306006021-1-7-2026-22-AS-SSAS-DQD3QW-20260115172748

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306006021
Report Date: 01/07/2026
Date Signed: 01/07/2026 04:24:53 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
12/16/2022 and conducted by Evaluator Garlli Tat

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20221216101146

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:	01/07/2026
		UNANNOUNCED	TIME BEGAN:	03:57 PM
MET WITH:	Administrator Sharonda Espana (via phone)		TIME COMPLETED:	04:40 PM

ALLEGATION(S):

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Client was hit at the facility.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Garlli Tat made an unannounced visit to the facility to deliver the findings on the above allegation. LPA met with staff 5 (S5) Diego Navarrete and explained the reason for the visit. S5 notified Licensee (LE) Sharonda Espana via telephone. During the course of the investigation, LPA inspected the facility, interviewed staff and residents, obtained and reviewed resident records. The investigation revealed the following:

It was alleged that client (C1) was hit at the facility. Per Individual Program Plan (IPP) dated December 5, 2022, by the Regional Center of Orange County (RCOC), C1 was admitted on November 8, 2022. Per IPP, C1 is diagnosed with Mild Intellectual Disability and has a history of making false statements, engaging in property destruction, and emotional outbursts. Interview with C1 revealed that they are not happy at Siani Adult Residential Facility and admitted they were acting out and had a lot of behaviors. C1 shared that he has a temper and prefers the previous home he lived in. Per C1, staff are not nice to him.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Garlli Tat
LICENSING EVALUATOR SIGNATURE:	DATE: 01/07/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/07/2026

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-20221216101146

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: 01/07/2026

NARRATIVE

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Four out of four staff denied client being hit at the facility, however two out of four staff confirmed they have seen C1 engage in aggressive behaviors, including slamming the bedroom door and punching and hitting staff. Staff #4 were not employed at the time C1 was living at the facility. Per incident report dated November 11, 2022, C1 threw his lamp on the floor and kicked holes in his bedroom door because he could not complete a task normally completed by his peers. On December 14, 2022, C1 thought staff were talking about him and began slamming the front door and bedroom door. Staff #2 told C1 to calm down and C1 began punching staff #2 on the hands, arm, chest, and stomach. When administrator came to see what was going on, C1 asked staff #2 to call 911. 911 was called and C1 was taken to the hospital for suicidal ideation. On December 12, 2022, C1 hit staff #2 because he was told to go to his room. Administrator directed staff to call Crisis Center because C1 was physically aggressive. C1 hit staff #2 in the head and kicked him on the side. C1 made abusive threats towards staff and administrator and C1 expressed didn’t want to live. 911 was called for suicidal and homicidal ideations. Two out of three clients denied witnessing staff #2 hitting C1. C4 confirmed that C1 has kicked a hole in the wall. One out of three clients interviewed stated they have heard staff hit client but didn’t see it.

Based on the evidence gathered during this investigation, although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is Unsubstantiated.

An exit interview was conducted with S5, and a copy of the report was reviewed and provided.

SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Garlli Tat
LICENSING EVALUATOR SIGNATURE:	DATE: 01/07/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/07/2026

LIC9099 (FAS) - (06/04)

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