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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306004596
Report Date: 04/30/2025
Date Signed: 04/30/2025 03:02:22 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
12/03/2021 and conducted by Evaluator Joseph Alejandre
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20211203092746
FACILITY NAME:JON ADULT RESIDENTIAL CARE HOMEFACILITY NUMBER:
306004596
ADMINISTRATOR:LEONCIO CANLASFACILITY TYPE:
735
ADDRESS:3801 LARIAT PLACETELEPHONE:
(714) 770-0892
CITY:FULLERTONSTATE: CAZIP CODE:
92835
CAPACITY:6CENSUS: 0DATE:
04/30/2025
UNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Enriqueta Gallegos TIME COMPLETED:
03:15 PM
ALLEGATION(S):
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Facility not providing activities to clients
Facility neglected client by not feeding them for two days
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Joseph Alejandre arrived unannounced for the purpose of delivering findings on this complaint. LPA met with Lead Staff member Enriqueta Gallegos and discussed the disposition. This complaint was opened on the morning of December 9, 2021 when an unannounced visit was made to the facility. A case management was also conducted on December 9, 2021 in the afternoon addressing some of the complaint allegations. Documents obtained during these visits are no longer available for review. The reports generated by this Agency for the December 9, 2021, visits do not address the issue of client activities. The complaint narrative is moot on the topic. A virtual visit conducted on April 22, 2025 by this Agency verifies that the facility is currently providing appropriate activities for clients in care. The allegation that clients were not fed for two days was addressed in a Regional Center Incident Report dated December 2, 2021 and concluded that the allegation was unsubstantiated and stemmed from client’s dislike of certain foods served. Although the allegations may be true, based upon statements, documents reviewed and observations made, there is not a preponderance of evidence to prove, or disprove, the allegations.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Joseph Alejandre
LICENSING EVALUATOR SIGNATURE:

DATE: 04/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2025
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 6
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
12/03/2021 and conducted by Evaluator Joseph Alejandre
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20211203092746

FACILITY NAME:JON ADULT RESIDENTIAL CARE HOMEFACILITY NUMBER:
306004596
ADMINISTRATOR:LEONCIO CANLASFACILITY TYPE:
735
ADDRESS:3801 LARIAT PLACETELEPHONE:
(714) 770-0892
CITY:FULLERTONSTATE: CAZIP CODE:
92835
CAPACITY:6CENSUS: 0DATE:
04/30/2025
UNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Enriqueta Gallegos TIME COMPLETED:
03:15 PM
ALLEGATION(S):
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9
Facility is in disrepair
Facility is lacking food
Facility not providing food options to clients
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Joseph Alejandre arrived unannounced for the purpose of delivering findings on this complaint. LPA met with Lead Staff member Enriqueta Gallegos and discussed the disposition. According to Orange County Regional Center Incident report dated December 2, 2021, representatives from the Agency observed on June 15, 2021, the front door of the facility not operating properly. Facility staff admitted that the door did not lock and that a bungee cord was being used to keep a resident from eloping from the facility. Unannounced visits by Regional Center staff on July 12, 2021, and December 14, 2021, to the facility found that the front door alarm not operating properly and that the food supply did not meet the requirements of Title Twenty-Two and that clients were not offered sufficient variety of food and that there was no fresh perishable food, such as fruits and vegetables or juice on hand. An unannounced visit to the facility by this Agency on December 9, 2021 found that staff were not following the posted menu, and that the food supply was inadequate and did not meet the requirements for sufficient perishable food. Based upon the documents reviewed, statements made, and observations made by this and an outside Agency,
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Joseph Alejandre
LICENSING EVALUATOR SIGNATURE:

DATE: 04/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 6
Control Number 22-AS-20211203092746
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: JON ADULT RESIDENTIAL CARE HOME
FACILITY NUMBER: 306004596
VISIT DATE: 04/30/2025
NARRATIVE
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 the preponderance of evidence standard has been met. Therefore, the allegations are SUBSTANTIATED. The following deficiencies were observed (see LIC 9099D) and cited from the California Code of Regulations, Title 22, Division 6 of California Code of Regulations. Failure to correct the deficiency and/or repeat deficiencies within a 12-month period may result in civil penalties. Exit interview conducted and a copy of the report and appeal rights was provided.
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Joseph Alejandre
LICENSING EVALUATOR SIGNATURE:

DATE: 04/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 6
Control Number 22-AS-20211203092746
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: JON ADULT RESIDENTIAL CARE HOME
FACILITY NUMBER: 306004596
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/30/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/01/2025
Section Cited
CCR
80087(a)
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80087(a) Buildings and Grounds. The facility shall be clean, safe, sanitary and in good repair at all times for the safety and well-being of clients, employees and visitors. Based on observations and statements, this requirement has not been met as evidenced by...
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POC: Cleared at time of visit. Virtual visit on 04/22/2025 and site visits on 5/9/23; 12/7/23; 6/13/24; 10/16/24 and 12/4/24 by this Agency indicate no deficiencies regarding the facility front door or alarm system.
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Front door observed on 06/15/2021 to be locked with a bungee cord and on 7/12/2021 and 12/14/2021 the front door alarm did not operate properly. This posed an immediate risk to the welfare and personal rights of the clients in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Joseph Alejandre
LICENSING EVALUATOR SIGNATURE:

DATE: 04/30/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 6
Control Number 22-AS-20211203092746
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: JON ADULT RESIDENTIAL CARE HOME
FACILITY NUMBER: 306004596
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/30/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/07/2025
Section Cited
CCR
85076(d)(1)
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85076(d)(1) Food Service…Supplies of staple nonperishable foods for a minimum of one week and fresh perishable foods for a minimum of two days shall be maintained on the premises. Based on observations and documents reviewed, this requirement has not been met as evidenced by...
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POC: Cleared at time of visit. Site visits by this agency on 5/9/2023; 12/07/2023; 6/13/2024; 10/16/2024 and 12/04/2024 found no deficiencies regarding the facility’s food service.
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Visits by this Agency on 12/09/2021 and Orange County Regional Center on 7/12/2021 and 12/14/2021 found facility did not have required amounts of fresh perishable foods on hand. This posed a potential risk to the health of clients in care.
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Type B
05/07/2025
Section Cited
CCR
80076(a)(1)
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80076(a)(1) Food Services. All food shall be safe and of the quality and in the quantity necessary to meet the needs of the clients. Based on observation and documents reviewed, this requirement has not been met as evidenced by:
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POC: Cleared at time of visit. Site visits by this agency on 5/9/2023; 12/07/2023; 6/13/2024; 10/16/2024 and 12/04/2024 found no deficiencies regarding the facility’s food service.
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 An unannounced visit by this Agency on 12/09/2021 found no ham, bacon, or juice in the facility’s food supply in order to follow the posted menu. This posed a potential risk to the health and personal rights of the clients in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Joseph Alejandre
LICENSING EVALUATOR SIGNATURE:

DATE: 04/30/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 6
Control Number 22-AS-20211203092746
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: JON ADULT RESIDENTIAL CARE HOME
FACILITY NUMBER: 306004596
VISIT DATE: 04/30/2025
NARRATIVE
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Therefore, the allegations are UNSUBSTANTIATED. An exit interview was conducted and a copy of the report provided.
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Joseph Alejandre
LICENSING EVALUATOR SIGNATURE:

DATE: 04/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2025
LIC9099 (FAS) - (06/04)
Page: 6 of 6