306006344-5-14-2026-22-AS-AORZ-DU8UAV-20260519152516

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306006344
Report Date: 04/28/2026
Date Signed: 05/14/2026 03:25:01 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
03/24/2026 and conducted by Evaluator RoseMarie Ruppert

COMPLAINT CONTROL NUMBER: 22-AS-20260324113805

FACILITY NAME:	COGIR OF BREA		FACILITY NUMBER:	306006344
ADMINISTRATOR:	FAYE, SAMUEL		FACILITY TYPE:	740
ADDRESS:	700 MADISON WAY		TELEPHONE:	(714) 681-0105
CITY:	BREA	STATE: CA	ZIP CODE:	92821
CAPACITY:	110	CENSUS: 80	DATE:	04/28/2026
		UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Cynthia Figueroa, Executive Director		TIME COMPLETED:	04:15 PM

ALLEGATION(S):

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Staff do not ensure resident is accorded with dignity and respect in their personal relationships with others
Staff do not ensure resident is provided personal privacy
Staff do not ensure resident is spoken to in an appropriate manner
Staff do not ensure resident is served meals in a timely manner as a form of punishment

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) made an unannounced visit to deliver findings for a complaint investigated by the Department. LPA was greeted and granted entry by the Concierge at 11am. LPA met with Executive Director (ED) Cynthia Figueroa and explained the purpose of the visit.

LPA obtained the current staff roster and there are eighty residents in care. LPA reviewed Resident #1 (R1)'s Identification and Emergency Information, Physician's Report dated 8/20/2025, Preplacement Appraisal Information dated 8/11/2025 and R1's Plan of care, dated 8/11/2025, LPA also reviewed the file of Staff #1 (S1) which included: Personnel Record, Criminal Record Statement, Health Screening Report, Corrective Action Form and a written report from S1. S1 recently resigned and no longer is employed by the community. Brea Police Department has also conducted two welfare checks and shared with R1 that there has been no crime and police reports were not filed.

(Continued on LIC 9099-C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: RoseMarie Ruppert
LICENSING EVALUATOR SIGNATURE:	DATE: 04/28/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2026

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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Control Number 22-AS-20260324113805

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: 04/28/2026

NARRATIVE

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(Continued from LIC 9099)

Per Physician's Report dated 8/20/2025, Resident #1 (R1) has primary diagnoses of osteoporosis and osteoarthritis. R1 does not have mental cognitive impairment but has a history of behavior expression of paranoia. R1 is independent and does not require assistance with mobility/ambulation. Per medical assessment the resident is non-ambulatory due to physical condition diagnoses. R1 is capable of administering their own medications. The pre-appraisal from 8/11/2025 states R1 doesn't prefer to be social but is encouraged to join activities. R1 is capable of doing their own laundry and household tasks. Per R1's Care Plan R1 has a history of occasional anxiety and depression or mood disorder.

It was alleged that: Staff do not ensure resident is accorded with dignity and respect in their personal relationships with others. Per LPA staff and resident interviews, R1 usually comes to the dining room for dinner. A comment was made, at the dinner table that female residents stink. Another resident at the table then covered their nose. R1 felt the comment was made towards them. LPA interviewed six of six residents. Three residents at the table were interviewed. One resident confirmed the allegation, a second resident denied the allegation and the third resident moved out of the community and could not be interviewed. Two additional residents were interviewed and denied the allegation. The allegation that Staff do not ensure resident is accorded with dignity and respect in their personal relationships with others is Unsubstantiated.

LPA investigated the allegation that Staff do not ensure resident is provided personal privacy. Staff were instructed to conduct a room check for a resident's missing laundry. Two staff members knocked on R1's door and requested entry. The staff stated they were looking for a resident's missing laundry items and requested permission to look in R1's closet and dresser. R1 permitted entry to search for the missing items. R1 does not use laundry services and is able to do their own laundry. Several days later, R1 shared the incident with management, stating they were not afforded privacy and that the staff members entered while R1 was in the bathroom. Staff and management are aware that R1 prefers to be private and so staff will enter the apartment in pairs as needed, to ensure R1 is more at ease with staff. R1 is independent and does not require a lot of services and staff do not enter R1's apartment often. One resident confirmed the allegation and three residents denied the allegation. The allegation that Staff do not ensure resident is provided personal privacy is Unsubstantiated.

(Continued on LIC 9099-C1)

SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: RoseMarie Ruppert
LICENSING EVALUATOR SIGNATURE:	DATE: 04/28/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2026

LIC9099 (FAS) - (06/04)

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Control Number 22-AS-20260324113805

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: 04/28/2026

NARRATIVE

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(Continued from LIC 9099-C)

It was also alleged that Staff do not ensure resident is spoken to in an appropriate manner. It was reported to management that two persons entered R1's apartment and were asking questions about R1's medications and medical information. The incident occurred on a Saturday and management was not aware of the incident until Monday. Management interviewed staff and reviewed facility hallway cameras. It was determined the two people visiting were a Physician's Assistant (PA) and Social Worker (SW) from the Primary Care Provider agency; whom R1 permitted entry. R1 also reported that another staff member made inappropriate comments while watching an evening movie. When asked what the comments were, R1 referred to a film the staff member was discussing. The staff member has since resigned and left the community. One resident confirmed the above allegation and three residents denied the allegation; stating staff are always professional and courteous. Five of five staff interviewed all denied the allegation. Thus the allegation that staff do not ensure resident is spoken to in an appropriate manner is Unsubstantiated.

LPA investigated the allegation that: Staff do not ensure resident is served meals in a timely manner as a form of punishment. It was reported to LPA that dining staff did not provide a meal at dinner to punish the resident. LPA interviewed five of five staff members who denied the allegation. Three of five residents interviewed also denied the allegation. One resident was unavailable to interview who were present. Staff interviews shared that R1 had eaten an entree and, later, ordered another entree. The server took the second entree order but, as the staff member was walking to the kitchen, was delayed by another table. The order was then placed with the chef. As the residents at R1's table received their initial dinner orders, one of the residents inquired about the second order for R1. The server stated the order was placed but R1 immediately got up from the table and left the dining room. This was brought to management's attention and the chef spoke with R1 about the incident and assured R1 it was not a delay to punish the resident and the order was completed. Thus the allegation that Staff do not ensure resident is served meals in a timely manner as a form of punishment is Unsubstantiated.

(Continued on LIC 9099-C2)

SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: RoseMarie Ruppert
LICENSING EVALUATOR SIGNATURE:	DATE: 04/28/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2026

LIC9099 (FAS) - (06/04)

Page: 3 of 4

Control Number 22-AS-20260324113805

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: 04/28/2026

NARRATIVE

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(Continued from LIC 9099 C1)

Based on LPA's file review, observations and interviews the allegations that: Staff do not ensure resident is accorded with dignity and respect in their personal relationships with others, Staff do not ensure resident is provided personal privacy, Staff do not ensure resident is spoken to in an appropriate manner and, Staff do not ensure resident is served meals in a timely manner as a form of punishment are Unsubstantiated. The allegations may have happened or are valid, but there is not a preponderance of the evidence to prove that the alleged violations occurred.

An exit interview was conducted with Executive Director (ED) Cynthia Figueroa and a copy of this report,and LIC 811 were provided to the facility.

***This is an amended report.***

SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: RoseMarie Ruppert
LICENSING EVALUATOR SIGNATURE:	DATE: 04/28/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2026

LIC9099 (FAS) - (06/04)

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