<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306004668
Report Date: 07/28/2026
Date Signed: 07/28/2026 11:34:59 AM

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
03/20/2023 and conducted by Evaluator Jessica Cho
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20230320140108
FACILITY NAME:PRIMROSE RESIDENTAL CAREFACILITY NUMBER:
306004668
ADMINISTRATOR:LACY FADDOULFACILITY TYPE:
740
ADDRESS:651 PRIMROSE STREET S.TELEPHONE:
(949) 682-5229
CITY:ANAHEIMSTATE: CAZIP CODE:
92804
CAPACITY:6CENSUS: 5DATE:
07/28/2026
UNANNOUNCEDTIME BEGAN:
08:15 AM
MET WITH:Miriam Esquivel- House ManagerTIME COMPLETED:
11:35 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff abused resident in care.
Staff denied resident access to their personal funds.
The licensee did not provide proper notice of increase in rate.
Staff are unqualified to meet residents needs.
Residents are not allowed to choose their physician.
Staff denied resident's room and roommate choice.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On July 28, 2026, Licensing Program Analyst (LPA) Jessica Cho made an unannounced visit for the purpose of continuing the investigation and delivering findings into the above allegations. LPA was greeted and granted entry after stating the purpose of the visit. During the course of the investigation, a walkthrough of the physical plant and four residents, five staff, one witness interivews were conducted. A record review and copies of the following documentation were obtained: Resident Rosters, Personnel Report Summary, Face Sheets, Admission Agreements, Physician's Reports, Personal Rights, Inividual Program Plans (IPPs), ledgers, and resident check. Also obtained are personnel records consisting of Face Sheets and training certificates.

The investigation is as follows: Regarding the allegation, Staff abused resident in care, it is alleged Staff #1 (S1) would isolate, berate, insult resident(s) due to their mental faculties, appearance, and weight. Also alleged, S1 would ignore and verbally/physically abuse resident(s).
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Jessica Cho
LICENSING EVALUATOR SIGNATURE:

DATE: 04/16/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/16/2026
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
03/20/2023 and conducted by Evaluator Jessica Cho
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20230320140108

FACILITY NAME:PRIMROSE RESIDENTAL CAREFACILITY NUMBER:
306004668
ADMINISTRATOR:LACY FADDOULFACILITY TYPE:
740
ADDRESS:651 PRIMROSE STREET S.TELEPHONE:
(949) 682-5229
CITY:ANAHEIMSTATE:CAZIP CODE:
92804
CAPACITY:6CENSUS: 5DATE:
07/28/2026
UNANNOUNCEDTIME BEGAN:
08:15 AM
MET WITH:Miriam Esquivel- House ManagerTIME COMPLETED:
11:35 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Licensee is the residents' power of attorney.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On July 28, 2026, Licensing Program Analyst (LPA) Jessica Cho made an unannounced visit for the purpose of continuing the investigation and delivering findings into the above allegation. LPA was greeted and granted entry after stating the purpose of the visit. During the course of the investigation, a walkthrough of the physical plant and four residents, five staff, one witness interivews were conducted. A record review and copies of the following documentation were obtained: Resident Rosters, Personnel Report Summary, Face Sheets, Admission Agreements, Physician's Reports, Personal Rights, Inividual Program Plan (IPP), ledger, and resident checks. Also obtained are personnel records consisting of Face Sheets and training certificates.

Regarding the allegation, Licensee is the residents' power of attorney, it is alleged S1 is the agent for the power of attorney for R1. Four of four staff interviewed confirmed R1 is/was not a resident at this facility also verified per the Individual Program Plan (IPP) dated January 17, 2023, and Resident Rosters dated May 12, 2022, and November 15, 2025.
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Jessica Cho
LICENSING EVALUATOR SIGNATURE:

DATE: 07/28/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/28/2026
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-20230320140108
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: PRIMROSE RESIDENTAL CARE
FACILITY NUMBER: 306004668
VISIT DATE: 07/28/2026
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
The admission agreements and IPPs do not indicate S1 as the designated agent for the power of attorney (POA) for any of the five current residents registered to this time. The admission agreements were signed by the resident or the responsible person other than S1.

Therefore, this agency has investigated the complaint and based on interviews which were conducted and the records that were reviewed, the allegation is deemed UNFOUNDED. We have found that the complaint was 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 House Manager Miriam Esquivel, and a copy of this report was provided at exit.
SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Jessica Cho
LICENSING EVALUATOR SIGNATURE:

DATE: 07/28/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/28/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 6
Control Number 22-AS-20230320140108
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: PRIMROSE RESIDENTAL CARE
FACILITY NUMBER: 306004668
VISIT DATE: 07/28/2026
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
Based on observations conducted on August 22-23, 2023, April 7, 2026, and April 16, 2023, residents were treated with respect and dignity. Staff were observed to be courteous, kind, and professional during the visits. Based on the interviews, one out of four residents indicated S1 would "beat up" and "slap" their friend but had not provided further context to corroborate the abuse had occurred towards self. Four of four staff denied the allegation indicating residents are not discriminated against, treated with respect, and dignity. The Individual Program Plan dated January 17, 2023, and Resident Rosters dated May 12, 2022, and November 15, 2025, indicate Resident #1 (R1) is/was not a resident of this facility. LPAs were unable to interview Resident #2 (R2) as contact information and records were unavailable due to R2 moving out in 2016.

Regarding the allegation, Staff denied resident access to their personal funds, it is alleged R2 was denied access to their funds. R2 was not interviewed as contact information, and records were unavailable due to R2 moving out in 2016. Additionally, R1's Individual Program Plan (IPP) dated January 17, 2023, and Resident Rosters dated May 12, 2022, and November 15, 2025, indicate R1 is/was not a resident of this facility. LPAs observed the Personal and Incidental (P&I) funds secured in a locked safe in the living room. Based on the review of the available P&I funds, LPA verified the amount available was accurate according to the ledger. Based on the interviews, three out of four residents denied the allegation as the residents indicated trusting and relying on S1, with their finances and being able to access their funds as needed. One resident could not be interviewed due to their medical condition. Based on the review of the IPPs and Admission Agreements of current residents, the licensee is the designated payee to handle three of four residents’ cash resources which includes incidental expense monies (P&I) while one resident independently manages their own finances. S1 denied the public guardian receiving commission for resident referrals. Three out of four interviewed staff did not corroborate with the allegation.

Regarding the allegation, the licensee did not provide proper notice of increase in rate, it is alleged there was an unexplainable, significant rate hike, and depletion of resident's finances once residents were referred to the facility. None of the residents were able to provide details about their shared cost and notice of increase during the interviews. Three of the four staff were also unable to provide information. S1 indicated an increase of their shared cost was on January 1st of each year when the Social Security (SSI) rate increased. The increase would then be discussed during the annual or quarterly meetings with the regional center, resident, and their representative per S1. S1 indicated the regional center would reimburse the facility for the cost of living.
SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Jessica Cho
LICENSING EVALUATOR SIGNATURE:

DATE: 07/28/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/28/2026
LIC9099 (FAS) - (06/04)
Page: 4 of 6
Control Number 22-AS-20230320140108
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: PRIMROSE RESIDENTAL CARE
FACILITY NUMBER: 306004668
VISIT DATE: 07/28/2026
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
In review of the signed admission agreements, the admission agreement states that the facility would provide a "60 day written notice to the resident or the person responsible." Residents were not informed within the 60 day period because the regional center provides the information during the annual/quarterly meetings at the time S1 would be notified as well. R2 was not interviewed as contact information, and records were unavailable due to R2 moving out in 2016. Additionally, R1's Individual Program Plan (IPP) dated January 17, 2023, and Resident Rosters dated May 12, 2022, and November 15, 2025, indicate R1 is/was not a resident of this facility.

Regarding the allegation, Staff are unqualified to meet the resident’s needs, it is alleged staff do not have adequate training or the ability to communicate in English to understand the resident’s needs. Based on the review of three staff files, fingerprint/background clearance transfers, annual training requirements, CPR/First Aid, and health clearances were met. Interviews revealed two of three staff did present to have some challenges understanding and communicating in English. However, both staff indicated their level of understanding and speaking does not impact the care and supervision of the residents and their needs. Four of four residents indicated that their needs had been met so far and did not experience much trouble communicating with staff.

Regarding the allegation, Residents are not allowed to choose their physician, it is alleged the facility had a “preferred” physician for all the residents including R1. R1 is/was not a registered resident. Based on the interviews, two of four staff denied the allegation while the remaining two staff did not have information to provide. Three of the four current residents were not aware who their current doctor is while one of the residents expressed satisfaction with S1 selecting their doctor.

Regarding the allegation, Staff denied resident’s room and roommate choice, it is alleged Resident #3 (R3) had shared a room with R2. R2 had requested a different room in the facility due to R2 sleeping nude at the time. R2 and R3 are former residents, and LPA was unable to obtain their records as it had been over 3 years since the residents had not resided at the facility. Based on the walk through of the physical plant, there is one private bedroom and two shared bedrooms. Interviews revealed one of four residents being unsatisfied with their living arrangement but indicated getting along with their current roommate. Based on observations, the private bedroom is occupied by another resident, and the interviewed resident had already moved back from the other shared bedroom which they had already occupied before.
SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Jessica Cho
LICENSING EVALUATOR SIGNATURE:

DATE: 07/28/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/28/2026
LIC9099 (FAS) - (06/04)
Page: 5 of 6
Control Number 22-AS-20230320140108
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: PRIMROSE RESIDENTAL CARE
FACILITY NUMBER: 306004668
VISIT DATE: 07/28/2026
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
Based on observation, interviews, and record review, although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are deemed UNSUBSTANTIATED.

An exit interview was conducted with House Manager Miriam Esquivel, and a copy of this report was provided at exit.
SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Jessica Cho
LICENSING EVALUATOR SIGNATURE:

DATE: 07/28/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/28/2026
LIC9099 (FAS) - (06/04)
Page: 6 of 6