<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306002155
Report Date: 07/13/2023
Date Signed: 07/13/2023 11:03:39 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
07/07/2023 and conducted by Evaluator Joseph Alejandre
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20230707083239
FACILITY NAME:BRANDON MANORFACILITY NUMBER:
306002155
ADMINISTRATOR:MARY YEPESFACILITY TYPE:
740
ADDRESS:28421 BRANDON DR.TELEPHONE:
(949) 365-9082
CITY:LAGUNA NIGUELSTATE: CAZIP CODE:
92677
CAPACITY:5CENSUS: 5DATE:
07/13/2023
UNANNOUNCEDTIME BEGAN:
08:22 AM
MET WITH:Mary YepesTIME COMPLETED:
10:45 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Uncleared adult living at the facility.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Joseph Alejandre made an unannounced visit to conduct the required 10-day visit to begin the investigation into the allegations listed above. LPA met with Administrator Mary Yepes and explained the reason for the visit. The investigation into the allegation, unlicensed adult living at the facility revealed the following. LPA and the Administrator toured the facility. 5 residents were present at the facility along with the facility Administrator. The Administrator reported that a caregiver would be arriving at 10:00 am to start to work. Caregiver 1 arrived during LPA's visit. LPA did not observe any visitors at the facility and did not observe any individuals not associated to the facility on the premises. LPA interviewed staff and residents. LPA observed a small bed in the master bedroom closet. LPA observed medications in a box next to the bed that were unsecured. The Administrator reported the bed is for their use. LPA observed the medications were for residents and the Administrator. Based on the evidence gathered the allegation, uncleared adult living at the facility is deemed unsubstantiated. Although the allegation may have happened or is valid, there is no preponderance of evidence to prove the alleged violation did or did not occur. An exit interview was conducted and a copy of the report provided.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Luz Adams
LICENSING EVALUATOR NAME: Joseph Alejandre
LICENSING EVALUATOR SIGNATURE:

DATE: 07/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2023
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 1