306002176-1-27-2026-22-AS-SSAS-DQTVU2-20260130154401

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306002176
Report Date: 01/27/2026
Date Signed: 01/27/2026 02:59:09 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
01/23/2026 and conducted by Evaluator Ruth Martinez

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20260123120601

FACILITY NAME:	SUNNY HILLS VILLA ELDER CARE HOME		FACILITY NUMBER:	306002176
ADMINISTRATOR:	DELIA GOG		FACILITY TYPE:	740
ADDRESS:	25121 BAUTISTA DRIVE		TELEPHONE:	(949) 351-2984
CITY:	LAGUNA HILLS	STATE: CA	ZIP CODE:	92653
CAPACITY:	6	CENSUS: 4	DATE:	01/27/2026
		UNANNOUNCED	TIME BEGAN:	07:40 AM
MET WITH:	Delia Gog		TIME COMPLETED:	03:30 PM

ALLEGATION(S):

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Facility not providing agreed upon services.
Staff rough with resident during continence care.
Staff are leaving resident in soiled brief for extended period of time.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Ruth Martinez conducted an unannounced visit to the facility to investigation the above identified complaint allegation and deliver findings. LPA Martinez met with Delia Gog, Administrator, and explained the purpose of the visit.

During the course of the investigation, interviews were conducted, a tour of the physical plant of the facility was conducted, a review of resident records was completed and copy of pertinent documents obtained.
It is alleged that facility not providing agreed upon services. Records review revealed that the admissions agreement for residents (R1) services provided are as follows: basic services which may include but are not limited to care and supervision, food services, helping gain access to supportive devices, assistance with dressing, toileting, bathing, grooming, mobility, medication management, laundry, and providing basic hygiene items. There are no optional services listed. Interview with staff stated that R1 is provided basic

Continued on LIC9099-C

Unsubstantiated

Estimated Days of Completion: 1

SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Ruth Martinez
LICENSING EVALUATOR SIGNATURE:	DATE: 01/27/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2026

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-20260123120601

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: SUNNY HILLS VILLA ELDER CARE HOME	FACILITY NUMBER: 306002176
	VISIT DATE: 01/27/2026

NARRATIVE

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services that are listed in the admissions agreement as well as incontinence care and transferring from bed to wheelchair. When R1 is changed, it needs to be transferred and/or getting up from bed it is done with two person assistance and with the use of a hoyer lift. Interview with R1 stated that staff help them out all the time, get up from bed, come and reposition them and transfer them from the bed to the wheelchair all the time. Staff help them get out of bed all the time because they can’t do it on their own. LPA took a tour of the facility and observed staff assisting residents with getting out of bed.

It is alleged that staff are rough with resident during continence care. Interview with staff stated that when R1 is changed during continence care it is done by two persons assist and with the assistance of a hoyer lift. Interview with R1 stated that staff change them when they are soiled and also check on them often to see if they need to be changed. They like the staff here and living here, but wish they could go home. I pay a lot for this place and get good treatment for the price I pay. I have no complaints about how I am treated and I have no concerns to report. Interview with 3 of 3 residents stated that staff is good to them and treat them good, they are not rough with them or treat them bad at all.

It is alleged that staff are leaving resident in soiled briefs for extended period of time. Record review reflects on resident appraisal that R1 uses diapers. Interview with staff stated that R1 does not wear briefs but does use diapers and is checked every two hours for a diaper change, for transfers or for getting out of bed. R1’s diaper is changed about 3-4 times a day and whenever R1 indicates that they need a change. R1 at times when soiled request that they wait to be changed but staff let R1 know that they have to be changed because it is not good to be left soiled and then R1 allows them to change the diaper. Interview with R1 stated that they get changed often and when needed by staff. They get help by two staff and they use the hoyer lift to assist them as well. They don’t get left for a long time with my diapers soiled. Staff come to ask them if they are wet and then also check to make sure, they come often to check on me but no they don’t recall them leaving them soiled for a long time.

Based on the information mentioned above, the Department is unable to ascertain if the allegations occurred as reported. Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove or refute the alleged violations occurred; therefore, these allegations are deemed Unsubstantiated.
An exit interview was conducted with the Administrator and a copy of this LIC9099 report was left at facility.

SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Ruth Martinez
LICENSING EVALUATOR SIGNATURE:	DATE: 01/27/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2026

LIC9099 (FAS) - (06/04)

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