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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306006150
Report Date: 07/17/2025
Date Signed: 07/17/2025 01:03:56 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
07/11/2025 and conducted by Evaluator Joseph Alejandre
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20250711142600
FACILITY NAME:CALIFORNIA CARE MENTAL HEALTHFACILITY NUMBER:
306006150
ADMINISTRATOR:BOUQUET, JASONFACILITY TYPE:
772
ADDRESS:25542 DANA MESA DRTELEPHONE:
(949) 291-3333
CITY:SAN JUAN CAPISTRANOSTATE: CAZIP CODE:
92675
CAPACITY:6CENSUS: 3DATE:
07/17/2025
UNANNOUNCEDTIME BEGAN:
11:31 AM
MET WITH:Hayley MontesTIME COMPLETED:
01:15 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility did not provide a copy of the admission agreements to clients.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Joseph Alejandre made an unannounced visit to conduct the required 10-day visit to begin the investigation into the allegation listed above. LPA was greeted and granted entry by staff and explained the reason for the visit. The investigation into the allegation, facility did not provide a copy of the admission agreements to clients, revealed the following. No client names were provided as to who did not receive a copy of their sgned admission agreement. LPA interviewed the 3 clients at the facility. 3 out of 3 clients reported they received a copy of their admission agreement. The Program Director reported that all clients receive a copy of their signed admission agreement. LPA attempted to contact 6 former clients. LPA only made contact with 1 former client who reported they received a copy of their admission agreement. A review of facility records shows the 3 current clients and the 6 former clients all have a signed admission agreement on file. No evidence was gathered to support the allegation, therefore the allegation is deemed unsubstantiated, meaning although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. An exit interview was conducted and a copy of the report provided.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Joseph Alejandre
LICENSING EVALUATOR SIGNATURE:

DATE: 07/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2025
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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