306000831-5-5-2026-22-AS-APAO-DTV44P-20260507184640

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306000831
Report Date: 05/05/2026
Date Signed: 05/05/2026 12:29:39 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
06/23/2021 and conducted by Evaluator Pang Lee

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20210623125429

FACILITY NAME:	BROOKDALE GARDEN GROVE		FACILITY NUMBER:	306000831
ADMINISTRATOR:	PAMELA BRADLEY		FACILITY TYPE:	740
ADDRESS:	10200 CHAPMAN AVE		TELEPHONE:	(714) 636-6453
CITY:	GARDEN GROVE	STATE: CA	ZIP CODE:	92840
CAPACITY:	140	CENSUS: 115	DATE:	05/05/2026
		UNANNOUNCED	TIME BEGAN:	11:30 AM
MET WITH:	Brisseth Arrellano		TIME COMPLETED:	11:45 AM

ALLEGATION(S):

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Staff neglect resulted in resident’s hospitalization
Staff neglected resident’s calls for help multiple times

INVESTIGATION FINDINGS:

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On 05/05/2026, Licensing Program Analyst (LPA) Pang Lee conducted a Microsoft Teams meeting with Facility Designated Administrator (FDA) Brisseth Arrellano, for the purpose of delivering complaint findings for the allegations above. A brief interview with FDA Arrellano.

It was alleged that staff neglect resulted in the resident being hospitalized. During the course of the investigation, the Department conducted interviews with facility staff, residents in care, and a resident’s responsible party. Based on interviews with five out of five residents, all reported no concerns regarding care and supervision. All residents also stated that they feel safe living in the facility. LPA Lee attempted to interview Resident 1 (R1); however, R1 is no longer residing at the facility and was not able to contact R1’s responsible party. In an interview with another resident’s responsible party, it was stated that staff are helpful and check on their mother several times a day, and that they “couldn’t ask for better care.”

CONTINUED LIC 9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Czarrina A Camilon-Lee
LICENSING EVALUATOR NAME: Pang Lee
LICENSING EVALUATOR SIGNATURE:	DATE: 05/05/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/05/2026

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-20210623125429

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: BROOKDALE GARDEN GROVE	FACILITY NUMBER: 306000831
	VISIT DATE: 05/05/2026

NARRATIVE

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Based on a review of records, there was no documentation indicating that R1 was hospitalized. LPA also attempted to obtain additional records/information regarding the allegation; however, further details could not be obtained from the facility, and current facility staff were not working at the time of the alleged incident. Based on interviews and records reviewed during the investigation, LPA Lee was unable to corroborate the allegation.

It was alleged that staff neglected residents’ calls for help multiple times. During the course of the investigation, the Department conducted interviews with facility staff, residents in care, and a resident’s responsible party. Based on interviews with facility staff, it was reported that the typical response time to residents’ calls for assistance is approximately five minutes. However, depending on staffing levels and residents’ needs, response times may occasionally take longer, but no longer than 15 minutes. Interviews with five out of five residents indicated that they are provided pendant call necklaces and reported no concerns regarding staff not responding to call pendants. Residents stated that response times are usually immediate, and at the longest, within approximately 15 minutes. In an interview with a resident’s responsible party, it was stated that during one visit, their mother activated the pendant, and facility staff “came immediately.” LPA also attempted to obtain additional records, including pendant call logs related to the allegation; however, these documents could not be obtained from the facility, and current staff present were not working at the time of the alleged incident. Based on interviews and records reviewed during the investigation, LPA Lee was unable to corroborate the allegation.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did nor did not occur, therefore, the allegation is unsubstantiated. An Exit Interview was conducted with (FDA) Arrellano and a copy of this report was provided to the facility via email. A certified copy will be sent to the facility mailing address.

SUPERVISORS NAME: Czarrina A Camilon-Lee
LICENSING EVALUATOR NAME: Pang Lee
LICENSING EVALUATOR SIGNATURE:	DATE: 05/05/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/05/2026

LIC9099 (FAS) - (06/04)

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