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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306006464
Report Date: 05/15/2026
Date Signed: 05/15/2026 12:11:32 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
09/11/2024 and conducted by Evaluator Cassandra Mikkelson
COMPLAINT CONTROL NUMBER: 22-AS-20240911142253
FACILITY NAME:SOMERSET HOME 4FACILITY NUMBER:
306006464
ADMINISTRATOR:BELEN, LENETTE L.FACILITY TYPE:
735
ADDRESS:1668 W PALAIS ROADTELEPHONE:
(714) 814-8149
CITY:ANAHEIMSTATE: CAZIP CODE:
92802
CAPACITY:0CENSUS: DATE:
05/15/2026
UNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:TIME COMPLETED:
12:30 PM
ALLEGATION(S):
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Facility is not giving medications as prescribed
Client does not have access to phone
Client is not allowed to leave facility
INVESTIGATION FINDINGS:
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On 05/15/2026, Licensing Program Analyst (LPA) contacted the licensee via phone and email to deliver final findings regarding a complaint that was received on 09/11/2024.

**Report continued on 9099-C page
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Cassandra Mikkelson
LICENSING EVALUATOR SIGNATURE:

DATE: 05/15/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2026
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-20240911142253
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: SOMERSET HOME 4
FACILITY NUMBER: 306006464
VISIT DATE: 05/15/2026
NARRATIVE
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Facility is not giving medications as prescribed

Based on the information obtained during the course of the investigation, the Department is unable to determine the validity of the allegation listed above. Therefore, the allegation listed is unsubstantiated.

Client does not have access to phone

Based on the information obtained during the course of the investigation, the Department is unable to determine the validity of the allegation listed above. Therefore, the allegation listed is unsubstantiated.

Client is not allowed to leave facility

Based on the information obtained during the course of the investigation, the Department is unable to determine the validity of the allegation listed above. Therefore, the allegation listed is unsubstantiated.

A finding that a complaint allegation is unsubstantiated means that, although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.

Licensee was advised a copy of this report will be sent via certified mail. Two copies of this report will be sent. The Licensee is to sign and return a copy to the Orange County Regional office.

SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Cassandra Mikkelson
LICENSING EVALUATOR SIGNATURE:

DATE: 05/15/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2