306001407-7-18-2025-22-AS-AORZ-DKJSWG-20250814141419

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306001407
Report Date: 07/18/2025
Date Signed: 07/18/2025 12:32:42 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
05/28/2025 and conducted by Evaluator Samer Haddadin

COMPLAINT CONTROL NUMBER: 22-AS-20250528130635

FACILITY NAME:	EMERALD COURT		FACILITY NUMBER:	306001407
ADMINISTRATOR:	DAIZEL C GASPERIAN		FACILITY TYPE:	740
ADDRESS:	1731 MEDICAL CENTER		TELEPHONE:	(714) 778-5100
CITY:	ANAHEIM	STATE: CA	ZIP CODE:	92801
CAPACITY:	299	CENSUS: 248	DATE:	07/18/2025
		UNANNOUNCED	TIME BEGAN:	08:00 AM
MET WITH:	Kelsey Chavez		TIME COMPLETED:	01:00 PM

ALLEGATION(S):

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Facility staff did not respond to resident in a timely manner

INVESTIGATION FINDINGS:

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On May 25, 2025, Licensing Program Analyst (LPA) Samer Haddadin conducted an unannounced complaint visit to present findings regarding the reported allegation cited above. Upon arrival, LPA Haddadin was greeted by Service Manager Kelsy Chavez, who granted access to the facility. Executive Director Dillon Cagulada later joined the visit.
During the investigation, LPA Haddadin toured the facility, interviewed one resident and four staff members, and reviewed all relevant facility records pertaining to pendent device activations. The allegation under review was that “Facility staff did not respond to resident in a timely manner- pendent call.” (The pendent is a device that residents wear and press when they require assistance.)
Four staff interviews and four residents interviews were conducted. Per staff interviews, all four employees confirmed that their response times intervals range from ten to twelve minutes and that they summon additional staff if a delay is anticipated. Four residents interviewed also indicated that staff respond to pendent calls but were unable to recall exact response times.
****CONTINUE***

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Samer Haddadin
LICENSING EVALUATOR SIGNATURE:	DATE: 07/18/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/18/2025

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-20250528130635

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: EMERALD COURT	FACILITY NUMBER: 306001407
	VISIT DATE: 07/18/2025

NARRATIVE

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Record review of the Device Activity Report for May 25, 2025, revealed that every pendent call that day was acknowledged in under ten minutes, with the longest recorded response time being ten minutes and the shortest six minutes.
Therefore, based on the preponderance of evidence gathered through interviews, record review, and analysis of the facility’s response logs, the allegation that staff “did not respond to a resident’s pendent call in a timely manner” is UNSUBSTANTIATED. Although timely responses are essential to resident safety, the evidence does not support a finding that the facility failed to meet its standard of care.
No deficiencies were cited during today’s visit. An exit interview was conducted with the Executive Director, and a copy of this report was provided to facility administration.

SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Samer Haddadin
LICENSING EVALUATOR SIGNATURE:	DATE: 07/18/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/18/2025

LIC9099 (FAS) - (06/04)

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