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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306006302
Report Date: 07/28/2025
Date Signed: 07/28/2025 12:05:36 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
04/30/2025 and conducted by Evaluator Sean Haddad
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20250430093633
FACILITY NAME:TELECARE PALMVIEW HOUSEFACILITY NUMBER:
306006302
ADMINISTRATOR:HERRERA-GARCIA, DANIELFACILITY TYPE:
737
ADDRESS:2255 W CRESTWOOD LANETELEPHONE:
(657) 999-5356
CITY:ANAHEIMSTATE: CAZIP CODE:
92804
CAPACITY:4CENSUS: 4DATE:
07/28/2025
UNANNOUNCEDTIME BEGAN:
11:18 AM
MET WITH:Leo CastanedaTIME COMPLETED:
12:20 PM
ALLEGATION(S):
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Staff did not follow clinical recommendations for clients
Documentation for clients' is not being maintained
INVESTIGATION FINDINGS:
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This unannounced inspection is being conducted by Licensing Program Analyst (LPA) Sean Haddad for the purpose of delivering findings for the investigation into the above identified complaint allegations. LPA met with Staff Leo Castaneda and explained the reason for today’s inspection.

The investigation into the allegations that staff did not follow clinical recommendations for clients and documentation for clients' is not being maintained revealed the following: During the course of the investigation, LPA inspected the facility, interviewed Program Administrator (PA) Kristen Newman and Administrator (AD) Emily Palacios, and obtained and reviewed copies of the client roster, staff roster, client care plans, and Client #1’s (C1) consultation logs.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Sean Haddad
LICENSING EVALUATOR SIGNATURE:

DATE: 07/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/28/2025
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 5
Control Number 22-AS-20250430093633
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME: TELECARE PALMVIEW HOUSE
FACILITY NUMBER: 306006302
VISIT DATE: 07/28/2025
NARRATIVE
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Regarding the allegation that staff did not follow clinical recommendations for clients: it was alleged that one client did not receive the clinically recommended number of primary care consultation in March 2025 and physical therapy in January 2025 and that all three clients did not receive the clinically recommended number of dietician consultation hours in March 2025 and April 2025. LPA interviewed PA who admitted the allegation. Per PA, C1 did not receive the required number of primary consultation hours in March 2025. LPA reviewed C1’s care plan which indicates they should receive 10 hours of primary care consultation per month. Per C1’s consultation logs, C1 only received 3 hours and 15 minutes of primary care consultation hours in March 2025. Per PA, three clients have dietician consultation services in their care plans, but the clients did not receive dietician consultation services in March 2025 and April 2025 and the facility does not have consultation logs for these services. LPA reviewed the care plans for three clients which confirm they should be receiving dietician consultation services. The information obtained corroborated the allegation.

Regarding the allegation that documentation for clients' is not being maintained: it was alleged that the consultation logs were not available for one client’s psychiatry consultation for November 2024. LPA interviewed PA who admitted the allegation, stating that while C1 likely received the required number of psychiatry consultation hours in November 2024, these consultation hours were not documented in C1’s file and the consultation logs for these hours do not exist. The information obtained corroborated the allegation.

During the course of the investigation, the Department obtained sufficient evidence to substantiate the allegations mentioned above. The preponderance of evidence standard has been met; therefore, the above allegations are Substantiated. See LIC9099D for cited deficiencies per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted and a copy of this report and appeal rights was discussed with and provided to facility representative.
SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Sean Haddad
LICENSING EVALUATOR SIGNATURE:

DATE: 07/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/28/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 22-AS-20250430093633
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

FACILITY NAME: TELECARE PALMVIEW HOUSE
FACILITY NUMBER: 306006302
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/28/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/25/2025
Section Cited
CCR
80075(a)
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80075 Health Related Services (a) The licensee shall ensure that each client receives necessary first aid and other needed medical or dental services… This requirement was not met as evidenced by:
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Licensee stated they will ensure all clients receive all required medical service hours per month and submit proof to LPA by POC due date.
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Based on documents and admission, the licensee did not ensure 3 out of 3 clients received the total number of required medical service hours per month, which poses a potential health risk to persons in care.
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Type B
08/25/2025
Section Cited
CCR
89970(a)(7)
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89970 Client Records … (a) The licensee shall ensure the client records include the following: … (7) Data collection, including progress notes, professional/consultant visits, and interventions/outcomes… This requirement was not met as evidenced by:
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Licensee stated they will ensure all medical care hours are logged for all clients and submit proof to LPA by POC due date.
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Based on documents and admission, the licensee did not ensure one client’s file contained documentation of psychiatry consultation visits for November 2024, which poses a potential health risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Sean Haddad
LICENSING EVALUATOR SIGNATURE:

DATE: 07/28/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/28/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 5