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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306005985
Report Date: 05/12/2026
Date Signed: 05/12/2026 04:31:57 PM

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
08/04/2023 and conducted by Evaluator Fred Arias
COMPLAINT CONTROL NUMBER: 22-AS-20230804125157
FACILITY NAME:ROYAL CARE FAMILY HOMESFACILITY NUMBER:
306005985
ADMINISTRATOR:ASIS, EMELYNFACILITY TYPE:
740
ADDRESS:506 N. ROYAL ST.TELEPHONE:
(562) 461-9820
CITY:ANAHEIMSTATE: CAZIP CODE:
92806
CAPACITY:6CENSUS: 6DATE:
05/12/2026
UNANNOUNCEDTIME BEGAN:
03:40 PM
MET WITH:Rose AngTIME COMPLETED:
04:46 PM
ALLEGATION(S):
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Resident developed a pressure injury while in care
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Fred Arias conducted an unannounced complaint visit to finalize an investigation into the above allegation. LPA was greeted and granted entry into the facility and explained the reason for the visit.

It was alleged resident developed a pressure injury while in care. LPA conducted interviews with staff and residents. LPA reviewed records obtained.

The investigation determined as follows: Regarding the allegation resident developed a pressure injury while in care, it was reported staff did not assist Resident 1 (R1) with repositioning, leading to a pressure injury. LPA interviews with one out of five residents stated they receive assistance twice a day with repositioning. The resident added they do not have bed sores. Two out of the remaining four residents stated they are able to reposition themselves. The remaining two residents could not be qualified for interviews.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Fred Arias
LICENSING EVALUATOR SIGNATURE:

DATE: 05/12/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2026
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 5
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
08/04/2023 and conducted by Evaluator Fred Arias
COMPLAINT CONTROL NUMBER: 22-AS-20230804125157

FACILITY NAME:ROYAL CARE FAMILY HOMESFACILITY NUMBER:
306005985
ADMINISTRATOR:ASIS, EMELYNFACILITY TYPE:
740
ADDRESS:506 N. ROYAL ST.TELEPHONE:
(562) 461-9820
CITY:ANAHEIMSTATE: CAZIP CODE:
92806
CAPACITY:6CENSUS: 6DATE:
05/12/2026
UNANNOUNCEDTIME BEGAN:
03:40 PM
MET WITH:Rose AngTIME COMPLETED:
04:46 PM
ALLEGATION(S):
1
2
3
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5
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9
Staff do not ensure residents have planned activities at the facility
INVESTIGATION FINDINGS:
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3
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5
6
7
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9
10
11
12
13
Licensing Program Analyst (LPA) Fred Arias conducted an unannounced complaint visit to finalize an investigation into the above allegation. LPA was greeted and granted entry into the facility and explained the reason for the visit.

It was alleged staff do not ensure residents have planned activities at the facility. LPA conducted interviews with staff and residents. LPA reviewed records obtained.

The investigation determined as follows: Regarding the allegation staff do not ensure residents have planned activities at the facility, it was reported there are no activities at the facility. Interviews with four out of six residents including an interview conducted on August 10, 2023 by the Department stated there are no planned activities at the facility. The remaining two residents could not be qualified for interviews. Interviews with four out of four staff stated there are activities at the facility including games. However, two out of four staff stated they were unaware of an activities calendar existing.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Fred Arias
LICENSING EVALUATOR SIGNATURE:

DATE: 05/12/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 22-AS-20230804125157
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: ROYAL CARE FAMILY HOMES
FACILITY NUMBER: 306005985
VISIT DATE: 05/12/2026
NARRATIVE
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 One out of those two staff added three residents are not offered activities due to their conditions. LPA record review revealed an activities calendar from April 2025 that is mainly composed of movie time, bingo, and reading books or newspapers.

Based on interviews conducted and record review, the preponderance of evidence standard has been met. Therefore, the above allegation is found to be SUBSTANTIATED.

California Code of Regulations, (Title 22, Division 6), are being cited on the attached LIC 9099D.

An exit interview was conducted and a copy of the report was left with the facility representative along with appeal rights.
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Fred Arias
LICENSING EVALUATOR SIGNATURE:

DATE: 05/12/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2026
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 22-AS-20230804125157
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: ROYAL CARE FAMILY HOMES
FACILITY NUMBER: 306005985
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/12/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/31/2026
Section Cited
CCR
87462
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87462 Social Factors
The facility shall obtain sufficient information about each person's likes and dislikes and interests and activities, ... to suggest the program of activities in which the individual may wish to participate.
The requirement is not met as evidenced by:
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Assistant AD stated she will complete an activities assessment for each resident including likes and dislike and use the information to create a new activities calendar. Assistant AD will have staff sign off on completed activities every week.
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Four out of six residents stated there are no activities offered at the facility which poses a potential personal rights risks 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: Alisa Ortiz
LICENSING EVALUATOR NAME: Fred Arias
LICENSING EVALUATOR SIGNATURE:

DATE: 05/12/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2026
LIC9099 (FAS) - (06/04)
Page: 5 of 5
Control Number 22-AS-20230804125157
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: ROYAL CARE FAMILY HOMES
FACILITY NUMBER: 306005985
VISIT DATE: 05/12/2026
NARRATIVE
1
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3
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5
6
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 Interviews with two out of four staff stated they assist residents with repositioning. One of the remaining two staff stated they assist changing and repositioning Resident 6 (R6) three times per day. The remaining staff stated they recall R1 and R1 did not have any pressure injuries observed during their stay at the facility. The staff added R1 was able to reposition themselves. Record reviewed revealed R1 had one medical appointment from May 1, 2023 through September 30, 2023 with their primary care physician. The progress report dated September 11, 2023 did not indicate any treatment related to a pressure injury. R1’s physician’s report dated December 20, 2022 indicates R1 was non-ambulatory and not bedridden. Staff training records reviewed for the year 2023 did not include evidence of postural support or repositioning training.

Based on interviews and record review, the allegation of resident developed a pressure injury while in care is therefore deemed unsubstantiated meaning that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.

An exit interview was conducted and a copy of the report was left with the facility representative.
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Fred Arias
LICENSING EVALUATOR SIGNATURE:

DATE: 05/12/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 5