<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306004637
Report Date: 07/15/2025
Date Signed: 07/15/2025 02:56:34 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
10/18/2024 and conducted by Evaluator Jerome Haley
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20241018160617
FACILITY NAME:SOLEIL SENIOR LIVINGFACILITY NUMBER:
306004637
ADMINISTRATOR:LISA GAITANFACILITY TYPE:
740
ADDRESS:23741 SINGAPORE STREETTELEPHONE:
(949) 716-7614
CITY:MISSION VIEJOSTATE: CAZIP CODE:
92691
CAPACITY:6CENSUS: 6DATE:
07/15/2025
UNANNOUNCEDTIME BEGAN:
12:50 PM
MET WITH:Lisa BransenTIME COMPLETED:
03:15 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility retained a resident with a prohibited health condition.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Jerome Haley made an unannounced visit to close the investigation into the complaint allegation above. LPA Haley was greeted by staff and explained the reason for the visit upon entry.
During the investigation interviews were conducted with facility staff, a resident, a family member, and a nurse. 7 of 7 individuals denied the allegation or were unable to provide any information to support or corroborate the complaint allegation. According to S1, Resident 1 (R1) had some redness on their buttocks/back area, but there was only redness. According to S1,there is no wound. During an interview with a Home Health Nurse (HHN1), it was discovered R1 was recently released from a skilled nursing facility due to a fall. According to the HHN1, R1 has a wound on the right lower leg and a wound/rash on the buttocks area which is the reason HHN1 is providing wound care. HHN1 added, staff at the facility was advised to reposition R1 every two hours because the wound on the buttocks area is healing slowly because R1 is incontinent. The nurse stated the wound on the back area can be staged as a stage 2. The nurse stated the wound is red, it’s raw, but it’s being treated with barrier cream.
Continued on LIC9099C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Jerome Haley
LICENSING EVALUATOR SIGNATURE:

DATE: 07/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2025
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-20241018160617
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: SOLEIL SENIOR LIVING
FACILITY NUMBER: 306004637
VISIT DATE: 07/15/2025
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Based on the information gathered during the investigation through interviews and document review, the Department is unable to ascertain if the allegation occurred as reported. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove or refute the alleged violation occurred; therefore, the allegation is deemed Unsubstantiated.

An exit interview was conducted, and a copy of this report was provided.
SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Jerome Haley
LICENSING EVALUATOR SIGNATURE:

DATE: 07/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2