306004449-8-28-2025-22-AS-AORZ-DKZTFM-20250829144147

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306004449
Report Date: 08/28/2025
Date Signed: 08/28/2025 01:27:53 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
05/23/2025 and conducted by Evaluator Samer Haddadin

COMPLAINT CONTROL NUMBER: 22-AS-20250523160619

FACILITY NAME:	MAC RESIDENTIAL HOME		FACILITY NUMBER:	306004449
ADMINISTRATOR:	EVELINA SCHAEFER		FACILITY TYPE:	735
ADDRESS:	705 N. GILBERT STREET		TELEPHONE:	(714) 995-4131
CITY:	ANAHEIM	STATE: CA	ZIP CODE:	92801
CAPACITY:	6	CENSUS:	DATE:	08/28/2025
		UNANNOUNCED	TIME BEGAN:	01:03 PM
MET WITH:			TIME COMPLETED:	04:30 PM

ALLEGATION(S):

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Facility is hitting clients
Faciity is not providing proper assistance in dressing client
Facility is not providing proper nutrition/hydration for client

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Samer Haddadin conducted an unannounced complaint visit to deliver findings regarding the above allegations. Upon arrival, LPA Haddadin was greeted and granted entry by Direct Support Professional (DSP) Cookie Fiame. During the course of the investigation, LPA toured the facility, conducted interviews with clients and staff, and reviewed facility records relevant to the allegations involving Client 1 (C1).
The following allegations were investigated: “Facility is hitting clients,” “Facility is not providing proper assistance in dressing client,” and “Facility is not providing proper nutrition/hydration for client.” With respect to the allegation that the facility is hitting clients, LPA interviewed three staff members and three clients, all of whom denied the allegation. Additionally, LPA did not observe any bruises, injuries, or indicators of physical abuse on the clients interviewed.
{***CONTINUE***}

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Samer Haddadin
LICENSING EVALUATOR SIGNATURE:	DATE: 08/28/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2025

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-20250523160619

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: MAC RESIDENTIAL HOME	FACILITY NUMBER: 306004449
	VISIT DATE: 08/28/2025

NARRATIVE

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Regarding the allegation that the facility is not providing proper assistance in dressing clients, it was reported that a client was over-dressed on a warm day and lacked a change of clothing while attending Day Program. LPA interviewed three staff members and three clients, all of whom denied the allegation. LPA also observed clients during the visit and did not note any instance of over-dressing or inappropriate clothing for the weather conditions.
Concerning the allegation that the facility is not providing proper nutrition or hydration to clients, LPA inspected the facility’s food supplies and confirmed that sufficient and appropriate food was available, including special diet items consistent with physician orders. LPA also interviewed three staff members and three clients, who each denied the allegation.
Based on the evidence obtained through interviews, record review, and observations, there is not a preponderance of evidence to support that the alleged violations occurred. Therefore, the allegations are deemed UNSUBSTANTIATED. This means that while the reported concerns may have occurred or may be valid, there is not sufficient evidence to prove the facility violated applicable regulations.
No deficiencies were cited during today’s visit. An exit interview was conducted, and a copy of this report was provided to the facility.

SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Samer Haddadin
LICENSING EVALUATOR SIGNATURE:	DATE: 08/28/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2025

LIC9099 (FAS) - (06/04)

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