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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306006421
Report Date: 10/20/2025
Date Signed: 10/20/2025 04:50:27 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
01/31/2025 and conducted by Evaluator Edward Kim
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20250131171222
FACILITY NAME:BAYSHIRE YORBA LINDAFACILITY NUMBER:
306006421
ADMINISTRATOR:COLEMAN, CHADFACILITY TYPE:
741
ADDRESS:17803 IMPERIAL HWYTELEPHONE:
(714) 777-9666
CITY:YORBA LINDASTATE: CAZIP CODE:
92886
CAPACITY:114CENSUS: 100DATE:
10/20/2025
UNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Executive Director- Austin MorrisTIME COMPLETED:
05:00 PM
ALLEGATION(S):
1
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7
8
9
The Administrator is not present in the facility.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On October 20, 2025, Licensing Program Analyst Edward Kim conducted a subsequent complaint visit to deliver complaint investigation findings. LPA met with Executive Director (ED) Austin Morris and explained the purpose of today’s visit.

The investigation consisted of the following. On February 6, 2025, LPA Kim toured the facility with ED Austin Morris. LPA requested and obtained copies of the resident roster and staff roster. LPA requested copies of residents service records which include Physician’s Report, Appraisal/Needs and Services Plan, and other pertinent records. LPA interviewed six (S1-S6) staff and three residents (R1-3). LPA attempted four resident interviews.

The investigation revealed the following:
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Edward Kim
LICENSING EVALUATOR SIGNATURE:

DATE: 10/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2025
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
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
01/31/2025 and conducted by Evaluator Edward Kim
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20250131171222

FACILITY NAME:BAYSHIRE YORBA LINDAFACILITY NUMBER:
306006421
ADMINISTRATOR:COLEMAN, CHADFACILITY TYPE:
741
ADDRESS:17803 IMPERIAL HWYTELEPHONE:
(714) 777-9666
CITY:YORBA LINDASTATE: CAZIP CODE:
92886
CAPACITY:114CENSUS: 100DATE:
10/20/2025
UNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Executive Director- Austin MorrisTIME COMPLETED:
05:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Licensee is not ensuring the facility Administrator is qualified.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On October 20, 2025, Licensing Program Analyst Edward Kim conducted a subsequent complaint visit to deliver complaint investigation findings. LPA met with Executive Director (ED) Austin Morris and explained the purpose of today’s visit.

The investigation consisted of the following. On February 6, 2025, LPA Kim toured the facility with ED Austin Morris. LPA requested and obtained copies of the resident roster and staff roster. LPA requested copies of residents service records which include Physician’s Report, Appraisal/Needs and Services Plan, and other pertinent records. LPA interviewed six (S1-S6) staff and three residents (R1-R3). LPA attempted four resident interviews.

The investigation revealed the following:
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Edward Kim
LICENSING EVALUATOR SIGNATURE:

DATE: 10/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 22-AS-20250131171222
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: BAYSHIRE YORBA LINDA
FACILITY NUMBER: 306006421
VISIT DATE: 10/20/2025
NARRATIVE
1
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3
4
5
6
7
8
9
10
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12
13
14
15
16
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21
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32
Allegation: Licensee is not ensuring the facility Administrator is qualified.

It is alleged that Executive Director Austin Morris does not possess an RCFE Administrator Certification.

During a complaint investigation visit, the LPA observed the Administrator’s Certificate displayed at the facility entrance. The certificate lists Chad Coleman as the Administrator, with an effective date of January 10, 2023, and an expiration date of May 10, 2025. Upon further investigation and review of the CDSS Administrator Certification Online Application Portal, the LPA confirmed that Chad Coleman submitted all required documentation and completed the necessary training for his certification renewal. It was also verified that Chad Coleman is the current Facility Administrator, and that Austin Morris is not required to hold an Administrator certification.

Based on the information gathered during the investigation through observations and document review, the allegation mentioned above is deemed Unfounded, meaning the allegation is false, could not have happened and/or is without a reasonable basis.

Exit interview was conducted and a copy of the report was provided to Executive Director Austin Morris.

SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Edward Kim
LICENSING EVALUATOR SIGNATURE:

DATE: 10/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 22-AS-20250131171222
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: BAYSHIRE YORBA LINDA
FACILITY NUMBER: 306006421
VISIT DATE: 10/20/2025
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
Allegation: The Administrator is not present in the facility.

It is alleged that the Administrator was last seen in the community in October 2024 and on January 16, 2025.
Based on interviews, three out of three residents denied the allegation that the administrator was not present in the facility. Five out of six staff denied the allegation, while one confirmed that the administrator was not present in the facility. Additionally, five staff confirmed the administrator is at the facility at least two times during the week, four to eight hours a day. Based on review of the facility’s staff schedule, administrator’s name was not included, however, during an unannounced visit at the facility in September 2025, LPA Kim observed the administrator was present.

Based on records review, interviews, and observations, LPA did not find sufficient evidence to support the above allegation. Although the allegation 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 allegation is Unsubstantiated.

Exit interview was conducted and a copy of the report was provided to Executive Director Austin Morris.
SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Edward Kim
LICENSING EVALUATOR SIGNATURE:

DATE: 10/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 4