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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306004718
Report Date: 11/19/2025
Date Signed: 11/19/2025 04:32:32 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
02/04/2021 and conducted by Evaluator Andrea Mendivil
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20210204134059
FACILITY NAME:GROVES OF TUSTIN, THEFACILITY NUMBER:
306004718
ADMINISTRATOR:LIANA FOOTEFACILITY TYPE:
740
ADDRESS:1262 BRYAN AVETELEPHONE:
(714) 730-5009
CITY:TUSTINSTATE: CAZIP CODE:
92780
CAPACITY:100CENSUS: 68DATE:
11/19/2025
UNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Robin Aquino - Regional Faciltiy Director TIME COMPLETED:
12:30 PM
ALLEGATION(S):
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9
Resident was neglected and lacked proper care and supervision.
INVESTIGATION FINDINGS:
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On this day, Licensing Program Analyst (LPA) Andrea Mendivil made an unannounced visit to deliver complaint findings. LPA was greeted and granted entry into the faciltiy by staff and explained the reason for the visit.

The Department received a complaint on 02/04/2021 and LPA Chin conducted the initial 10 day visit on 02/10/2021. LPA Chin conducted interviews of staff and resident. Regarding the allegation resident was neglected and lacked proper care and supervision, the investigation revealed the following:

It was reported that Resident 1 (R1) had a wtinessed fall and hit their head. It was reported that R1 was diagnosed with Parkinsons and was able to ambulate based on interviews with Debbie Garibaldi, Resident Care Director. Per interviews with 3 out of 3 staff that worked at the faciltiy in 2021 stated they were able to meet residents needs and they did not neglect residents.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Andrea Mendivil
LICENSING EVALUATOR SIGNATURE:

DATE: 11/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/19/2025
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-20210204134059
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME: GROVES OF TUSTIN, THE
FACILITY NUMBER: 306004718
VISIT DATE: 11/19/2025
NARRATIVE
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Interviews with 7 out of 7 residents stated their needs are met and staff is not neglectful. Based on interviews with residents they stated that the staff is very helpful and responsive.

Therefore based on the preponderance of evidence through interviews the allegation that resident was neglected and lacked proper care and supervision, is determined to be UNSUBSTANTIATED, meaning that although the allegation may have happened or are valid, there is not a preponderance of evidence to prove that the alleged violation occurred.

No deficiencies cited.
An exit interview was conducted and a copy of this report was provided.
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Andrea Mendivil
LICENSING EVALUATOR SIGNATURE:

DATE: 11/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/19/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2