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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306005566
Report Date: 08/06/2024
Date Signed: 08/06/2024 03:07:51 PM

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
08/02/2024 and conducted by Evaluator Joseph Alejandre
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20240802123802
FACILITY NAME:A1 RCFE @ DELPHINEFACILITY NUMBER:
306005566
ADMINISTRATOR:VILLARMINO, SHIRLEYFACILITY TYPE:
740
ADDRESS:923 HUGGINS AVETELEPHONE:
(714) 399-5040
CITY:PLACENTIASTATE: CAZIP CODE:
92870
CAPACITY:6CENSUS: 6DATE:
08/06/2024
UNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Shirley VillarminoTIME COMPLETED:
03:15 PM
ALLEGATION(S):
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Facility is in financial distress.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Joseph Alejandre made an unannounced visit to conduct the required 10-day visit to begin the investigation into the allegation listed above. LPA met with Administrator Shirley Villarmo and explained the reason for the visit. LPA and Administrator toured the facility. LPA observed the facility has electricity, gas, water, internet and phone service. LPA observed the kitchen is clean and organized. LPA observed the kitchen is clean and organized. Medications are kept locked in a kitchen cabinet and knives are kept locked in a kitchen drawer. LPA interviewed staff and the Administrator. The Administrator reported that rent and all utilities have been paid for the month of August. The Administrator reported that the Licensee BBML Homes Inc. has declared bankruptcy. LPA reviewed the bank statement for the Licensee and verified the facility does not have 3 months of operating costs in the account. No Health and Safety concerns noted during the visit. Based on the information gathered the preponderance of evidence standard has been met, therefore the allegation is substantiated. Deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. An exit interviewed was conducted and a copy of the report along with appeal rights was provided to the Administrator.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Sheila SantosTELEPHONE: (714) 334-2062
LICENSING EVALUATOR NAME: Joseph AlejandreTELEPHONE: 714-705-6018
LICENSING EVALUATOR SIGNATURE:

DATE: 08/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2024
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-20240802123802
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: A1 RCFE @ DELPHINE
FACILITY NUMBER: 306005566
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/06/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/07/2024
Section Cited
CCR
87213
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The licensee shall have a financial plan that conforms to the requirements of Section 87155, Application for License, and that assures sufficient resources to meet operating costs for care of residents;...
This requirement is not being met as evidenced by...
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The Licensee agrees to submit a plan that ensures the facility will have sufficient resources to meet the operating costs to meet the needs of the residents. Licensee to submit the plan to the LPA for approval.
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The Administrator verified that the Licensee has filed for bankruptcy and facility documents show the facility does not have sufficient funds to operate the facility which poses an immediate Health and Safety risk to residents 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.
SUPERVISOR'S NAME: Sheila SantosTELEPHONE: (714) 334-2062
LICENSING EVALUATOR NAME: Joseph AlejandreTELEPHONE: 714-705-6018
LICENSING EVALUATOR SIGNATURE:

DATE: 08/06/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2024
LIC9099 (FAS) - (06/04)
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