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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306005453
Report Date: 03/27/2026
Date Signed: 05/08/2026 09:04:52 AM

Substantiated


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
03/11/2026 and conducted by Evaluator Samer Haddadin
COMPLAINT CONTROL NUMBER: 22-AS-20260311085816
FACILITY NAME:SILVER LINING RESIDENTIAL CAREFACILITY NUMBER:
306005453
ADMINISTRATOR:FADDOUL, LACYFACILITY TYPE:
740
ADDRESS:1243 N. BROOKHURST STREETTELEPHONE:
(661) 810-7293
CITY:ANAHEIMSTATE: CAZIP CODE:
92801
CAPACITY:14CENSUS: DATE:
03/27/2026
UNANNOUNCEDTIME BEGAN:
08:33 AM
MET WITH:Lacy FaddoulTIME COMPLETED:
03:49 PM
ALLEGATION(S):
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Staff did not allow resident to return to the facility
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Samer Haddadin conducted an announced visit to deliver findings regarding the above-mentioned allegation. Upon arrival, LPA was greeted and granted entry by staff and later met with Licensee Lacy Faddoul. LPA explained the purpose of the visit.
It was alleged that “Staff did not allow resident to return to the facility.” During the course of the investigation, LPA reviewed facility records and conducted interviews with staff, residents, the Responsible Party, and the Licensee.
LPA reviewed Resident 1’s (R1) Admission Agreement, dated May 8, 2025, which confirmed that R1 was admitted to Silver Lining Residential Care. LPA also reviewed an incident report dated February 23, 2026, which documented that R1 became physically aggressive toward staff and physically assaulted another resident. The report further indicated that R1 was taken by the CAT team on a 5150 hold for 72 hours.
{***CONTINUE9099C*** {***THIS IS AN AMENDED REPORT***}
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Samer Haddadin
LICENSING EVALUATOR SIGNATURE:

DATE: 03/27/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/27/2026
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 3
Control Number 22-AS-20260311085816
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: SILVER LINING RESIDENTIAL CARE
FACILITY NUMBER: 306005453
VISIT DATE: 03/27/2026
NARRATIVE
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LPA conducted interviews with four staff members, all of whom corroborated the allegation. Staff stated they feared for their safety if R1 were to return to the facility. LPA also interviewed R1’s Responsible Party, who corroborated the allegation and stated that the facility did not want R1 to return due to R1’s behavior at the facility. In addition, LPA interviewed the Licensee, who confirmed that the facility did not want R1 to return because of concerns for the safety of both residents and staff. LPA also conducted interviews with three residents, all of whom stated they observed R1 behaving aggressively toward another resident; however, they were unable to state whether R1 had been permitted to return to the facility.
LPA’s record review further revealed that, pursuant to the Admission Agreement, the facility was required to provide R1 with a written 30-day eviction notice if it intended to evict the resident. However, no written eviction notice was provided. During the interview, the Licensee admitted that no written eviction notice had been issued to R1.
Based on the evidence gathered the preponderance of evidence standard has been met therefore the allegation is substantiated. An exit interview was conducted and a copy of the report provided along with appeal rights.
{***THIS IS AN AMENDED REPORT***}
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Samer Haddadin
LICENSING EVALUATOR SIGNATURE:

DATE: 03/27/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/27/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 22-AS-20260311085816
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: SILVER LINING RESIDENTIAL CARE
FACILITY NUMBER: 306005453
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/27/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
03/30/2026
Section Cited
CCR
87224(c)
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87224 Eviction Procedures
(c) The licensee shall, in addition to either serving the required thirty (30) days notice, sixty (60) days notice or... three (3) days notice on the resident, notify or mail a copy of the notice to quit to the resident's responsible person.
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The licensee agrees to read and review regulation section 87224 on Eviction Procedures. The licensee will send a signed statement of acknowledgement and understanding to LPA by the close of business on the POC due date
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This requirement was not met as evidenced by: not accepting R1 back to the facility, which poses an immediate personal rights risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Samer Haddadin
LICENSING EVALUATOR SIGNATURE:

DATE: 03/27/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/27/2026
LIC9099 (FAS) - (06/04)
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