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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306004491
Report Date: 10/21/2025
Date Signed: 10/21/2025 03:10:23 PM

Unfounded


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
10/15/2025 and conducted by Evaluator Hanna Gough
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20251015125341
FACILITY NAME:ELEGANT CARE VILLA - BUENA PARKFACILITY NUMBER:
306004491
ADMINISTRATOR:MARK JOHN M. ALIPIOFACILITY TYPE:
740
ADDRESS:5491 BURLINGAME AVENUETELEPHONE:
(714) 606-1087
CITY:BUENA PARKSTATE: CAZIP CODE:
90621
CAPACITY:6CENSUS: 6DATE:
10/21/2025
UNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Marife GironellaTIME COMPLETED:
03:30 PM
ALLEGATION(S):
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Staff forces residents to sleep early.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Hanna Gough arrived at the facility to investigate the above mentioned complaint allegation. LPA was greeted and granted entry by staff. LPA met with Administrator (AD) Marife Gironella and discussed the purpose of the investigation.

It is alleged that residents are put in bed for the night between the hours of 4:00PM and 4:30PM and that they are in bed until morning. The investigation into the facility allegation of staff forces residents to sleep early revealed the following: LPA reviewed progress notes for five of six residents in care that between October 1, 2025, and October 20, 2025, three of six residents when noted to be put in bed for the night was between the hours of 7:00PM and 8:30PM. One of six residents when noted to be put in bed for the night was consistently at 8:30PM and one of six residents when noted to be put in bed for the night was between 8:30PM and 10:00PM. LPA observed medication lists for six of six residents for the month of October. LPA observed four of six residents have 8:00PM medications and that they were all taken daily.
Continue on LIC9099C
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Hanna Gough
LICENSING EVALUATOR SIGNATURE:

DATE: 10/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2025
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-20251015125341
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: ELEGANT CARE VILLA - BUENA PARK
FACILITY NUMBER: 306004491
VISIT DATE: 10/21/2025
NARRATIVE
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LPA conducted interviews with staff and residents. Three of six residents informed LPA that they go to bed when they want and that they are not forced to go to bed at any time of the day. One of six residents informed LPA that they like to take a nap in the afternoon, eat dinner and then go back to bed soon after dinner. Four of four staff informed LPA that residents are not forced to take naps in the afternoon and they are not forced to go to bed at a specific time. Four of four staff informed LPA that the majority of the residents are ready for bed around 8:00PM. Three of four staff informed LPA that if the resident does not want to go to bed or take a nap, they offer them to stay and continue doing what they are doing or offer another activity.

Based on the evidence gathered, the Department finds that the allegation staff forces residents to sleep early is deemed UNFOUNDED. The allegation is false, could not have happened, and/or is without a reasonable basis. Therefore the department dismisses the allegation.

An exit interview was conducted and a copy of this report was left at the facility.

SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Hanna Gough
LICENSING EVALUATOR SIGNATURE:

DATE: 10/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2