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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306006403
Report Date: 09/13/2025
Date Signed: 09/13/2025 12:42:15 PM

Unsubstantiated


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
10/31/2024 and conducted by Evaluator Kimberly Lyman
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20241031163012
FACILITY NAME:ENDOR CARE HOMEFACILITY NUMBER:
306006403
ADMINISTRATOR:GARCIA, CRYSTALFACILITY TYPE:
735
ADDRESS:760 S. FAIRWAY LANETELEPHONE:
(714) 300-9512
CITY:ANAHEIMSTATE: CAZIP CODE:
92807
CAPACITY:6CENSUS: 3DATE:
09/13/2025
UNANNOUNCEDTIME BEGAN:
12:21 PM
MET WITH:Mitra DixonTIME COMPLETED:
01:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility failed to seek medical attention
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Kimberly Lyman conducted an unannounced complaint visit to deliver findings on the above allegation. LPA was greeted and granted entry into the facility and explained the reason for the visit.

During the course of the investigation, LPA toured the facility and interviewed staff as well as reviewed and obtained pertinent documentation such as Individual Program Plan. Regarding the allegation that facility failed to seek medical attention, the investigation revealed the following: Client 1(C1) admitted into the facility on 10/23/2024 after living at home. Client was refusing to eat as becoming acclimated into a new environment. The client had vomited on 10/30/2024 but appeared well enough to attend day program on 10/31/2025. The client was sent home from day program for being off balance and facility called 911. Client was not admitted into the hospital and was sent back to the facility. On 11/04/2025, the client was sent out again and was admitted this time for electrolyte abnormalities. During the hospital stay, the client was prescribed medication for Colitis and CONTINUED ON LIC 9099C DATED 09/13/2025
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Kimberly Lyman
LICENSING EVALUATOR SIGNATURE:

DATE: 09/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2025
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-20241031163012
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: ENDOR CARE HOME
FACILITY NUMBER: 306006403
VISIT DATE: 09/13/2025
NARRATIVE
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had diabetic medication changed. Three out of three staff and witness confirm medical attention was sought for the client. Based on record review and interviews conducted, LPA is unable to corroborate the allegation. Therefore, the allegation is deemed unsubstantiated, meaning that although the allegation may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. An exit interview was conducted and a copy of this report was provided to facility.
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Kimberly Lyman
LICENSING EVALUATOR SIGNATURE:

DATE: 09/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2