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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306004771
Report Date: 10/10/2024
Date Signed: 10/10/2024 04:59:08 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
10/08/2024 and conducted by Evaluator Jerome Haley
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20241008082533
FACILITY NAME:GOLDEN FLOWER MANOR, LLCFACILITY NUMBER:
306004771
ADMINISTRATOR:FLORICA GHEORGHEFACILITY TYPE:
740
ADDRESS:2411 E. LA PALMA AVE.TELEPHONE:
(714) 215-4283
CITY:ANAHEIMSTATE: CAZIP CODE:
92806
CAPACITY:6CENSUS: 5DATE:
10/10/2024
UNANNOUNCEDTIME BEGAN:
02:15 PM
MET WITH:Florica GheorgheTIME COMPLETED:
05:10 PM
ALLEGATION(S):
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Staff shoved food at residents.
Staff yells at residents.
Staff doesn't treat residents with dignity and respect.
INVESTIGATION FINDINGS:
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Regarding the complaint allegation: Staff shoved food at residents

5 of 8 individuals interviewed including facility resident denied the complaint allegation. Multiple residents interviewed denied the allegation, and also denied seeing staff shove food at any resident. One of the residents who’s assisted with feeding denied the allegation and said staff treat them well.

Regarding the complaint allegation: Staff yells at residents

5 of 8 individuals interviewed including facility residents denied the complaint allegation. One of the residents stated, some of the residents are hard of hearing so staff might raise their voice, but the resident denied staff yell at them or any other residents. Another resident stated, staff may elevate their voice, but the resident said they would not call it yelling.
Continued on LIC9099C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Jerome Haley
LICENSING EVALUATOR SIGNATURE:

DATE: 10/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2024
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-20241008082533
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: GOLDEN FLOWER MANOR, LLC
FACILITY NUMBER: 306004771
VISIT DATE: 10/10/2024
NARRATIVE
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Regarding the complaint allegation: Staff doesn't treat residents with dignity and respect.

5 of 8 individuals interviewed including facility residents denied the complaint allegation. Multiple residents said they are treated well by the staff. One resident said the Unidentified Individual 1 (UI1) is an angel when the resident was asked how they (UI1) treat them.

Based on the information gathered during the investigation through interviews, the Department is unable to ascertain if the allegations occurred as reported. Although the allegations may have happened or are 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: 10/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2