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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306005780
Report Date: 04/21/2025
Date Signed: 04/21/2025 10:37:11 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
09/28/2022 and conducted by Evaluator William Vanegas
COMPLAINT CONTROL NUMBER: 22-AS-20220928111256
FACILITY NAME:CANDLEBERRY CAREFACILITY NUMBER:
306005780
ADMINISTRATOR:ROSARIO, ROBERTO DELFACILITY TYPE:
740
ADDRESS:4216 CANDLEBERRY AVE.TELEPHONE:
(949) 290-6006
CITY:SEAL BEACHSTATE: CAZIP CODE:
90740
CAPACITY:6CENSUS: DATE:
04/21/2025
UNANNOUNCEDTIME BEGAN:
08:10 AM
MET WITH:Socrates YturraldeTIME COMPLETED:
09:45 AM
ALLEGATION(S):
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-Staff leave resident in wheelchair for extended period of time
-Staff leave resident in shower for extended period of time
-Staff do not respond to resident cry for help
-Staff barricaded resident's door
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) William Vanegas made an unannounced inspection for the purposes of delivering findings regarding the above-mentioned allegations. Upon arrival LPA Vanegas was greeted and granted entry to the facility by Care Giver (CG) Shellad Yturralde. LPA Vanegas explained the nature of the inspection. During the course of the inspection, LPA Vanegas obtained and reviewed copies of records pertinent to Resident 1(R1).

Interviews were conducted with three residents, and three staff on duty. Interviews conducted revealed the following. LPA Vanegas attempted to contact R1two times and was unsuccessful. Regarding the allegation stating facility staff leave R1 in wheelchair for extended period, interviews with R2, R3, and R4 informed LPA Vanegas that they have never witnessed staff members leaving residents in a wheelchair for an extended period.
CONTINUED ON LIC9099C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: William Vanegas
LICENSING EVALUATOR SIGNATURE:

DATE: 04/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/21/2025
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-20220928111256
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: CANDLEBERRY CARE
FACILITY NUMBER: 306005780
VISIT DATE: 04/21/2025
NARRATIVE
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Regarding the allegation stating facility staff leave resident in the shower for extended period, interviews conducted with residents in care revealed that all residents have never been left in the shower for an extended period; additionally, if they do need help, they get assistance right away. R2, R3, and R4 confirmed this information.

Regarding the allegation that R1 cries out for help, but the staff do not respond to the cries for help; resident interviews revealed the following. R2, R3, and R4 stated that if they need help, they get assistance in a timely manner. They get help at all hours through the day if they require it, and at all hours throughout the night if needed. Additionally, LPA Vanegas tested the call button system for assistance, and staff responded immediately.

Regarding the allegation stating that resident doors are barricaded interviews with staff and residents in care reveled the following: R4 stated that they have never seen any barricaded doors. R2, R3, and R4 all stated that they have never seen any barricaded doors. S1, S2, and S3 stated that they have never barricaded any doors in the facility.

Based on the observations made and interviews, conducted during today’s inspection. The above allegations are deemed to be unsubstantiated. No deficiencies are being cited today per Tittle 22- Chapter 8 division 6 of the California Code of Regulations. An exit interview was conducted with CG Socrates Yturralde and a copy of this report was provided to the facility.

SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: William Vanegas
LICENSING EVALUATOR SIGNATURE:

DATE: 04/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/21/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2