<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306005907
Report Date: 07/22/2026
Date Signed: 07/22/2026 11:37:02 AM

Unfounded


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
05/20/2026 and conducted by Evaluator Garlli Tat
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20260520083259
FACILITY NAME:TESSA'S PLACE 1FACILITY NUMBER:
306005907
ADMINISTRATOR:AVENDANO, ELEONORFACILITY TYPE:
740
ADDRESS:26075 ARCADA DRIVETELEPHONE:
(949) 331-3822
CITY:MISSION VIEJOSTATE: CAZIP CODE:
92691
CAPACITY:6CENSUS: 5DATE:
07/22/2026
UNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Mark CruzTIME COMPLETED:
11:50 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff admitted resident against their will.
Staff chemically restrained resident.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Garlli Tat made an unannounced visit to the facility to deliver the findings on the above allegations. LPA met with Administrator Mark Cruz and explained the purpose of the visit.

An initial complaint investigation visit took place on May 21, 2026. During the visit, LPA accompanied by staff, conducted a tour of the facility's physical plant. LPA requested and obtained the resident roster, staff roster and the following documents for Resident 1 (R1); admission agreement dated April 24, 2026, Medical Assessment for Residential Care Facilities dated November 20, 2025, Physician’s Report dated April 24, 2026, Emergency Information, Move-in notification letter dated April 24, 2026, ISP dated December 21, 2025, and Power of Attorney for Health Care dated April 30, 2026. Five staff, including administrator, four witnesses, and six resident interviews were conducted.

The investigation revealed the following: Continued on LIC9099-C.
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Garlli Tat
LICENSING EVALUATOR SIGNATURE:

DATE: 07/22/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2026
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 8
Control Number 22-AS-20260520083259
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: TESSA'S PLACE 1
FACILITY NUMBER: 306005907
VISIT DATE: 07/22/2026
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
R1 reported that the medication the facility administered was not prescribed. A review of R1’s medication records shows all of their prescribed medications were from their last hospital visit. 2 of R1’s family members reported that during R1’s hospital visit on April 24, R1 was prescribed anti-anxiety (Divalproex (Depakote) 125 mg) medication to calm them down. A review of records shows the hospital did prescribe Divalproex (Depakote) 125 mg to R1 during their visit. The facility had no control over what medications were prescribed to R1 while they were at the hospital. None of the evidence gathered supports the allegation.

Based on the evidence gathered, the allegation is deemed Unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. The Department has therefore dismissed the complaint.

An exit interview was conducted with the Administrator and a copy of this LIC9099 report was left at the facility.

SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Garlli Tat
LICENSING EVALUATOR SIGNATURE:

DATE: 07/22/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 8
Control Number 22-AS-20260520083259
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: TESSA'S PLACE 1
FACILITY NUMBER: 306005907
VISIT DATE: 07/22/2026
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
Based on review of R1’s admission agreement, residents may have a cell phone. Residents may also use the facility phone at no charge. R1 reported that they used the facility phone because when they moved in, they did not have their cell phone. 5 out of 5 staff members interviewed reported that R1 moved to the facility without their cell phone. R1 stated that they believed their phone was withheld by a family member but could not recall which family member. 5 out of 5 staff members reported that after R1 moved in they had their cell phone but did not know who gave it to them. The Administrator reported that R1’s family member brought them their phone but none of the other witnesses could corroborate this report. R1 did not remember who brought them their cell phone but once they received it, they could call anyone they wanted. 5 out 5 staff members reported they never withheld R1’s cell phone. 1 out of 5 residents reported that they have never been denied the use of their cell phone. 2 out of the 5 remaining residents stated they are able to use their cellphones. The 2 remaining residents did not answer the question and did not acknowledge the question with any type of response.

Based on the evidence gathered during the investigation, the allegations are found to be Unsubstantiated, meaning that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur.

An exit interview was conducted, and a copy of the present report was provided to a facility representative.

SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Garlli Tat
LICENSING EVALUATOR SIGNATURE:

DATE: 07/22/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2026
LIC9099 (FAS) - (06/04)
Page: 5 of 8
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
05/20/2026 and conducted by Evaluator Garlli Tat
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20260520083259

FACILITY NAME:TESSA'S PLACE 1FACILITY NUMBER:
306005907
ADMINISTRATOR:AVENDANO, ELEONORFACILITY TYPE:
740
ADDRESS:26075 ARCADA DRIVETELEPHONE:
(949) 331-3822
CITY:MISSION VIEJOSTATE:CAZIP CODE:
92691
CAPACITY:6CENSUS: 5DATE:
07/22/2026
UNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Mark CruzTIME COMPLETED:
11:50 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff denied resident access to their phone.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Garlli Tat made an unannounced visit to the facility to deliver the findings on the above allegations. LPA met with Administrator Mark Cruz and explained the purpose of the visit.
An initial complaint investigation visit took place on May 21, 2026. During the visit, LPA accompanied by staff, conducted a tour of the facility's physical plant. LPA requested and obtained the resident roster, staff roster and the following documents for Resident 1 (R1); admission agreement dated April 24, 2026, Medical Assessment for Residential Care Facilities dated November 20, 2025, Physician’s Report dated April 24, 2026, Emergency Information, Move-in notification letter dated April 24, 2026, ISP dated December 21, 2025, and Power of Attorney for Health Care dated April 30, 2026. Five staff, including administrator, four witnesses, and six resident interviews were conducted.

Regarding the allegation that staff denied resident access to their phone, it was reported that staff withheld R1 from using their cellphone. Continued on LIC9099-C.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Garlli Tat
LICENSING EVALUATOR SIGNATURE:

DATE: 07/22/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 8
Control Number 22-AS-20260520083259
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: TESSA'S PLACE 1
FACILITY NUMBER: 306005907
VISIT DATE: 07/22/2026
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
Regarding the allegation that Staff admitted resident against their will, it was reported that R1 does not have Dementia, lives on their own, and is not conserved. R1 moved into the facility on April 24, 2026, and moved out of the facility on April 30, 2026. LPA reviewed the admission agreement for R1. R1’s responsible party signed the admission agreement on R1’s behalf. R1 was previously living on their own with In-Home-Supportive Services. Per review of medical assessment dated November 20, 2025, R1 is diagnosed with Alzheimer’s Disease, history of hysterectomy, osteopenia, urinary incontinence, and major depressive disorder. R1 also experienced disorientation, is unable to bathe or groom self, has bladder incontinence, unable to administer own medication, and is non-ambulatory due to medical condition. R1 lived independently with In Home Supportive Services until a hospital visit on April 24, 2026. Witnesses reported that R1 was discharged from the hospital to the facility because the hospital would not discharge R1 to their own home. LPA attempted to interview the hospital social worker, but they refused to answer any questions. Two out of six residents interviewed, including R1, stated R1 was admitted against their will by family. R1 reported they did not want to move to the facility but were made to do so by a family member. 1 out 5 residents reported that they thought R1 was moved into the facility against their will by their family. 4 out of 5 residents interviewed had no knowledge of the incident. Three out of five staff stated the family admitted the resident to the facility. Two out of five staff had no relevant information regarding this allegation. LPA interviewed 4 witnesses who had knowledge of the allegation, 2 family members, a friend of R1 and R1’s former IHSS worker. The IHSS worker reported that the family moved the resident into the facility. The IHSS worker reported that R1 did not have the ability to live on their own. LPA interviewed 2 family members of R1 who reported that R1 was not equipped to live on their own, so they moved R1 into the facility. None of the evidence gathered supports the allegation. None of the evidence gathered supports the allegation because the facility staff did not seek R1 as a client because R1’s family members and the hospital acted to move R1 into the facility.

Regarding the allegation that staff chemically restrained resident, it was reported that staff used medication to sedate resident. It was alleged that the sedative, Depakote, was used to restrict R1’s movements. Per medical assessment dated November 20, 2025, R1 was not prescribed Depakote at the time. Per physician’s report dated April 24, 2026, R1 was prescribed Divalproex (Depakote) 125 mg for restlessness, anxiety, and agitation. This medication was prescribed to R1 while they were at the hospital. R1 was admitted to the facility with a list of medications, which included Divalproex (Depakote) 125 mg. Six out of six staff interviewed stated medication is administered according to the physician’s orders. Continued on LIC9099-C.

SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Garlli Tat
LICENSING EVALUATOR SIGNATURE:

DATE: 07/22/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 8
Control Number 22-AS-20260520083259
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: TESSA'S PLACE 1
FACILITY NUMBER: 306005907
VISIT DATE: 07/22/2026
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
Regarding the allegation that staff denied resident freedom of movement, it was alleged that the facility isolated R1 from family and friends and placed R1 on a “lockdown”. Per review of admission agreement, the facility encourages regular visits and appointments are not necessary. R1 reported that staff did not allow them to go outside. Resident 2 (R2) reported that they saw R1 go outside of the facility with their family and friend. One out of five staff interviewed (Staff 1) reported that R1 was not allowed to leave the facility with anyone unless the responsible party permitted it. Staff 1 (S1) reported that one of R1’s family members came to visit the facility, and they wanted to take R1 out of the facility to go eat. S1 reported that they did not let R1 leave the facility with their family member for 45 minutes until they called R1’s responsible party. All witnesses present verified that the phone call lasted around 45 minutes. R1’s responsible party finally allowed R1 and their family member to leave the facility. R1 and the family returned a few hours later. R1 is not conserved and there are no restraining orders barring anyone from seeing R1. The Administrator was not aware that S1 didn't allow R1 to leave with their family member. R1 was not allowed to leave the facility with their family member who was not legally barred from visiting them.

Based on evidence gathered through interviews and document review, the preponderance of evidence has been met, therefore, the above allegation is found to be Substantiated. Violations are being cited per Title 22 of California Code of Regulations. See LIC 9099-D for cited deficiencies per Title 22 Division 6 of the California Code of Regulations.

An exit interview was conducted with Administrator and a copy of this LIC9099-D, along with a copy of the Appeal Rights were left at the facility.

SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Garlli Tat
LICENSING EVALUATOR SIGNATURE:

DATE: 07/22/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2026
LIC9099 (FAS) - (06/04)
Page: 7 of 8
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
05/20/2026 and conducted by Evaluator Garlli Tat
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20260520083259

FACILITY NAME:TESSA'S PLACE 1FACILITY NUMBER:
306005907
ADMINISTRATOR:AVENDANO, ELEONORFACILITY TYPE:
740
ADDRESS:26075 ARCADA DRIVETELEPHONE:
(949) 331-3822
CITY:MISSION VIEJOSTATE:CAZIP CODE:
92691
CAPACITY:6CENSUS: 5DATE:
07/22/2026
UNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Mark CruzTIME COMPLETED:
11:50 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff denied resident freedom of movement.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Garlli Tat made an unannounced visit to the facility to deliver the findings on the above allegations. LPA met with Administrator Mark Cruz and explained the purpose of the visit.

An initial complaint investigation visit took place on May 21, 2026. During the visit, LPA accompanied by staff conducted a tour of the facility's physical plant. LPA requested and obtained the resident and staff roster, admission agreement dated April 24, 2026, Medical Assessment for Residential Care Facilities dated November 20, 2025, Physician’s Report dated April 24, 2026, Emergency Information, Move-in notification letter dated April 24, 2026, ISP dated December 21, 2025, and Power of Attorney for Health Care dated April 30, 2026. Five staff, including administrator, four witnesses, and six resident interviews were conducted.

The investigation revealed the following: Continued on LIC9099-C.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Garlli Tat
LICENSING EVALUATOR SIGNATURE:

DATE: 07/22/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 6 of 8
Control Number 22-AS-20260520083259
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: TESSA'S PLACE 1
FACILITY NUMBER: 306005907
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/22/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/23/2026
Section Cited
CCR
97468.1(a)(6)
1
2
3
4
5
6
7
(a) Residents in all residential care facilities for the elderly shall have [..] the following rights:
(6) To leave or depart the facility at any time and to not be locked into any room, [...], or on facility premises by day or night. [...]
1
2
3
4
5
6
7
Licensee agrees to train all staff on CCR 87468.1(a)(6) and Licensee agrees to sign a statement of understanding for CCR 87468.1(a)(6). Licensee to submit proof of correction documentation to CCLD by POC due date.
8
9
10
11
12
13
14
This requirement was not met as evidenced by: Based on interviews, the licensee did not allow R1 to leave the facility premises until permission was granted by responsible party, which poses an immediate health and safety risk to persons in care.
8
9
10
11
12
13
14
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Sheila Santos
LICENSING EVALUATOR NAME: Garlli Tat
LICENSING EVALUATOR SIGNATURE:

DATE: 07/22/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2026
LIC9099 (FAS) - (06/04)
Page: 8 of 8