306004655-11-4-2024-22-AS-SSAS-DAYQGD-20241113110921

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306004655
Report Date: 11/04/2024
Date Signed: 11/04/2024 08:51:14 AM

Unfounded

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
05/21/2024 and conducted by Evaluator Ruth Martinez

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20240521101351

FACILITY NAME:	LAS ESTANCIAS ASSISTED CARE		FACILITY NUMBER:	306004655
ADMINISTRATOR:	CELIA RODRIGUEZ		FACILITY TYPE:	740
ADDRESS:	1409 WHITTIER AVENUE		TELEPHONE:	(714) 488-9995
CITY:	BREA	STATE: CA	ZIP CODE:	92821
CAPACITY:	6	CENSUS: 4	DATE:	11/04/2024
		UNANNOUNCED	TIME BEGAN:	07:40 AM
MET WITH:	Celia Rodriguez		TIME COMPLETED:	09:10 AM

ALLEGATION(S):

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-Patient's rights violaton.
-Resident is being evicted illegally from the facility.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Ruth Martinez visited the facility to deliver findings for the investigation into the above identified complaint allegation. LPA arrived at facility and was greeted at the door by staff and granted entry. LPA spoke with Celia Rodriguez, Administrator and explained the purpose of the visit.

Findings are based upon this investigation which included records review, interviews with the following: 3 out of 3 staff interviewed, a witness and 3 of 3 residents.
It is alleged that patient’s rights violation. Record review from Providence St. Jude Medical Center on May 5, 2024, indicated that resident (R1) was discharge as follows patient other criteria for discharge: will go with infinite hospice to board and care. Records for Newport Hospice indicate that R1 was admitted on hospice care on May 6, 2024, singed by R1’s responsible party. Interview with 3 of 3 staff indicated that R1 was in the hospital and when discharged they were placed on hospice care. When R1 returned to the

Continued LIC9099-C

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Armando J Lucero	TELEPHONE: (949) 430-1222
LICENSING EVALUATOR NAME: Ruth Martinez	TELEPHONE: (657) 285-1397
LICENSING EVALUATOR SIGNATURE:	DATE: 11/04/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/04/2024

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-20240521101351

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: LAS ESTANCIAS ASSISTED CARE	FACILITY NUMBER: 306004655
	VISIT DATE: 11/04/2024

NARRATIVE

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facility they were already on hospice care. R1 was discharged on Infinite Hospice, but R1’s responsible party decided to go with Newport Hospice the day R1 was released, and it was changed. Interview with 3 of 3 residents indicated that they had never witnessed staff yelling at another resident or to them.
It is alleged that resident is being evicted illegally from the facility. Interview with witness (W1) revealed that the Administrator told them, “They would be happier if they moved somewhere else". The Administrator denied this report. The Administrator reported that an eviction notice was never sent to R1 or their responsible party. This information was verified by W1. R1 was moved out on May 29, 2024, by choice of responsible party. R1's belongings were moved out of the facility by June 8, 2024. W1 verified that they decided to move R1 out of the facility and they were not forced to move. None of the evidence gathered supports the allegation.

We have found the complaint allegation is unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. We have therefore dismissed the complaint.

An exit interview was conducted with Administrator and a copy of this LIC9099 report was left at facility.

SUPERVISOR'S NAME: Armando J Lucero	TELEPHONE: (949) 430-1222
LICENSING EVALUATOR NAME: Ruth Martinez	TELEPHONE: (657) 285-1397
LICENSING EVALUATOR SIGNATURE:	DATE: 11/04/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/04/2024

LIC9099 (FAS) - (06/04)

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