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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306002201
Report Date: 04/23/2026
Date Signed: 04/23/2026 03:04:55 PM

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
03/23/2026 and conducted by Evaluator Kimberly Lyman
COMPLAINT CONTROL NUMBER: 22-AS-20260323110021
FACILITY NAME:PATCHWORK QUILT GUEST HOME IIFACILITY NUMBER:
306002201
ADMINISTRATOR:RIZALINA S. REYESFACILITY TYPE:
740
ADDRESS:25182 CAMPO ROJOTELEPHONE:
(949) 581-7049
CITY:LAKE FORESTSTATE: CAZIP CODE:
92630
CAPACITY:6CENSUS: 6DATE:
04/23/2026
UNANNOUNCEDTIME BEGAN:
02:25 PM
MET WITH:Dhalynjoy and Danny DeJesusTIME COMPLETED:
03:20 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff yelled at resident in care
Staff inappropriately spoke to resident in care
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Kimberly Lyman conducted an unannounced complaint visit to deliver findings on the above allegations. LPA was greeted and granted entry into the facility and explained the reason for the visit.
During the course of the investigation, LPA toured the facility and interviewed staff and residents. Regarding the allegations that staff yelled at resident in care and staff inappropriately spoke to resident in care, the investigation revealed the following: Licensee indicated an incident on 03/21/2026 where Staff 1 (S1) and S2 got into a verbal altercation in the facility. Both staff were yelling at each other but not at residents. The staff were separated and there were no further incidents. Administrator indicates neither staff is employed at the facility since the incident. Two out of two staff and four out of four residents deny witnessing staff yell or talk inappropriately to residents. Based on interviews conducted, LPA is unable to corroborate the allegations. Therefore, the allegations have been determined to be unsubstantiated, meaning that although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. Exit interview conducted and a copy of this report was left at the facility.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Kimberly Lyman
LICENSING EVALUATOR SIGNATURE:

DATE: 04/23/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/23/2026
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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