306005213-1-26-2026-22-AS-APAO-DR2LBX-20260206073728

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306005213
Report Date: 01/26/2026
Date Signed: 01/26/2026 09:39:56 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
09/19/2024 and conducted by Evaluator Brandon Lopez

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20240919092048

FACILITY NAME:	ROSSMOOR SUNSHINE VILLA-RUTH ELAINE		FACILITY NUMBER:	306005213
ADMINISTRATOR:	ROBERT DALE KALAGAYAN		FACILITY TYPE:	740
ADDRESS:	3212 RUTH ELAINE DRIVE		TELEPHONE:	(562) 572-9931
CITY:	ROSSMOOR	STATE: CA	ZIP CODE:	90720
CAPACITY:	6	CENSUS: 5	DATE:	01/26/2026
		UNANNOUNCED	TIME BEGAN:	08:00 AM
MET WITH:	Caregiver Veronica Perez		TIME COMPLETED:	09:45 AM

ALLEGATION(S):

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Staff yells at or belittles resident
Facility did not arrange for medical care appropriate to resident needs

INVESTIGATION FINDINGS:

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On January 26, 2026, Licensing Program Analyst (LPA) Brandon Lopez made an unannounced visit to the facility to deliver the complaint findings. LPA was greeted and granted entry into the facility by staff after explaining the purpose for the visit. Licensee (LI) Flormine Resurreccion was notified via telephone and later arrived to assist with the inpsection.

During the course of the investigation, LPA interviewed residents, interviewed staff, reviewed and obtained pertinent documents to this complaint. Regarding the allegation, staff yells at or belittles resident, the following has been concluded: It was alleged that staff yelled at or belittled Resident #1 (R1). LPA conducted an interview with R1 who confirmed the allegation. LPA conducted an additional five resident interviews. Two out of the five residents interviewed were unable to be qualified for an interview. However, three out of the five residents interviewed denied the allegation and stated that staff have never mistreated them. LPA conducted four staff interviews. Four out of the four staff interviewed denied the allegation. Staff interviewed also denied ever observing a staff yell at or belittle a resident. CONTINUED ON LIC9099-C

Unsubstantiated

Estimated Days of Completion: 90

SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Brandon Lopez
LICENSING EVALUATOR SIGNATURE:	DATE: 01/26/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2026

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-20240919092048

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: ROSSMOOR SUNSHINE VILLA-RUTH ELAINE	FACILITY NUMBER: 306005213
	VISIT DATE: 01/26/2026

NARRATIVE

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Regarding the allegation, facility did not arrange for medical care appropriate to resident needs, the following has been concluded: It was alleged that the facility did not arrange for medical care appropriate to R1's needs. LPA conducted an interview with R1 who confirmed the allegation. LPA conducted four staff interviews. Four out of the four staff interviewed denied the allegation. Staff interviewed stated that medical care was also sought for R1 when it was necessary or when it was requested from R1.

Based on the evidence gathered during the investigation, the Department is unable to ascertain if the allegations occurred as reported. Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove or refute the alleged violation occurred; therefore, the two allegations are deemed UNSUBSTANTIATED. An exit interview was conducted with Licensee Flormine Resurreccion and a copy of the report was provided.

SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Brandon Lopez
LICENSING EVALUATOR SIGNATURE:	DATE: 01/26/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2026

LIC9099 (FAS) - (06/04)

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