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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306005941
Report Date: 09/25/2025
Date Signed: 09/25/2025 11:33:35 AM

Substantiated


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
09/11/2025 and conducted by Evaluator Brandon Lopez
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20250911132234
FACILITY NAME:HORWITZ FAMILY HOUSEFACILITY NUMBER:
306005941
ADMINISTRATOR:MCDONALD, LISAFACILITY TYPE:
735
ADDRESS:1621 PORTOLA AVENUETELEPHONE:
(818) 782-2211
CITY:SANTA ANASTATE: CAZIP CODE:
92705
CAPACITY:6CENSUS: 4DATE:
09/25/2025
UNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:House Manager German NavarreteTIME COMPLETED:
10:30 AM
ALLEGATION(S):
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Facility Administrator is not qualified as a certified Administrator
Facility staff are not receiving required trainings
Facility staff did not safeguard the clients' cash resources and valuables
Facility does not have personnel records
Facility staff is not giving the clients their medications as prescribed
INVESTIGATION FINDINGS:
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On September 25, 2025, Licensing Program Analyst (LPA) Brandon Lopez made an unannounced visit to the facility to deliver the findings of the complaint allegations listed above. LPA was greeted and granted entry into the facility by staff after explaining the purpose the visit. House Manager German Navarrete was notified via telephone and later arrived to assit with the visit.

The initial visit was conducted on September 18, 2025. During the visit, LPA conducted a tour of the physical plant, reviewed client records, requested personnel records, and reviewed clients' medication and medication administrator records.

Regarding the allegation that, facility administrator is not qualified as a certified administrator, the following has been concluded: LPA observed that on the LIC500 Personnel Report dated September 22, 2025, Staff #1 (S1) is listed as the facility Administrator. LPA observed that S1 has a valid Administrator certificate which expires on April 28, 2026. CONTINUED ON LIC9099-C
Substantiated
Estimated Days of Completion: 90
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Brandon Lopez
LICENSING EVALUATOR SIGNATURE:

DATE: 09/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2025
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 6
Control Number 22-AS-20250911132234
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: HORWITZ FAMILY HOUSE
FACILITY NUMBER: 306005941
VISIT DATE: 09/25/2025
NARRATIVE
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However, LPA also conducted six staff interviews. Four out of six staff interviews confirmed that S1 is not at the facility a sufficient amount of hours to administer the facility within compliance as required by regulations. Four out of six staff interviews conducted reported that S1 is at the facility once or twice a month for half the day. Based on the evidence gathering during this investigation, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED.

Regarding the allegation that, facility staff are not receiving required training's, the following has been concluded: LPA reviewed the training records for eight facility staff. The training records reviewed included the initial and continuous training that staff have received. LPA observed that two out of the eight facility staff were missing the required training regarding principles of nutrition, food preparation and storage and menu planning. Based on the evidence gathering during this investigation, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED.

Regarding the allegation that, facility staff did not safeguard the clients' cash resources and valuables, the following has been concluded: LPA reviewed an audit regarding the facility's Personal and Incidental (P&I) funds that was conducted between December 1, 2021, to March 31, 2022. LPA observed that the audit revealed a total discrepancy of $3,299.37 in which a total of six clients P&I were mismanaged. LPA also observed checks that have been made out to the client's families that were affected to refund the total amounts missing. LPA also conducted two staff interviews who confirmed the audit was accurate and that the clients who were affected due to the mismanagement of the P&I will be refunded. Based on the evidence gathering during this investigation, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED.

Regarding the allegation that, facility does not have personnel records, the following has been concluded: Based on the LIC500 Personnel Report dated September 22, 2025, the facility currently has eight staff employed. During the initial visit on September 18, 2025, LPA requested the personnel records for all eight facility staff at 10:33 AM. The facility was unable to provide LPA the personnel records for two out of the eight facility staff during the visit. LPA received the two missing personnel records via email on September 19, 2025, at 11:53 AM. Based on the evidence gathering during this investigation, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED.

CONTINUED ON LIC9099-C
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Brandon Lopez
LICENSING EVALUATOR SIGNATURE:

DATE: 09/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 6
Control Number 22-AS-20250911132234
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: HORWITZ FAMILY HOUSE
FACILITY NUMBER: 306005941
VISIT DATE: 09/25/2025
NARRATIVE
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Regarding the allegation that, facility staff is not giving the clients their medications as prescribed, the following has been concluded: During the initial visit on September 18, 2025, LPA reviewed the medication and medication administration records (MAR) for all four clients in care. LPA observed the facility is providing three unprescribed supplements to Client #1 (C1). LPA also observed the MAR's for three out of four clients were not being documented correctly with missing signatures after medications were dispensed. Based on the evidence gathering during this investigation, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED.

All five allegations for this complaint have been substantiated. Deficiencies are being cited on the attached LIC9099-Ds. An exit interview was conducted with House Manager German Navarrete. A copy of the report and Appeal Rights were provided.
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Brandon Lopez
LICENSING EVALUATOR SIGNATURE:

DATE: 09/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 6
Control Number 22-AS-20250911132234
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: HORWITZ FAMILY HOUSE
FACILITY NUMBER: 306005941
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/25/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/24/2025
Section Cited
CCR
85064(e)
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85064 Administrator Qualifications and Duties: (e) The administrator shall be on the premises the number of hours necessary to manage and administer the facility in compliance with applicable law and regulation.

This requirement is not evidenced by:
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The House Manager stated that they will create a written plan on how they will ensure the administrator is at the facility a sufficient amount of hours to bring the facility back into compliance. The House Manager agreed to provide the written plan to LPA via email or fax by POC date.
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Based on interviews conducted, the Licensee did not ensure the administrator is at the facility a sufficient amount of hours necessary to administer the facility in compliance. This poses a potential health and safety risk to persons in care.
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Type B
10/24/2025
Section Cited
CCR
80065(f)(1)
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80065 Personnel Requirements: (f) All personnel shall be given on-the-job training ... in the following areas... (1) Principles of nutrition, food preparation and storage and menu planning.

This requirement is not evidenced by:
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The House Manager stated that they will train the two staff in principles of nutrition, food preparation and storage and menu planning. The Regional Director agreed to provide proof of training to LPA via email or fax by POC date.
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Based on training records reviewed for eight staff, the Licensee did not ensure that two out of the eight staff had the required training in principles of nutrition, food preparation and storage and menu planning. This poses a potential health and safety risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Brandon Lopez
LICENSING EVALUATOR SIGNATURE:

DATE: 09/25/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 6
Control Number 22-AS-20250911132234
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: HORWITZ FAMILY HOUSE
FACILITY NUMBER: 306005941
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/25/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/26/2025
Section Cited
CCR
80026(b)
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80026 Safeguards for Cash Resources..: (b) If such a client is accepted ... in care, his/her cash resources, ... be handled by the licensee or .. staff, and shall be safeguarded .. with the requirements specified in (c) through (n) below.
This requirement is not evidenced by:
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The House Manager stated that they will provide a written statement on when each client impacted will receive their reimbursement. The House Manager agreed to provide the written statement to LPA via email or fax by POC date.
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Based on records reviewed and interviews conducted, the Licensee did not ensure that each clients' P&I were safeguarded which resulted in a discrepancy of $3,299.37 impacting a total of six clients. This poses and immediate health, safety, and personal rights risk to persons in care.
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Type A
09/26/2025
Section Cited
CCR
80075(b)
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80075 Health Related Services:
(b) Clients shall be assisted as needed with self-administration of prescription and nonprescription medications.

This requirement is not evidenced by:
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The House Manager stated they will immediate stop providing the supplements to C1. The House Manager also stated that will conduct a training with staff regarding administering documenting medication. The House Manager agreed to provide LPA proof of training via email or fax by POC date.
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Based on an audit conducted on clients' medication and medication administration records, the Licensee did not ensure C1 had a valid prescription for the three supplements and did not ensure that the MARs for three out of four clients were documented correctly. This poses and immediate health and safety risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Brandon Lopez
LICENSING EVALUATOR SIGNATURE:

DATE: 09/25/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 6
Control Number 22-AS-20250911132234
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: HORWITZ FAMILY HOUSE
FACILITY NUMBER: 306005941
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/25/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/24/2025
Section Cited
CCR
80066(e)(1)
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80066 Personnel Records: (e) All personnel records... shall be available for review. (1) The licensee shall be permitted to retain.. records in a central .. location provided that they are readily available to the licensing agency at the facility site ...
This requirement is not evidenced by:
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The House Manager stated that they will create a written plan on how they will ensure all personnel records are readily available to Community Care Licensing and other authorized agencies. The House Manager agreed to provide the written plan to LPA via email or fax by POC date.
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Based on interviews and records reviewed, the Licensee did not ensure that two out of eight personnel records were available for review during the initial complaint visit conducted on September 18, 2025. This poses and potential health, safety, and personal rights risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Brandon Lopez
LICENSING EVALUATOR SIGNATURE:

DATE: 09/25/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2025
LIC9099 (FAS) - (06/04)
Page: 6 of 6