306005768-9-4-2025-22-AS-APAO-DLENVH-20250911104757

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306005768
Report Date: 09/04/2025
Date Signed: 09/04/2025 01:43:08 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
04/10/2025 and conducted by Evaluator Claudia Gutierrez

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20250410150918

FACILITY NAME:	SAINT AGNES CARE		FACILITY NUMBER:	306005768
ADMINISTRATOR:	ROSARIO, ROBERTO DEL		FACILITY TYPE:	740
ADDRESS:	4931 CARTHAGE STREET		TELEPHONE:	(657) 258-9152
CITY:	PLACENTIA	STATE: CA	ZIP CODE:	92870
CAPACITY:	6	CENSUS: 6	DATE:	09/04/2025
		UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Lester Del Rosario		TIME COMPLETED:	02:00 PM

ALLEGATION(S):

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Resident was inappropriately touched by caregiver

INVESTIGATION FINDINGS:

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An unannounced Complaint Investigation was conducted on this day by Licensing Program Analyst (LPA) Claudia Gutierrez for the purpose of delivering findings. LPA met with Administrator (AD) Lester Del Rosario and explained the purpose of the inspection.

Complaint alleges Resident 1 (R1) was inappropriately touched by Staff 1 (S1).

During the course of the investigation, resident file review was conducted to include R1’s Physician Report and interviews were conducted with R1, facility residents, and staff.

Per R1’s Physician Report dated January 16, 2025, R1 can occasionally communicate but has difficulty most of the time due to their medical diagnosis. During their interview, R1 did not disclose any inappropriate touching by S1 or any other facility staff. Per R1, S1 and all facility staff treat them well. R1 denied having any concerns. (Cont. LIC9099-C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Claudia Gutierrez
LICENSING EVALUATOR SIGNATURE:	DATE: 09/04/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/04/2025

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-20250410150918

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

FACILITY NAME: SAINT AGNES CARE	FACILITY NUMBER: 306005768
	VISIT DATE: 09/04/2025

NARRATIVE

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During their interview, S1 stated they assist R1 with all Activities of Daily Living (ADLs), including showering and grooming. S1 denied ever touching R1 inappropriately during ADLs or otherwise. Per S1, R1 had never reported feeling uncomfortable around them or indicated they had been touched inappropriately by S1 or any other staff. S1 denied personally touching R1 or any other resident inappropriately and denied witnessing or having any knowledge of any other staff touching R1 or any other resident inappropriately.

During their interview, Administrator (AD) Lester Del Rosario denied having any knowledge of staff touching any residents inappropriately and denied any resident reporting any such incidents. AD denied R1 reporting any concerns regarding staff, including S1. Per AD, R1's statements in general tend to be inconsistent due to their medical condition, and R1 will usually repeat back what is said to them. AD denied R1 ever informing them S1 had touched them inappropriately. AD denied having any concerns regarding S1 or any other staff.
Interviews were also conducted with three facility residents. Three of three residents interviewed denied the allegation and denied being personally touched inappropriately by staff or having any knowledge of R1 or any other resident being touched inappropriately by S1 or any other staff.

Due to allegation being uncorroborated during interviews conducted, the Department is unable to determine if resident was inappropriately touched by staff. Although the above allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore at this time the above allegation is unsubstantiated.

An exit interview was conducted and copy of this report was provided at the end of the inspection.

SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Claudia Gutierrez
LICENSING EVALUATOR SIGNATURE:	DATE: 09/04/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/04/2025

LIC9099 (FAS) - (06/04)

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