<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306006302
Report Date: 10/07/2025
Date Signed: 10/07/2025 12:47:30 PM

Substantiated


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
09/29/2025 and conducted by Evaluator RoseMarie Ruppert
COMPLAINT CONTROL NUMBER: 22-AS-20250929135107
FACILITY NAME:TELECARE PALMVIEW HOUSEFACILITY NUMBER:
306006302
ADMINISTRATOR:LEONARDO CASTANEDAFACILITY TYPE:
737
ADDRESS:2255 W CRESTWOOD LANETELEPHONE:
(657) 999-5356
CITY:ANAHEIMSTATE: CAZIP CODE:
92804
CAPACITY:4CENSUS: 4DATE:
10/07/2025
UNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Christina Mance, Regional Director of Operations TIME COMPLETED:
12:46 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff did not prevent a resident from physically assaulting another resident in care
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Rose Ruppert made an unannounced visit to investigate a complaint received in the Regional Office. LPA was greeted and granted entry by Staff #1 and explained the purpose of the visit.

It was alleged that staff did not prevent a resident from physically assaulting another resident in care. LPA requested five of five staff files and reviewed two of two client files and reviewed an Unusual Incident Report received in the office on 10/1/2025. An incident occurred on 9/29/2025 at 8:15am where Client #1 (C1) hit Client #2 (C2).

Per review of C1's Individual Behavior Support Plan (IBSP) dated 8/18/2025 the primary objective is to reduce physical aggression to 0 times per month across 6 months of consecutive observation. C1 has two staff members assigned to them. Per Individual Program Plan (IPP) on 12/23/2025 C1 prefers to be isolated
(Continued on LIC 9099-C)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: RoseMarie Ruppert
LICENSING EVALUATOR SIGNATURE:

DATE: 10/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2025
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 3
Control Number 22-AS-20250929135107
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: 10/07/2025
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
(Continued from LIC 9099)
and free of noise and others. Per review of C2's Individual Behavior Support Plan dated 9/5/2024 C2's primary objective is to reduce physical aggressive behavior to 0 times per month across 6 consecutive months, C2 also has two staff members assigned to them. Per Individualized Program Plan (IPP) dated 3/7/2025 C2's behaviors were focused on ways for C2 to remain in optimal mental and physical health; with the help of the facility and medical team.

On 9/29/25 both C1 and C2 approached the kitchen trash can from different directions. One assigned staff member for C1, was cooking breakfast and it is unclear where the second assigned staff member to C1 was located. C2 was also approaching the trash can and also has two staff members assigned to them. One of C2's assigned staff members, immediately stood between the two clients as they met at the kitchen trash can. C1 was able to reach around the staff member between them and struck C2. C2 immediately tried to retaliate and staff members attempted to restrain C2 with a CPI hold A second team hold was initiated with C2 and two staff members for C1 immediately left the area, went outside through the backyard and waited with a third client, and staff members, in the garage. Staff and clients returned indoors when C2 left the facility on a walk with two staff members.

LPA interviewed three of three clients. Two of the three clients confirmed staff did not prevent the incident from occurring. Three of three staff were interviewed and also confirmed the incident could have been avoided. One of one witness was interviewed and was present but was tasked with making breakfast. The witness immediately went to assist during the incident and took C1 outdoors and to the garage.

Based on LPA's record review, observations and interviews, the preponderance of evidence standard has been met, therefore the allegation that Staff did not prevent a resident from physically assaulting another resident in care is Substantiated.

An exit interview was conducted with Christina Mance, Regional Director of Operations and a copy of this report, LIC 811, LIC 9099-D and Appeal Rights were provided to the facility.
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: RoseMarie Ruppert
LICENSING EVALUATOR SIGNATURE:

DATE: 10/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 22-AS-20250929135107
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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/07/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/08/2025
Section Cited
CCR
80078(a)
1
2
3
4
5
6
7
80078 Responsibility for Providing Care and Supervision. (a) The licensee shall provide care and supervision as necessary to meet the client's needs. This requirement was not met as evidenced by: Based on record review, client and staff interviews, staff did
1
2
3
4
5
6
7
Qualified Behavioral Professional provided inservice after the incident on 9/29 for supervision and pad use and will email to LPA. Telecare will provide the debrief information to LPA by POC date.
8
9
10
11
12
13
14
not prevent a client from hitting another client. This poses an immediate health and safety risk to clients in care.
8
9
10
11
12
13
14
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
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: Alisa Ortiz
LICENSING EVALUATOR NAME: RoseMarie Ruppert
LICENSING EVALUATOR SIGNATURE:

DATE: 10/07/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3