306001351-1-12-2026-22-AS-APAO-DQDV95-20260116151345

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306001351
Report Date: 01/12/2026
Date Signed: 01/12/2026 02:40:19 PM

Unfounded

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
09/07/2022 and conducted by Evaluator RoseMarie Ruppert

COMPLAINT CONTROL NUMBER: 22-AS-20220907150650

FACILITY NAME:	TESS LOVING HOME II		FACILITY NUMBER:	306001351
ADMINISTRATOR:	MARITES VILLANUEVA		FACILITY TYPE:	740
ADDRESS:	2785 E. DIANA AVE.		TELEPHONE:	(714) 630-0999
CITY:	ANAHEIM	STATE: CA	ZIP CODE:	92806
CAPACITY:	6	CENSUS: 3	DATE:	01/12/2026
		UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Marites "Tess" Villanueva, Administrator		TIME COMPLETED:	03:00 PM

ALLEGATION(S):

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Resident sustained multiple wounds in care due to neglect by facility staff.
Facility staff did not seek medical attention for resident in timely manner.
Facility retained a resident beyond their level of care.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Rose Ruppert made an unannounced visit to investigate a complaint received in the Regional Office. LPA was greeted and granted entry by Staff #1 (S1) at 1pm. LPA met with Administrator (AD) Marites "Tess" Villanueva and explained the purpose of the visit.

LPA obtained the following documentation for Resident #1 (R1): Physician's Report dated June 21, 2021, Resident Appraisal, Identification and Emergency Information and Admission Agreement. Resident had a diagnosis of dermatitis and required wound care and came from a Skilled Nursing Facility (SNF). The Resident Appraisal dated June 21, 2021 notes that R1 had superficial wounds all over the body due to dermatitis. R1 was bed bound and non-ambulatory with mild cognitive impairment.

LPA reviewed hospice paperwork for R1. R1 initially came to the facility on hospice care on June 23, 2021 from a SNF but was discharged on March 29, 2022. On August 2, 2022, the facility contacted hospice due
(Continued on LIC 9099-C)

Unfounded

Estimated Days of Completion:

SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: RoseMarie Ruppert
LICENSING EVALUATOR SIGNATURE:	DATE: 01/12/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/12/2026

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-20220907150650

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: TESS LOVING HOME II	FACILITY NUMBER: 306001351
	VISIT DATE: 01/12/2026

NARRATIVE

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(Continued from LIC 9099)

to non healing wounds and R1 began receiving hospice services and had a wound specialist that visited two times per week starting on August 2-29, 2022. Hospice continued to monitor and the hospice nurse asked the medical director for assessment. Hospice requested R1 be sent to the hospital on August 29, 2022.

LPA reviewed hospital discharge paperwork from August 29, 2022. Paperwork stated, R1, "...has had a long term history of non healing wounds due to severe dementia and functional quadriplegia. The wounds have been worsening to the point where her boarding care feels that they are unable to care for them. She was subsequently referred to the emergency department for evaluation." The principal problem, per hospital paperwork, was sepsis. R1 returned to the facility on September 2, 2022 and received hospice services. Resident passed away on September 4, 2022 at the facility.

LPA interviewed two of two staff members who both recalled the incident. Two of two staff denied all of the allegations. LPA interviewed two of two witnesses. Both witnesses denied all of the allegations.

Based on LPA's observations, record review and interviews the allegations that: Resident sustained multiple wounds in care due to neglect by facility staff, Facility staff did not seek medical attention for resident in timely manner and Facility retained a resident beyond their level of care are Unfounded. The allegations are false, could not have happened, and/or are without a reasonable basis.

An exit interview was conducted with Administrator, Marites "Tess" Villanueva and a copy of this report and LIC 811, were provided to the facility.

SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: RoseMarie Ruppert
LICENSING EVALUATOR SIGNATURE:	DATE: 01/12/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/12/2026

LIC9099 (FAS) - (06/04)

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