306006127-3-20-2026-22-AS-APAO-DUXSGL-20260611135208

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306006127
Report Date: 03/20/2026
Date Signed: 03/20/2026 04:27:59 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
03/13/2026 and conducted by Evaluator Alvaro Ramirez Jr.

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20260313130126

FACILITY NAME:	GRACIE'S GUEST HOME		FACILITY NUMBER:	306006127
ADMINISTRATOR:	AZNAR, MARY GRACE		FACILITY TYPE:	735
ADDRESS:	13292 SIEMON AVE		TELEPHONE:	(714) 727-8741
CITY:	GARDEN GROVE	STATE: CA	ZIP CODE:	92843
CAPACITY:	6	CENSUS: 6	DATE:	03/20/2026
		UNANNOUNCED	TIME BEGAN:	01:24 PM
MET WITH:	Mary Aznar-Administrator		TIME COMPLETED:	04:42 PM

ALLEGATION(S):

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Staff hit client.
Facility did not comply with the reporting requirements.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Alvaro Ramirez, Jr. conducted an unannounced initial 10-Day complaint visit to initiate the investigation into the above allegations and to deliver the findings of the investigation. LPA was greeted and granted entry into the facility and met with Administrator (AD) Mary Aznar. LPA explained the reason for the visit.

This agency has investigated the complaint alleging that staff hit client. Regarding the allegation, the following was revealed: During the investigation LPA reviewed the Regional Center of Orange County (RCOC) Individual Program Plan (IPP) for Client 1 (C1). Per RCOC IPP, C1 is independent. Per RCOC IPP, C1 will exaggerate about things and states that C1 lies in order to get what she wants. During the course of the interviews with client, C1 reported that staff accidentally hit her while helping her with her inhaler. Per C2, staff have never hit her. During the course the interviews with staff, Staff 1 (S1) reported that staff never hit C1. S2 reported that staff have not hit C1.
CONTINUED ON LIC9099-C...

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Alvaro Ramirez Jr.
LICENSING EVALUATOR SIGNATURE:	DATE: 03/20/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2026

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-20260313130126

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: GRACIE'S GUEST HOME	FACILITY NUMBER: 306006127
	VISIT DATE: 03/20/2026

NARRATIVE

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During the interviews the AD reported that during an incident C1 was trying to drink the hand sanitizer. AD stated that staff was trying to take away the hand sanitizer from C1 and during the struggle the hand sanitizer slightly hit C1. During the interviews with witnesses, Witness 1 (W1) reported that staff have not hit C1 and stated that C1 has been giving contradicting scenarios.

Regarding the allegation that facility did not comply with the reporting requirements, the following was revealed: During the course of the investigation LPA reviewed the RCOC Special Incident Report dated March 12, 2026 for C1. Per Special Incident Report, on March 11, 2026, C1's brother was notified regarding C1 refusing to take her medication and attempting to drink hand sanitizer. During the interviews with clients, C1 reported that the incident was reported to her mother. Per C2, staff notify Regional Center of any incidents involving her. During the interviews with staff, S1 and S2 reported that the incident was not reported because staff did not hit C1. During the interviews AD reported that the incident was reported to C1's Responsible Party. Per W1, he was notified about the incident regarding C1.

Based on the information gathered during the investigation and review of documents obtained, LPA is unable to ascertain if the allegations occurred as reported due to conflicting information. Although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove or refute the alleged violations occurred; therefore, these allegations are deemed UNSUBSTANTIATED.

For today’s visit, there were no citations issued per Title 22, Division 6 of the California Code of Regulations.

LPA conducted an exit interview with AD Aznar, and a copy of this report was provided to the facility.

SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Alvaro Ramirez Jr.
LICENSING EVALUATOR SIGNATURE:	DATE: 03/20/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2026

LIC9099 (FAS) - (06/04)

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