306005636-8-28-2026-22-AS-SSAS-DXTN5B-20260911100916

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306005636
Report Date: 08/28/2026
Date Signed: 08/28/2026 03:40:11 PM

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
06/02/2026 and conducted by Evaluator Alvaro Ramirez Jr.

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20260602154618

FACILITY NAME:	MAINPLACE SENIOR LIVING		FACILITY NUMBER:	306005636
ADMINISTRATOR:	RHONWINN HIPOLITO		FACILITY TYPE:	740
ADDRESS:	1800 1832 W. CULVER AVENUE		TELEPHONE:	(714) 978-2534
CITY:	ORANGE	STATE: CA	ZIP CODE:	92868
CAPACITY:	153	CENSUS: 117	DATE:	08/28/2026
		UNANNOUNCED	TIME BEGAN:	12:16 PM
MET WITH:	Rhonwinn Hipolito-Executive Director		TIME COMPLETED:	03:15 PM

ALLEGATION(S):

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Staff do not distribute residents' medications as prescribed
Staff are falsifying information to licensing

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Alvaro Ramirez, Jr. conducted an unannounced visit to deliver findings on the above allegations received on June 2, 2026. LPA was greeted and granted entry into the facility and met with Executive Director (ED) Rhonwinn Hipolito. LPA explained the reason for the visit.

This Department has investigated the complaint alleging that staff do not distribute the residents' medication as prescribed. Regarding the allegation the following was revealed: During the initial visit LPA reviewed the Medication Administration Record (MAR) dated June 1, 2026, to June 30, 2026, for Resident (R1) through R4. Per MAR, R1-R4 were being given their medications as prescribed. LPA reviewed the MAR dated August 1, 2026, to August, 31, 2026, for R1-R3. Per MAR, R1-R3 are being administer their medications as prescribed. During the initial visit on June 9, 2026, and subsequent visit on August 28, 2026, LPA reviewed the MARs and observed no discrepancies. During the interviews with residents, R5 reported that they get their medications as prescribed. R6 stated that staff always have their medications available.
CONTINUED ON LIC9099-C...

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Alvaro Ramirez Jr.
LICENSING EVALUATOR SIGNATURE:	DATE: 08/28/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2026

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-20260602154618

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: MAINPLACE SENIOR LIVING	FACILITY NUMBER: 306005636
	VISIT DATE: 08/28/2026

NARRATIVE

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Per R7, they are given their medications during meals and stated that staff are excellent. During the interviews with staff, Staff 1 (S1) reported that the residents are given their medications as prescribed and stated that staff request medication refills when there are seven pills left. S2 stated that sometimes they run out of medications. Per S3, in the past some residents would complaint about not receiving their medications.

Regarding the allegation that staff are falsifying information to licensing, the following was revealed: During the initial visit and subsequent visit LPA reviewed the MARs and observed no discrepancies. During the interviews with residents, R5-R7 reported that staff do not falsify the medication documentation. Per R6, staff are the best. R7 stated that staff are honest. During the interviews with staff, S1 reported that they are not aware about staff falsifying documents. Per S2, they have never been told to sign off on medication that was not administer. S3 stated that they heard that staff would falsify documents when the former Clinical Director worked here. Per S4, the only time staff would change the time the medication was administered is if staff have to respond to an emergency and they are not able to log it in right away. S4 stated that staff are not falsifying information to licensing.

Based on the information gathered during the investigation and review of documents obtained, LPA is unable to ascertain if the allegations occurred as reported due to conflicting information. Although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove or refute the alleged violations occurred; therefore, these allegations are deemed UNSUBSTANTIATED.

For today’s visit, there were no citations issued per Title 22, Division 6 of the California Code of Regulations.
LPA conducted an exit interview with ED Hipolito, and a copy of this report was provided to the facility.

SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Alvaro Ramirez Jr.
LICENSING EVALUATOR SIGNATURE:	DATE: 08/28/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2026

LIC9099 (FAS) - (06/04)

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