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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306003850
Report Date: 08/12/2025
Date Signed: 08/12/2025 03:48:56 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
04/05/2021 and conducted by Evaluator Andrea Mendivil
COMPLAINT CONTROL NUMBER: 22-AS-20210405162044
FACILITY NAME:WHISPERING OAKS - WAVERLYFACILITY NUMBER:
306003850
ADMINISTRATOR:IMELDA C. CAROFACILITY TYPE:
740
ADDRESS:14782 WAVERLY LANETELEPHONE:
(714) 931-1945
CITY:IRVINESTATE: CAZIP CODE:
92604
CAPACITY:6CENSUS: 5DATE:
08/12/2025
UNANNOUNCEDTIME BEGAN:
02:06 PM
MET WITH:Eduardo Diaz- Caregiver TIME COMPLETED:
04:15 PM
ALLEGATION(S):
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Facility is understaffed
INVESTIGATION FINDINGS:
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On this day Licensing Program Analyst (LPA) Andrea Mendivil made an unannounced visit to deliver complaint findings. LPA Mendivil was greeted and granted entry into the faciltiy and explained the reason for the visit. Administrator/Licensee Imelda Caro was available via telephone.

The Department received a complaint on 04/05/2021 and LPA Tirre conducted the initial 10 day visit on 04/09/2021. During LPA Mendivil's visit LPA Mendivil interviewed staff and residents. Regarding the allegation that facility is understaffed, the investigation revealed the following:

It was alleged the facilty was understaffed. Per interviews with Administrator/Licensee Imelda Caro in 2021 around the time the complaint was filed she had 4 caregivers staffed at the house. Imelda stated she cannot remember the exact number of residents but would have been between 5-6 residents. Imelda stated that they were able to meet all of the residents needs in 2021. CONT on LIC 9099-C dated 08/12/2025
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Andrea Mendivil
LICENSING EVALUATOR SIGNATURE:

DATE: 08/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2025
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-20210405162044
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: WHISPERING OAKS - WAVERLY
FACILITY NUMBER: 306003850
VISIT DATE: 08/12/2025
NARRATIVE
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Imelda stated they rotate shifts so everyone should have 2 days off, but can work overtime if needed. Imelda stated currently they have a staff of 3 caregivers and they are rotated and given 2 days off each. The facility has 2 live in caregivers that are available as needed overnight. Based on interviews with 2 out of 3 caregivers stated they are able to meet the residents needs with 2 caregivers. The final caregiver was not available for interviews.

LPA Mendivil has observed 1-2 caregivers in addition to Imelda on multiple visits to the facility on 08/02/2022, 10/14/2022 and 12/16/2024. Based on interviews with 3 out of 5 residents stated the staff meet their needs. One resident was not oriented to time and space and could not answer LPA Mendivil's questions and the final resident was asleep at the time of the visit.

Therefore based on the preponderance of evidence through observations and interviews the allegation that facility is understaffed is determined to be UNSUBSTANTIATED meaning that although the allegation may have happened or are valid, there is not a preponderance of evidence to prove that the alleged violation occurred. This agency has investigated this complaint.

No deficiencies cited.

An exit interview was conducted and a copy of this report this report was provided to facility administrator.

SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Andrea Mendivil
LICENSING EVALUATOR SIGNATURE:

DATE: 08/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2025
LIC9099 (FAS) - (06/04)
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