306006149-8-5-2026-22-AS-SSAS-DWQ297-20260806171124

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306006149
Report Date: 08/05/2026
Date Signed: 08/05/2026 11:01:07 AM

Unfounded

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
05/13/2026 and conducted by Evaluator Alvaro Ramirez Jr.

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20260513104158

FACILITY NAME:	CARE CONNECTION		FACILITY NUMBER:	306006149
ADMINISTRATOR:	GILBERT, ERIC		FACILITY TYPE:	740
ADDRESS:	416 S JENNIFER LANE		TELEPHONE:	(714) 289-2273
CITY:	ORANGE	STATE: CA	ZIP CODE:	92869
CAPACITY:	6	CENSUS: 6	DATE:	08/05/2026
		UNANNOUNCED	TIME BEGAN:	08:15 AM
MET WITH:	Eric Gilbert-Administrator		TIME COMPLETED:	11:15 AM

ALLEGATION(S):

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Staff does not ensure resident has privacy during medical visits
Staff prevents medical professionals from visiting resident

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Alvaro Ramirez, Jr. conducted an unannounced visit to deliver findings on the above allegations received on May 13, 2026. LPA was greeted and granted entry into the facility and met with Administrator (AD) Eric Gilbert. LPA explained the reason for the visit.

This Department has investigated the complaint alleging that staff does not ensure resident has privacy during medical visits. Regarding the allegation the following was revealed: During the interviews with residents, Resident 1 (R1) reported that they have privacy during their visits. Per R3, they have privacy during their medical visits. During the initial visit on May 20, 2026, LPA observed that R1 had privacy during their visit from Hospice. During the interviews with staff, Staff 1 (S1) and S2 reported that R1 has privacy during their medical visits. During the interviews with witnesses, Witness 1 (W1) and W2 reported that there is always privacy when visiting R1 and/or stated that R1 has privacy during their medical visits.
CONTINUED ON LIC9099-C...

Unfounded

Estimated Days of Completion:

SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Alvaro Ramirez Jr.
LICENSING EVALUATOR SIGNATURE:	DATE: 08/05/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2026

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 4

Control Number 22-AS-20260513104158

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: CARE CONNECTION	FACILITY NUMBER: 306006149
	VISIT DATE: 08/05/2026

NARRATIVE

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Regarding the allegation that staff prevents medical professionals from visiting resident, the following was revealed: During the initial visit LPA observed that Hospice was allowed to visit R1. During the interviews with residents R1 reported that they are allowed to have visitors. Per R3, their Doctor and Nurse have never been denied entrance. During the interviews with staff, S1 and S2 reported that staff have not prevented medical professionals from visiting R1. During the interviews with witnesses, W1 and W2 stated that they have never been denied entry to visit R1.

Therefore, these allegations are deemed UNFOUNDED, meaning the allegations are false, could not have happened and/or are without a reasonable basis.

For today’s visit, there were no citations issued per Title 22, Division 6 of the California Code of Regulations.
LPA Ramirez conducted an exit interview with AD Gilbert, 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: 08/05/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2026

LIC9099 (FAS) - (06/04)

Page: 2 of 4

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
05/13/2026 and conducted by Evaluator Alvaro Ramirez Jr.

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20260513104158

FACILITY NAME:	CARE CONNECTION		FACILITY NUMBER:	306006149
ADMINISTRATOR:	GILBERT, ERIC		FACILITY TYPE:	740
ADDRESS:	416 S JENNIFER LANE		TELEPHONE:	(714) 289-2273
CITY:	ORANGE	STATE:CA	ZIP CODE:	92869
CAPACITY:	6	CENSUS: 6	DATE:	08/05/2026
		UNANNOUNCED	TIME BEGAN:	08:15 AM
MET WITH:	Eric Gilbert-Administrator		TIME COMPLETED:	11:15 AM

ALLEGATION(S):

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Staff interfered with resident's medical device
Staff released personal information to an unauthorized individual

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Alvaro Ramirez, Jr. conducted an unannounced visit to deliver findings on the above allegations received on May 13, 2026. LPA was greeted and granted entry into the facility and met with Administrator (AD) Eric Gilbert. LPA explained the reason for the visit.

This Department has investigated the complaint alleging that staff interfered with resident's medical device. Regarding the allegation the following was revealed: During the interviews with residents, Resident 1 (R1) reported that they do not have a heart monitor. During the investigation LPA reviewed the UCI Health Medtronic/remote pacemaker dated May 12, 2026, for R1. Per UCI Health Medtronic, it states unit began transmitting after 92 days of disconnection. During the interviews with staff, Staff 1 (S1) reported that R1 has a heart monitor and stated that they do no monitor the heart monitor. Per S2, staff do not interfere with R1's heart monitor. During the interviews with witnesses, Witness 1 (W2) reported that she is not aware about R1 having a heart monitor.
CONTINUED ON LIC9099C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Alvaro Ramirez Jr.
LICENSING EVALUATOR SIGNATURE:	DATE: 08/05/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2026

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 4

Control Number 22-AS-20260513104158

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: CARE CONNECTION	FACILITY NUMBER: 306006149
	VISIT DATE: 08/05/2026

NARRATIVE

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Regarding the allegation that staff released personal information to an unauthorized individual, the following was revealed: During the interviews with witnesses, W3 reported that staff released R1's personal information to an unknown Health company without R1's authorization. During the interviews with residents, R1 reported that they are not aware if staff released their personal information to an unauthorized individual. During the interviews with staff, S1 and S2 reported that staff have not released R1's personal information to an unauthorized individual. W2 reported that she is not aware about staff releasing the resident's personal information to an unauthorized individual.

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 facility representative, 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: 08/05/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2026

LIC9099 (FAS) - (06/04)

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