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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306004791
Report Date: 04/29/2026
Date Signed: 04/29/2026 10:18:22 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
02/26/2026 and conducted by Evaluator Eboni Bentley
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20260226163914
FACILITY NAME:LOS TIEMPOS SENIOR LIVING #3FACILITY NUMBER:
306004791
ADMINISTRATOR:FIGUEROA,LESLYFACILITY TYPE:
740
ADDRESS:10869 GOLDENEYE AVETELEPHONE:
(714) 928-7912
CITY:FOUNTAIN VALLEYSTATE: CAZIP CODE:
92708
CAPACITY:6CENSUS: 4DATE:
04/29/2026
UNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Rosa Janeth Figueroa - AdministratorTIME COMPLETED:
10:15 AM
ALLEGATION(S):
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Licensee admitted a resident without their consent.
Staff does not ensure that resident had reasonable access to a telephone.
Staff are not ensuring that resident has access to their personal possessions.
INVESTIGATION FINDINGS:
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On April 29, 2026, Licensing Program Analysts (LPAs) Eboni Bentley and Jessica Cho arrived at the facility unannounced for the purpose of conducting a subsequent complaint investigation and delivering findings for the above allegations. LPAs were greeted, introduced selves, and were granted entry after stating the purpose of the visit to staff. Licensee/Administrator (Admin) Rosa Janeth Figueroa was contacted via telephone and arrived shortly to assist with the visit. During the course of the investigation, LPAs reviewed and obtained copies of facility documents including Resident Roster, Staff Roster, Resident Emergency Info & Contact Sheets, Physician's Reports, Personal Rights, and signed Admission Agreement for Resident #1 (R1). Interviews were successfully conducted with three residents, four staff, and five witnesses, however LPAs were unable to obtain statements for the three remaining residents due to their medical condition.

CONTINUE TO LIC9099-C......
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Kevin Saborit-Guasch
LICENSING EVALUATOR NAME: Eboni Bentley
LICENSING EVALUATOR SIGNATURE:

DATE: 04/29/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2026
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
02/26/2026 and conducted by Evaluator Eboni Bentley
COMPLAINT CONTROL NUMBER: 22-AS-20260226163914

FACILITY NAME:LOS TIEMPOS SENIOR LIVING #3FACILITY NUMBER:
306004791
ADMINISTRATOR:FIGUEROA,LESLYFACILITY TYPE:
740
ADDRESS:10869 GOLDENEYE AVETELEPHONE:
(714) 928-7912
CITY:FOUNTAIN VALLEYSTATE: CAZIP CODE:
92708
CAPACITY:6CENSUS: DATE:
04/29/2026
UNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Rosa Janeth Figueroa - AdministratorTIME COMPLETED:
10:15 AM
ALLEGATION(S):
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Staff did not ensure that the resident had access to their medical equipment as necessary while in care.
Staff are not allowing resident to go on outings.
Staff are not allowing resident to have visitors.
INVESTIGATION FINDINGS:
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THIS PAGE AMENDED TO ADD ALL THREE ALLEGATIONS
Regarding the allegation, Staff did not ensure that the resident had access to their medical equipment as necessary while in care, it is alleged that staff did not ensure R1 had access to their oxygen concentrator the date of move-in and did not have working hearing aids. Four out of four staff interviewed stated R1 had their oxygen concentrator and hearing aids on the day of move-in, January 23, 2026, and added the resident often removes the oxygen from their nose for comfort. During interview, one of four staff stated they contacted R1’s POA after R1 moved in, reported R1’s hearing aids were not working, and requested R1’s ear doctor information for repair. POA provided the information, per staff and witness, and a record review of a receipt from All Ear Doctors dated January 27, 2026, revealed R1’s hearing aids were serviced four days after moving in. Staff stated All Ear Doctors determined that hearing aids were operational but needed to be powered off when charging in order to work properly.

CONTINUE TO LIC9099-C......
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kevin Saborit-Guasch
LICENSING EVALUATOR NAME: Eboni Bentley
LICENSING EVALUATOR SIGNATURE:

DATE: 04/30/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2026
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-20260226163914
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: LOS TIEMPOS SENIOR LIVING #3
FACILITY NUMBER: 306004791
VISIT DATE: 04/29/2026
NARRATIVE
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Two out of three witnesses present on January 23rd and confirmed via the sign in log, denied the allegation, stating R1 had an oxygen concentrator at the facility and hearing aids on the day of move in. When interviewed, R1 stated they could not recall if the oxygen concentrator was present at the facility on January 23rd or if the hearing aids were working properly on the same date. Per review of the Physician’s Report (LIC602) dated January 26, 2026, R1 is diagnosed with Mild Cognitive Impairment, which affects their memory. LPAs observed R1’s hearing aids were operational as R1 was able to hear clearly during the interview and R1 later confirmed. Per R1’s Medical Assessment/Physician’s Report (LIC602) dated January 26, 2026, the hearing aids were serviced one day after the medical assessment.

Regarding the allegation, Staff are not allowing resident to go on outings, it is alleged that R1’s friends and caregiver were no longer allowed to take R1 out of the facility for their personal appointment as of Wednesday, January 28, 2026. Based on the interviews, one out of six residents corroborated while the two residents denied the allegation. LPA was unable take statements for the remaining three residents due to their medical condition. Administrator Rosa Figueroa indicated that R1’s friends and caregiver were restricted from taking R1 out of the facility at the request of R1’s POA, and therefore the outing was denied. Based on the review of the California Power of Attorney (POA) for Health Care and Health Care Instruction Form dated, July 1, 2020, R1 appointed an agent to handle their health care and signed the Uniform Statutory Form POA on November 12, 2025. During an interview, R1’s POA stated outings were restricted with R1’s friends and caregiver due to safety concerns.

Regarding the allegation, Staff are not allowing resident to have visitors, it is alleged that R1 was no longer allowed to have visits from R1’s friends and caregiver as of Wednesday, January 28, 2026. Based on the interviews, one out of six residents corroborated while the two residents denied the allegation. LPA was unable to take statements for the remaining three residents due to their medical condition. Based on the review of the visitor log, LPA verified that R1’s friend visited R1 on January 23, 2026, and January 24, 2026. R1’s caregiver visited on January 24, 2026. Administrator Rosa Figueroa indicated that R1’s friends and caregiver were restricted from visiting R1 at the request of R1’s POA, and therefore visitation was denied. During an interview, R1’s POA stated visits were restricted with R1’s friends and caregiver due to safety concerns.

CONTINUE TO LIC9099-C......
SUPERVISORS NAME: Kevin Saborit-Guasch
LICENSING EVALUATOR NAME: Eboni Bentley
LICENSING EVALUATOR SIGNATURE:

DATE: 04/29/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 6
Control Number 22-AS-20260226163914
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: LOS TIEMPOS SENIOR LIVING #3
FACILITY NUMBER: 306004791
VISIT DATE: 04/29/2026
NARRATIVE
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Based on observations, interviews, and records reviewed, although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the above allegations are deemed UNSUBSTANTIATED.

An exit interview was conducted, and a copy of this report, and LIC811 were provided to Administrator Rosa Janeth Figueroa.
SUPERVISORS NAME: Kevin Saborit-Guasch
LICENSING EVALUATOR NAME: Eboni Bentley
LICENSING EVALUATOR SIGNATURE:

DATE: 04/29/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2026
LIC9099 (FAS) - (06/04)
Page: 4 of 6
Control Number 22-AS-20260226163914
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: LOS TIEMPOS SENIOR LIVING #3
FACILITY NUMBER: 306004791
VISIT DATE: 04/29/2026
NARRATIVE
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The investigation revealed the following:

Regarding the allegation, Licensee admitted a resident without their consent, it is alleged that Licensee/Administrator Figueroa coerced R1 to move in without their consent by deceiving R1, stating that they were staying at the facility on the day of move-in. R1 moved into the facility on January 23, 2026, per Admission Agreement dated January 17, 2026. Based on the review of the California Power of Attorney (POA) for Health Care and Health Care Instruction Form dated, July 1, 2020, R1 appointed an agent to handle their health care and signed the Uniform Statutory Form POA on November 12, 2025. According to R1, R1 appointed the same POA to pay their bills and handle all their financial affairs. Four out of five witnesses interviewed denied the allegation, stating R1 was admitted to the facility by POA and family member. Witnesses stated, R1 knew the licensee for several years prior to being admitted, and the licensee did not coerce R1 into moving into the facility. During the interview, R1 stated their POA moved them into the facility, and the licensee did not coerce them into moving into the facility without their consent. R1 stated they like the facility, staff take good care of them, and everyone is nice. R1 also stated they trust the POA.

Regarding the allegation, Staff does not ensure that resident had reasonable access to a telephone, it is alleged that R1’s family member had taken R1’s personal cell phone and staff are not ensuring that R1 had access to a telephone the day R1 moved in. During the tour, LPAs observed a working facility telephone number, (714) 964-6310, to be operational. R1 was also observed to have their personal cell phone during the visit. R1 denied the allegation, indicating that the phone was in their possession the day R1 moved into the facility.

Regarding the allegation, Staff are not ensuring that resident has access to their personal possessions, it is alleged that staff did not ensure resident had access to their personal possessions when moving in from previous facility. Based on the interviews, three out of six residents denied the allegation, stating staff were not responsible for, nor involved in transporting their personal belongings to the facility. LPAs were unable to take statements for the remaining three residents due to their medical condition. During the interview, R1 stated that it was their POA and family’s responsibility to bring their personal belongings from their condo. R1 confirmed all their personal belongings from the previous facility have been brought to the current facility.

CONTINUE TO LIC9099-C......
SUPERVISORS NAME: Kevin Saborit-Guasch
LICENSING EVALUATOR NAME: Eboni Bentley
LICENSING EVALUATOR SIGNATURE:

DATE: 04/29/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2026
LIC9099 (FAS) - (06/04)
Page: 5 of 6
Control Number 22-AS-20260226163914
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: LOS TIEMPOS SENIOR LIVING #3
FACILITY NUMBER: 306004791
VISIT DATE: 04/29/2026
NARRATIVE
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Five out of five witnesses denied the allegation stating staff were not involved in transporting the residents’ personal belongings to the facility, and confirmed R1’s oxygen concentrator and cell phone were brought to the facility by the witnesses. Witness #2 (W2) stated they brought the oxygen concentrator when R1 moved in on January 23, 2026, and this is corroborated by a review of the visitor log. Witness #3 (W3) stated they brought the cell phone to the facility on January 24, 2026, which is corroborated by a review of the visitor log. Witness #5 (W5), stated they brought R1’s computer to the new facility on January 26, 2026, and this is corroborated by the visitor log. Therefore, the department has determined that the staff did not prevent access of R1’s personal belongings as it was the responsibility of the witnesses to bring R1’s possessions from the previous to the current facility.

This agency has investigated the complaint alleging, Licensee admitted a resident without their consent, Staff does not ensure that resident had reasonable access to a telephone, and Staff are not ensuring that resident has access to their personal possessions. We have found that the complaint was UNFOUNDED, meaning that the allegations were false, could not have happened and/or is without a reasonable basis.

An exit interview was conducted, and a copy of this report, and LIC811 were provided to Administrator Rosa Janeth Figueroa.
SUPERVISORS NAME: Kevin Saborit-Guasch
LICENSING EVALUATOR NAME: Eboni Bentley
LICENSING EVALUATOR SIGNATURE:

DATE: 04/29/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2026
LIC9099 (FAS) - (06/04)
Page: 6 of 6