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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306006302
Report Date: 08/19/2025
Date Signed: 08/19/2025 04:43:05 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
06/18/2025 and conducted by Evaluator Hanna Gough
COMPLAINT CONTROL NUMBER: 22-AS-20250618163648
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:
08/19/2025
UNANNOUNCEDTIME BEGAN:
04:05 PM
MET WITH:Leo CastanedaTIME COMPLETED:
05:00 PM
ALLEGATION(S):
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Facility did not meet the client’s needs
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Hanna Gough made an unannounced visit for the purpose of investigating the above mentioned complaint allegation. LPA was greeted and granted entry by staff. LPA met with Administrator (AD) Leo Castaneda and discussed the purpose of the visit.

The investigation into the allegation Facility did not meet the client’s needs revealed the following: During file review it was revealed that Client #1 (C1) was admitted to the facility on April 22, 2025. C1 has a physician’s report dated April 26, 2025, stating that C1 is non ambulatory and has motor impairment; does not care for own toileting needs; and is not able to care for personal needs. C1 being able to communicate was not marked on the physician’s report dated April 26, 2025 and was left blank. . LPA observed an Individual Program Plan for C1 dated March 27, 2025, stating that they communicate using limited words to convey their wants and needs along with nonverbal cues.
Continue on 9099-C

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Hanna Gough
LICENSING EVALUATOR SIGNATURE:

DATE: 08/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2025
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 4
Control Number 22-AS-20250618163648
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: TELECARE PALMVIEW HOUSE
FACILITY NUMBER: 306006302
VISIT DATE: 08/19/2025
NARRATIVE
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LPA reviewed a Functional Capability Assessment dated April 22, 2025, that stated that C1 needs help in all ADL’s and has a deficit in communication with help needed in toileting and that they do not tend to their own personal hygiene. LPA observed an Individual Behavior Support Plan dated April 28, 2025, stating that facility staff is always within arms reach to C1.

During interviews 4 of 4 staff stated that C1 has a 2:1 ratio at all times. LPA observed two staff with C1 during the course of the investigation. 4 of 4 staff informed LPA that C1 needs help with all ADL’s and is unable to communicate their needs clearly. 4 of 4 staff stated that they have to check C1 visually to ensure their needs are being met due to C1 not having a clear form of communication. 4 of 4 staff informed LPA that they check C1 for their needs and take care of them as soon as it is noticed. 1 of 4 staff informed LPA that if staff notice C1s pants have fallen or sagged, they will immediately fix it. Staff #1(S1) informed LPA that they have asked the responsible party for a proper belt and have not received one. 1 of 4 staff informed LPA that they will cut C1s nails, but due to them pulling their hands away they have asked C1s responsible party to provide a safer way of cutting C1s nails. S1 informed LPA that the facility has not received another method of cutting C1s nails after asking the responsible party for a safer method. LPA observed C1s nails to be of a shorter length at the time of the investigation. LPA attempted to contact C1s responsible party and was unable to make contact.

Based on information gathered during the investigation the department is unable to ascertain if the above allegation occurred as reported. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove or refute the alleged violation occurred; therefore, this allegations is deemed UNSUBSTANTIATED.

An exit interview was conducted with AD Leo Castaneda and a copy of this report was provided at the time of the investigation.

SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Hanna Gough
LICENSING EVALUATOR SIGNATURE:

DATE: 08/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 4