306004676-6-27-2025-22-AS-APAO-DJ7PUL-20250702113743

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306004676
Report Date: 06/27/2025
Date Signed: 06/27/2025 09:39:44 AM

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
05/30/2025 and conducted by Evaluator Hanna Gough

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20250530082124

FACILITY NAME:	SHERCON GUEST HOMES		FACILITY NUMBER:	306004676
ADMINISTRATOR:	CONSOLACION LUMAUIG		FACILITY TYPE:	740
ADDRESS:	13432 GALWAY STREET		TELEPHONE:	(714) 815-9214
CITY:	GARDEN GROVE	STATE: CA	ZIP CODE:	92844
CAPACITY:	6	CENSUS: 5	DATE:	06/27/2025
		UNANNOUNCED	TIME BEGAN:	08:00 AM
MET WITH:	Connie Lumauig		TIME COMPLETED:	10:00 AM

ALLEGATION(S):

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Staff told Home Health nurse they do not need their help resulting in Home Care no longer assisting the resident

INVESTIGATION FINDINGS:

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Licensing Program Analysts (LPAs) Hanna Gough and Andrea Mendivil made an unannounced visit for the purpose of investigating the mentioned above complaint allegation. LPAs met with Administrator (AD) Connie Lumauig and discussed the purpose of the investigation.

The investigation into the allegation that staff told home health nurse they do not need their help resulting in home care no longer assisting the resident revealed the following: During investigation, LPA inspected the facility, interviewed staff, residents, witnesses and obtained documents from facility files. Record review revealed that Resident #1 (R1) had a home health plan of care from April 15, 2025 until June 13, 2025. LPA reviewed discharge paperwork for R1 dated May 27, 2025. At the time of discharge R1 had no pressure ulcers present but the care is being cancelled due to the AD refusing care for R1. During interviews it was revealed by witness #1 (W1) who is the medical power of attorney on the home health discharge paperwork, that they asked home health to stop coming to the facility due to the lack of cooperation from the nurses.
Cont on LIC 9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Hanna Gough
LICENSING EVALUATOR SIGNATURE:	DATE: 06/27/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2025

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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Control Number 22-AS-20250530082124

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: SHERCON GUEST HOMES	FACILITY NUMBER: 306004676
	VISIT DATE: 06/27/2025

NARRATIVE

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W1 informed the AD that they had cancelled the services multiple times, but the home health agency kept coming. W1 instructed AD to inform the home health agency that they had cancelled the services for R1 due to the home health agency not contacting W1. W1 informed LPA that the AD did not cancel the services for the resident. LPA interviewed Home Health staff and they informed LPA that they were already going to discharged the resident in care due to the wound healing and lack of cooperation from the AD due to R1 having behaviors during the visits. Home health notes revealed that R1 had behaviors during 1 out of 7 visits. Home health staff notes dated April 18, 2025 stated that R1 was having behaviors and the home health nurse was unable to perform wound care and that the caregiver stated they will perform wound care once the resident is back to normal status. Home health notes dated April 21^st and 24^th, May 1^st, 6^th, 13^th, and 20^th, 2025 revealed that the resident had no behaviors and wound care was successfully given. LPA observed medical supplies for wound dressing in R1s bedroom closet.

Based on information gathered during the investigation the Department is unable to ascertain if the above 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, this allegation is deemed UNSUBSTANTIATED.

An exit interview was conducted with AD Connie Lumauig 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: 06/27/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2025

LIC9099 (FAS) - (06/04)

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