306005845-2-6-2023-22-AS-SSAS-CNUQY8-20230208113444

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306005845
Report Date: 02/06/2023
Date Signed: 02/06/2023 10:14:12 AM

Unfounded

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
01/25/2023 and conducted by Evaluator Jessica Cho

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20230125092405

FACILITY NAME:	SANTA MARIANA CARE		FACILITY NUMBER:	306005845
ADMINISTRATOR:	LIMPIADO, GIDEON		FACILITY TYPE:	740
ADDRESS:	18676 SANTA MARIANA		TELEPHONE:	(949) 349-8708
CITY:	FOUNTAIN VALLEY	STATE: CA	ZIP CODE:	92708
CAPACITY:	6	CENSUS: 6	DATE:	02/06/2023
		UNANNOUNCED	TIME BEGAN:	09:57 AM
MET WITH:	Roel Atanacio, Caregiver		TIME COMPLETED:	10:30 AM

ALLEGATION(S):

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Staff behavior poses as a risk to the residents.
Staff did not ensure the residents are properly fed while in care.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Jessica Cho made an unannounced visit to deliver the findings into the above-mentioned allegations. LPA met with Caregiver Roel Atanacio who then informed Administrator Karmian Galangi of LPA’s arrival. LPA stated the purpose of the visit by telephone and the Administrator verbally consented Caregiver Atanacio to sign the report. The following are the findings which involved record review and interviews:

During the investigation into the above allegations, LPA obtained and reviewed pertinent resident and staff records and conducted interviews with resident and staff. On the allegations that staff did not ensure the residents are properly fed while in care, it was alleged that the residents were not receiving meals therefore posing a risk. On January 26, 2023, LPA conducted a food supply inspection, and LPA observed that the facility had more than the required minimum two-day perishable and seven-day non-perishable food supply mandated per Title 22 Regulations.

Unfounded

Estimated Days of Completion:

NAME OF LICENSING PROGRAM MANAGER: Sheila Santos
NAME OF LICENSING PROGRAM ANALYST: Jessica Cho
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 02/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/06/2023

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-20230125092405

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: SANTA MARIANA CARE	FACILITY NUMBER: 306005845
	VISIT DATE: 02/06/2023

NARRATIVE

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Interviews were conducted with five residents and three staff, however one out of six residents were unavailable to interview. Per interviews conducted, five out of five residents indicated that three meals were served each day and that they enjoyed living at the facility. Additionally, three out of three staff interviewed all confirmed that three meals were provided with snacks in between and attempts were made to offer the meals again if the resident refused to eat on occasion. Furthermore, per observations, record review, and interviews, residents were being properly fed, therefore the staff behavior pertaining to meal service were not in question at this time.

Based on the information gathered for the above findings, the allegations are determined to be UNFOUNDED. We have found that the complaint was unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. We have therefore dismissed the complaint.

An exit interview was conducted with Caregiver Roel Atanacio, and this report was provided during this visit.

NAME OF LICENSING PROGRAM MANAGER: Sheila Santos
NAME OF LICENSING PROGRAM ANALYST: Jessica Cho
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 02/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/06/2023

LIC9099 (FAS) - (06/04)

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