306006071-9-16-2026-22-AS-SSAS-DY9U5B-20260925151629

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306006071
Report Date: 09/16/2026
Date Signed: 09/16/2026 02:01:52 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
01/07/2025 and conducted by Evaluator Brandon Lopez

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20250107094112

FACILITY NAME:	PALMS RETIREMENT CENTER		FACILITY NUMBER:	306006071
ADMINISTRATOR:	BARRIENTOS, ELEANOR		FACILITY TYPE:	740
ADDRESS:	312 N ROOSEVELT AVE		TELEPHONE:	(626) 353-4710
CITY:	FULLERTON	STATE: CA	ZIP CODE:	92832
CAPACITY:	144	CENSUS: 115	DATE:	09/16/2026
		UNANNOUNCED	TIME BEGAN:	08:00 AM
MET WITH:	Administrator Maria Dimacali		TIME COMPLETED:	01:30 PM

ALLEGATION(S):

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Staff did not assist resident with obtaining medical care in a timely manner
Staff did not distribute a resident's medication as prescribed
Staff do not maintain facility free from pests
Staff do not maintain facility sanitary

INVESTIGATION FINDINGS:

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On September 16, 2026, Licensing Program Analyst (LPA) Brandon Lopez made an unannounced visit to the facility to continue the investigation into the allegations listed above and to deliver the complaint findings. LPA was greeted and granted entry into the facility by staff after explaining the purpose for the visit. Administrator Maria Dimacali was notified via telephone and later arrived to assist with the inspection.

During the course of the investigation, the Department conducted a tour of the physical plant of the facility, conducted interviews with residents, with staff, reviewed and obtained pertinent documents for this complaint. Regarding the allegation, staff did not assist resident with obtaining medical care in a timely manner, the following has been concluded: During the course of the investigation, the Department conducted ten resident interviews. Nine out of the ten resident interviews denied the allegation. One resident interviewed corroborated the allegation and reported previous issues with staff not assisting them with medical care in a timely manner. During the investigation, the Department conducted five staff interviews.
CONTINUED ON LIC9099-C

Unsubstantiated

Estimated Days of Completion: 90

SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Brandon Lopez
LICENSING EVALUATOR SIGNATURE:	DATE: 09/16/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/16/2026

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-20250107094112

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: PALMS RETIREMENT CENTER	FACILITY NUMBER: 306006071
	VISIT DATE: 09/16/2026

NARRATIVE

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Five out of the five staff interviewed denied the allegation and reported no issues with medical care. The five staff also stated that they have not received any complaints from residents regarding medical care.

Regarding the allegation, staff did not distribute a resident's medication as prescribed, the following has been concluded: During the investigation, the Department conducted ten resident interviews. Nine out of the ten resident interviewed denied the allegation and reported no issues with their medication. One out of the ten residents interviewed corroborated the allegation and reported that staff have not given them their medication on schedule. The Department conducted five staff interviews regarding this allegation. Five out of the five staff interviewed denied the allegation and reported no issues with resident's medication being given. During the investigation, the Department audited the medication and medication administration records for the ten residents that were interviewed. The Department did not observe any discrepancies from the active medication orders and the medications that the facility had on hand. The Department observed all medications for the ten residents to be given in accordance to their prescribed orders.

Regarding the allegation, staff do not maintain facility free from pests, the following has been concluded: During the course of the investigation, the Department conducted a tour of the physical plant of the facility. The Department inspected areas such as the dining room, the kitchen, the activity room, the library, the two medication rooms, and ten resident bedrooms. The Department observed each area to be free of any pest. The Department did not observe any evidence to suggest the presence of pest. During the investigation, the Department conducted ten resident interviews. Seven out of the ten residents interviewed denied the allegation and reported that they have not observed any pest at the facility. Three out of the ten residents interviewed corroborated the allegation and reported that they have observed pest present at the facility in the past. The residents were unable to provide any evidence to support their statements. The Department also conducted five staff interviews. Five out of the five staff interviewed denied the allegation and reported that they have not observed pest present at the facility. The Department also obtained pest control records for the facility during the investigation and observed the facility receives pest control services on a monthly basis.

Regarding the allegation, staff do not maintain facility sanitary, the following has been concluded: During the course of the investigation, the Department conducted a tour of the physical plant of the facility. The Department inspected areas such as the dining room, the kitchen, the activity room, the library, the two medication rooms, and ten resident bedrooms. CONTINUED ON LIC9099-C

SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Brandon Lopez
LICENSING EVALUATOR SIGNATURE:	DATE: 09/16/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/16/2026

LIC9099 (FAS) - (06/04)

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Control Number 22-AS-20250107094112

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: PALMS RETIREMENT CENTER	FACILITY NUMBER: 306006071
	VISIT DATE: 09/16/2026

NARRATIVE

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The Department observed each area to be sanitary and free of any hazards. During the investigation, the Department conducted ten resident interviews. Ten out of the ten residents interviewed denied the allegation and reported being satisfied with the cleanliness of the facility. The Department also conducted five staff interviews. Five out of the five staff interviewed denied the allegation and reported no issues with the cleanliness of the facility.

Based on the evidence gathered during the investigation, the Department is unable to ascertain if the allegations occurred as reported. Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove or refute the alleged violations occurred; therefore, the four allegations above are deemed UNSUBSTANTIATED. An exit interview was conducted with Administrator Maria Dimacali and a copy of the report was provided at time of visit.

SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Brandon Lopez
LICENSING EVALUATOR SIGNATURE:	DATE: 09/16/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/16/2026

LIC9099 (FAS) - (06/04)

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