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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306006344
Report Date: 12/16/2025
Date Signed: 12/16/2025 04:10:50 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
12/10/2025 and conducted by Evaluator RoseMarie Ruppert
COMPLAINT CONTROL NUMBER: 22-AS-20251210102834
FACILITY NAME:COGIR OF BREAFACILITY NUMBER:
306006344
ADMINISTRATOR:FAYE, SAMUELFACILITY TYPE:
740
ADDRESS:700 MADISON WAYTELEPHONE:
(714) 681-0105
CITY:BREASTATE: CAZIP CODE:
92821
CAPACITY:110CENSUS: 84DATE:
12/16/2025
UNANNOUNCEDTIME BEGAN:
04:01 PM
MET WITH:Cynthia Figueroa, Executive DirectorTIME COMPLETED:
04:30 PM
ALLEGATION(S):
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Staff do not provide adequate food service
Staff do not ensure residents' medication is given in a timely manner
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Rose Ruppert made an unannounced visit to investigate a complaint that was received in the Regional Office. LPA was greeted and granted entry by the Concierge at 8am. LPA met with Executive Director (ED) Cynthia FIgueroa and explained the purpose of the visit.

LPA obtained the resident roster, a care staff schedule for December 2025 and a care staff roster with phone numbers. LPA also requested additional Unusual Incident Reports that were sent to the office on December 15, 2025, Resident room cleaning/linen schedules and Resident laundry schedules. LPA also reviewed three of three resident records and three of three staff records and an In-service manual.

It was alleged that Staff do not provide adequate food service. LPA interviewed the Culinary Experience Director and was invited to observe meals. LPA toured Memory Care (MC) at 8:20am and learned the hot box with breakfast items was delivered at 8am. LPA observed eight residents eating breakfast and asked
(Continued on LIC 9099-C)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: RoseMarie Ruppert
LICENSING EVALUATOR SIGNATURE:

DATE: 12/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2025
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 2
Control Number 22-AS-20251210102834
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: COGIR OF BREA
FACILITY NUMBER: 306006344
VISIT DATE: 12/16/2025
NARRATIVE
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(Continued from LIC 9099)
three of three residents if they enjoyed their breakfast. Three of three residents stated the food was good but the food was lukewarm and not hot. LPA inquired if residents would like the food to be hotter and all stated No.

LPA also checked the refrigerator in Memory Care that stores snacks overnight for MC residents. Staff are able to contact the kitchen if the refrigerator needs to be stocked and culinary checks the MC refrigerator at 2:30pm. At 6:30pm, prior to the kitchen closing, culinary stocks the MC refrigerator with sandwiches, fruits and drinks for residents to snack on overnight; if they are hungry. LPA did observe snack and drink items in the refrigerator.

At 11:50am LPA observed residents eating lunch in Memory Care. The hot box temperature was at 117 degrees and LPA felt inside the box and found it to be hot. LPA again interviewed residents at lunch time and most stated their food was warm, not hot. LPA asked if residents wanted the food to be warmed up and again, all residents stated they were fine. Based on six of six resident interviews and nine of nine staff interviews, the allegation that Staff do not provide adequate food service is Unsubstantiated.

It was alleged that Staff do not ensure residents' medication is given in a timely manner. LPA interviewed six of six care staff who denied this allegation. In Memory Care, the Med Tech has the Memory Care Coordinator as a back-up to provide medications in a timely manner. Medications have a one hour window before the medication time is given; as well as a one hour window after the medication is to be given. There have been no incidents where residents in Memory Care are not receiving their meds. One of six residents interviewed stated they do not get medications in a timely manner and has to wait at least two hours. Five of six residents did not have issues with medications. Nine of nine staff interviews also denied this allegation. Thus the allegation that Staff do not ensure residents' medication is given in a timely manner is Unsubstantiated.

Based on LPA observations, record review and interviews, although the allegations above may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur. Therefore, the allegations that Staff do not provide adequate food service and Staff do not ensure residents' medication is given in a timely manner are Unsubstantiated. An exit interview was conducted with Executive Director, Cynthia Figueroa, and a copy of this report and LIC 811 was provided to the facility.
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: RoseMarie Ruppert
LICENSING EVALUATOR SIGNATURE:

DATE: 12/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2