned to work on Friday, November 28, 2025 and is obtaining documentation regarding approval for staff to return to work. LPA spoke with AD regarding behavior mapping for C1 to ensure behaviors are documented.

Based on LPA's record review, observations and interviews, the allegation that Staff physically abused client is Unsubstantiated. The allegation may have happened or is valid, but there is not a preponderance of evidence to prove the alleged violation occurred. An exit interview was conducted with Gladys Framo, House Manager and a copy of this report was provided to the facility.

SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: RoseMarie Ruppert
LICENSING EVALUATOR SIGNATURE:	DATE: 12/09/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2025

LIC9099 (FAS) - (06/04)

Page: 2 of 2