306005316-5-15-2026-22-AS-APAO-DU4RJ8-20260515130330

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306005316
Report Date: 05/12/2026
Date Signed: 05/15/2026 08:34:25 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
Lookup Error,
, CA

This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/12/2024 and conducted by Evaluator Avelina Martinez

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20241112115343

FACILITY NAME:	ANAHEIM CROWN PLAZA		FACILITY NUMBER:	306005316
ADMINISTRATOR:	KIM N KINCAID		FACILITY TYPE:	740
ADDRESS:	641 SOUTH BEACH BLVD		TELEPHONE:	(714) 827-7007
CITY:	ANAHEIM	STATE: CA	ZIP CODE:	92804
CAPACITY:	200	CENSUS: 143	DATE:	05/12/2026
		UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Administrator- Gerardo Rodriguez		TIME COMPLETED:	01:15 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Facility staff are not preventing inappropriate interactions between residents.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

On May 12, 2026 at 1:00 PM, Licensing Program Analyst (LPA) Avelina Martinez conducted a MicrosoTeams meeting with Facility Designated Administrators for the purpose of delivering complaint findings for the allegation above.

Throughout the course of this investigation, LPA Martinez conducted interviews. The Orange County Regional Office obtained facility records. The investigation revealed there are no concerns relating to facility staff are not preventing inappropriate interactions between residents in care. When interviewed, resident 1 (R1) reported that they have not recently had any inappropriate interactions with other residents in care. R1 reported they have no concerns regarding staff are not preventing inappropriate interactions between residents in care. Due to the above noted information, although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, and therefore the allegation is unsubstantiated. An exit interview was conducted, and a copy of this report was provided to the facility. A copy of this report was provided via email and an electronic email read receipt confirms receiving these documents.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Czarrina A Camilon-Lee
LICENSING EVALUATOR NAME: Avelina Martinez
LICENSING EVALUATOR SIGNATURE:	DATE: 05/12/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2026

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 1