306006021-7-7-2025-22-AS-APAO-DKF9UU-20250810234119

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306006021
Report Date: 07/07/2025
Date Signed: 07/07/2025 11:15:38 AM

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
06/11/2025 and conducted by Evaluator William Vanegas

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20250611141242

FACILITY NAME:	SIANI ADULT RESIDENTIAL FACILITY		FACILITY NUMBER:	306006021
ADMINISTRATOR:	ESPANA, SHARONDA		FACILITY TYPE:	735
ADDRESS:	4591 LARKSPUR CIRCLE		TELEPHONE:	(909) 767-7030
CITY:	ANAHEIM	STATE: CA	ZIP CODE:	92807
CAPACITY:	4	CENSUS: 3	DATE:	07/07/2025
		UNANNOUNCED	TIME BEGAN:	08:08 AM
MET WITH:	Anthony Dees Jr Direct Support Staff		TIME COMPLETED:	09:45 AM

ALLEGATION(S):

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-Facility Has Bed Bugs

INVESTIGATION FINDINGS:

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On this day Licensing Program Analyst (LPA) William Vanegas made an unannounced visit to the facility for the purpose of delivering findings into the investigation of the allegation listed above. LPA Vanegas was greeted and granted entry to the facility by Direct Support Staff (DSP) Anthony Dees after LPA introduced themselves and stated the purpose of the visit.

An initial investigation visit was conducted on June 18, 2025. During the visit, LPA Vanegas conducted a tour of the facility, and observed all client rooms, and lifted sheets to physically look for bed bugs, LPA Vanegas did not observe any evidence or signs of bed bugs at the facility. LPA Vanegas gathered and reviewed pertinent records pertaining to clients in care in regard to the allegation stated above. LPA Vanegas interviewed one client as two different clients were not available for interview. LPA Vanegas also interviewed administrator, and staff#1.
CONTINUED ON LIC9099C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: William Vanegas
LICENSING EVALUATOR SIGNATURE:	DATE: 07/07/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2025

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-20250611141242

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: SIANI ADULT RESIDENTIAL FACILITY	FACILITY NUMBER: 306006021
	VISIT DATE: 07/07/2025

NARRATIVE

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The investigation into the allegation, facility has bed bugs, revealed the following. It was alleged that the facility has bed bugs. Staff that were interviewed denied the allegation. The Administrator (AD) reported that they have never witnessed any type of bug infestation in the facility, and that they have cleaning duties, AD states that they are responsible for keeping the facility clean and sanitary. AD States that staff are responsible for cleaning the facility, doing laundry, and cleaning client’s rooms. AD states that Client 1 (C1) had a rash on their arm, and they were taken to urgent care to get it evaluated. AD states that physician advised that it was not bed bug bites, but it was a rash.

Staff #1 (S1) reported that they have only been working at the facility for two months, S1 states that they are responsible for cleaning dishes, assisting clients with any activities of daily living, and making sure that they are getting any other help they need, and cleaning the client’s rooms. S1 states that they have never seen any infestations and have not experienced any fumigations while they have been working at the facility.
Client 2 (C2) reported the following: C2 states that they enjoy living at the facility, C2 states that the staff clean their rooms, wash their clothes, and cook for them. C2 states that they have never woken up with any mosquito bites, or any other type of bites since they have lived at the facility. C2 states that they have never seen any bed bugs or any other type of bugs in the facility.

Based on the evidence gathered the allegation, facility has bed bugs is deemed Unsubstantiated, although the allegation may have happened or is valid, there is no preponderance of evidence to prove the alleged violation did or did not occur. An exit interview was conducted and a copy of this report was provided to the facility.

SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: William Vanegas
LICENSING EVALUATOR SIGNATURE:	DATE: 07/07/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2025

LIC9099 (FAS) - (06/04)

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