306005442-9-23-2025-22-AS-SSAS-DLYPCC-20250929111142

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306005442
Report Date: 09/23/2025
Date Signed: 09/23/2025 10:59:41 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
03/02/2022 and conducted by Evaluator Ruth Martinez

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20220302111029

FACILITY NAME:	EASTERSEALS SOUTHERN CALIFORNIA - COUNTRY HILLS		FACILITY NUMBER:	306005442
ADMINISTRATOR:	ARMANDO FLORES		FACILITY TYPE:	735
ADDRESS:	640 WEST COUNTRY HILLS DRIVE		TELEPHONE:	(714) 526-4079
CITY:	LA HABRA	STATE: CA	ZIP CODE:	90631
CAPACITY:	4	CENSUS: 3	DATE:	09/23/2025
		UNANNOUNCED	TIME BEGAN:	10:05 AM
MET WITH:	Sean Estrella, Administrator		TIME COMPLETED:	11:35 AM

ALLEGATION(S):

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-Staff grabbed resident.
-Staff yelling at resident.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Ruth Martinez conducted an unannounced visit to the facility to conclude the investigation into the above identified complaint allegations. LPA arrived at the facility and was greeted at the door and granted entry. LPA spoke with Sean Estrella, Administrator and explained the purpose of the visit.

Findings are based upon this investigation which included facility file review, and interviews conducted.

It is alleged that staff grabbed resident, specifically while dealing with a behavior episode from a client. Record review revealed that preplacement dated November 27, 2018, indicates client (C1) behaviors are pushing others and attempts to bite others. C1 does not tolerate change well and may become upset or

Continued on LIC9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Ruth Martinez
LICENSING EVALUATOR SIGNATURE:	DATE: 09/23/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/23/2025

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-20220302111029

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: EASTERSEALS SOUTHERN CALIFORNIA - COUNTRY HILLS	FACILITY NUMBER: 306005442
	VISIT DATE: 09/23/2025

NARRATIVE

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agitated. C1’s semi-annual states intervention plan for current behavior excess such as verbal outburst, property destruction, physical aggression and self-injuries behavior. The interview with 2 of 2 staff stated that the regular staff that assist C1 was not on shift and staff on shift had to assist. C1 became upset because the regular staff that assisted client was not on shift. C1 began to yell and swing their arms at staff. Staff did not see assisting staff grab the client, however they did see that staff covered themselves with their arms to avoid C1 to swing arms at them.

It is alleged staff yelling at resident, specifically while a client was having a behavior episode. The interview with 2 of 2 staff stated that they heard C1 yelling out of an outburst and swinging their arms at staff. Staff assisting C1 kept asking C1 to stop repeatedly, but was not observed to be yelling. However, C1 was heard yelling at staff repeatedly, until another staff came to assist and took C1 outside to calm them down.

Based on the information mentioned above, the Department is unable to ascertain if the allegation occurred as reported. Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove or refute the alleged violation occurred; therefore, this allegations are deemed Unsubstantiated.

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

SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Ruth Martinez
LICENSING EVALUATOR SIGNATURE:	DATE: 09/23/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/23/2025

LIC9099 (FAS) - (06/04)

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