306005806-11-2-2023-22-AS-SSAS-CZYR5W-20240130114345

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306005806
Report Date: 11/02/2023
Date Signed: 11/02/2023 03:58:22 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
10/17/2023 and conducted by Evaluator Celine DePerio

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20231017090538

FACILITY NAME:	WE CARE SENIOR LIVING		FACILITY NUMBER:	306005806
ADMINISTRATOR:	SANSANO, CHERRYL		FACILITY TYPE:	740
ADDRESS:	24322 BARK ST.		TELEPHONE:	(949) 446-9841
CITY:	LAKE FOREST	STATE: CA	ZIP CODE:	92630
CAPACITY:	6	CENSUS: 4	DATE:	11/02/2023
		UNANNOUNCED	TIME BEGAN:	02:09 PM
MET WITH:	Facility Administrator - Cherryl Sansano		TIME COMPLETED:	04:22 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Facility failed to safeguard resident's belonging

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA) Celine De Perio conducted an unannounced visit to the facility to deliver the findings for the complaint received on 10/17/23. LPA De Perio explained the purpose of today's visit, was greeted, and granted entry by staff on duty. For this visit, LPA met with facility administrator (AD) Cherryl Sansano.

It was alleged that facility failed to safeguard resident's belongings. LPA De Perio conducted a total of 5 interviews that consisted of staff and residents, and all 5 interviews did not corroborate with the allegation. The 3 resident interviews confirmed that there were no safety concerns regarding safeguarding belongings. LPA De Perio conducted an interview with the assigned sheriff from the Orange County Sheriff's Office who was assigned to investigate the case after the facility reported that the resident’s belongings were missing, to which the sheriff stated that the investigation findings were inconclusive due to the contradicting evidence that was provided by the reporting party and the facility.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Luz Adams	TELEPHONE: (714) 222-3812
LICENSING EVALUATOR NAME: Celine DePerio	TELEPHONE: 714-703-2854
LICENSING EVALUATOR SIGNATURE:	DATE: 11/02/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/02/2023

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-20231017090538

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: WE CARE SENIOR LIVING	FACILITY NUMBER: 306005806
	VISIT DATE: 11/02/2023

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Per document review, LPA observed that the facility completes a checklist per resident of the belongings each resident has prior to moving into the facility. LPA conducted an audit review of resident 1 through resident 4 (R1, R2, R3, and R4’s) checklist and toured all four rooms. LPA observed that the noted items for R1, R2, R3, and R4 were observed to be in the resident’s possessions.

Based on LPA’s interviews which were conducted, review of documents obtained, and observations, LPA is unable to ascertain if the allegation occurred as reported. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove or refute the alleged violation occurred; therefore, this allegation is deemed UNSUBSTANTIATED.

An exit interview was conducted with AD Sansano

A copy of this report was provided and explained.

SUPERVISOR'S NAME: Luz Adams	TELEPHONE: (714) 222-3812
LICENSING EVALUATOR NAME: Celine DePerio	TELEPHONE: 714-703-2854
LICENSING EVALUATOR SIGNATURE:	DATE: 11/02/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/02/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 2