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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306002535
Report Date: 08/08/2023
Date Signed: 08/08/2023 03:03:50 PM

Unfounded


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
07/01/2020 and conducted by Evaluator Rosie Quiroz
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20200701110909
FACILITY NAME:PARADISE RESIDENTIAL HOMEFACILITY NUMBER:
306002535
ADMINISTRATOR:NOEMI FIGUEROAFACILITY TYPE:
740
ADDRESS:546 N. WRIGHTWOOD DRIVETELEPHONE:
(714) 516-2750
CITY:ORANGESTATE: CAZIP CODE:
92869
CAPACITY:6CENSUS: 5DATE:
08/08/2023
UNANNOUNCEDTIME BEGAN:
01:59 PM
MET WITH:Noemi Figueroa, AdministratorTIME COMPLETED:
02:18 PM
ALLEGATION(S):
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-Staff neglect led to hospitalization of resident
INVESTIGATION FINDINGS:
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 On today's date, Licensing Program Analyst (LPA) Rosie Quiroz made an unannounced visit for the purpose to deliver findings for complaint allegation listed above. LPA Quiroz was greeted and met with Administrator (AD) Noemi Figueroa and discussed purpose of today's visit.
On 7/03/2020, LPA Quiroz conducted 10 day visit virtually due to COVID-19 precautionary measures.
Regarding the allegation "Staff neglect led to hospitalization of resident," the investigation revealed the following:Resident 1 (R1) was admitted to the facility on 12/01/2019. Three of three interviewees interviewed indicated resident slowly declined after admission due to medical health conditions. Interviews conducted with three of three interviewees indicated (R1) displayed change of condition symptoms observed by Facility Staff on 6/29/2020 on or about 2:00pm. It was concluded that Facility Staff immediately reported change of conditon symptoms to (R1s) responsible Party. Three of three interviewees indicated that (R1s) Responsible Party requested to wait to take (R1) to Emergency Room until the following day 6/30/2020 in the afternoon in order for (R1s) Responsible Party to be present.
CONTINUED NEXT PAGE...
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Rosie Quiroz
LICENSING EVALUATOR SIGNATURE:

DATE: 08/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/04/2023
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 2
Control Number 22-AS-20200701110909
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME: PARADISE RESIDENTIAL HOME
FACILITY NUMBER: 306002535
VISIT DATE: 08/08/2023
NARRATIVE
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Documentation reviewed but not limited to MRI of the brain conducted on 7/1/2020 at 8:48am, revealed the following: Stroke, new onset more than 6 hours, suspected.
Therefore based on the preponderance of evidence through interviews and observations conducted by LPA Quiroz, the allegation that the "Staff neglect led to hospitalization of resident" is UNFOUNDED, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. This agency has investigated this complaint.

An exit interview was conducted with Administrator Noemi Figueroa and a copy of this report and LIC 811- Confidential Names were provided at exit.
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Rosie Quiroz
LICENSING EVALUATOR SIGNATURE:

DATE: 08/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2