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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306005385
Report Date: 01/15/2026
Date Signed: 01/15/2026 03:58:22 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
06/13/2025 and conducted by Evaluator Kevin Saborit-Guasch
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20250613153014
FACILITY NAME:ORANGE COUNTY CARE HOME IIFACILITY NUMBER:
306005385
ADMINISTRATOR:RASSOULI ZADEHEI, FAHIMEHFACILITY TYPE:
740
ADDRESS:27561 ALMENDRA DRIVETELEPHONE:
(949) 322-1078
CITY:MISSION VIEJOSTATE: CAZIP CODE:
92691
CAPACITY:6CENSUS: 6DATE:
01/15/2026
UNANNOUNCEDTIME BEGAN:
02:51 PM
MET WITH:Faith Rasouli, administrator (via telephone)TIME COMPLETED:
03:30 PM
ALLEGATION(S):
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9
Facility staff is engaging in retaliatory conduct against a resident
Staff is being verbally inappropriate in front of facility residents
Facility staff did not report health incidents appropriately to licensing staff
Facility staff did not notify a resident's responsible party of a serious health incident
INVESTIGATION FINDINGS:
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On this day, Licensing Program Analyst made an unannounced visit to the facility for the purpose of following up on the investigation of the four allegations listed above as well as to deliver findings to the facility. LPA was greeted and granted entry by administrator Faith Rasouli after stating the purpose of the visit. Allegations under review were listed during the visit. Administrator had to leave the premises during the visit and authorized care staff to sign on her behalf.

An initial complaint investigation visit was conducted on June 17, 2025. During the visit, LPA accompanied by facility staff conducted a tour of the facility's physical plantas well as interviewed residents and witnesses. Resident records were requested and obtained.

A follow-up visit took place on September 25, 2025. During the second visit, LPA conducted three staff interviews and five resident interviews.
CONTINUED ON FORM LIC9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Kevin Saborit-Guasch
LICENSING EVALUATOR SIGNATURE:

DATE: 01/15/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2026
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-20250613153014
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: ORANGE COUNTY CARE HOME II
FACILITY NUMBER: 306005385
VISIT DATE: 01/15/2026
NARRATIVE
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CONTINUED FROM LIC9099
Regarding the allegation that Facility staff is engaging in retaliatory conduct against a resident, the following has been concluded: Multiple communications from facility staff were made to the responsible party for resident R1 to inform them of the potential need to seek alternate placement due to the growing inability of facility staff to provide adequate care to R1 due to changes in their diabetes management. It is alleged that the requests to relocate were made after citations related to the management of R1's medication were issued by the Department as part of the investigation of complaint 22-AS-20250402163711.
Even though, the timing matches a potential retaliatory intent, the administrator also provided extensive documentation supporting their claim of a change in condition. There is therefore insufficient evidence to adequately corroborate that retaliation has been taking place.

Regarding the allegation that Staff is being verbally inappropriate in front of facility residents, none of the three visits conducted allowed licensing staff to observe potential inappropriate verbal behavior from staff. A majority of residents interviewed denied having ever witnessed or been subjected to inappropriate verbal behavior. One staff and one resident interviewed appear to identify one potential staff member who could have made inappropriate comments without identify clear circumstances or providing sufficient evidence. The staff member in question is no longer employed by the facility.

Regarding the allegation that Facility staff did not report health incidents appropriately to licensing staff, multiple incident reports for resident R1 were submitted to licensing staff as required during R1's period of admission. No specific instances of hospitalization or health incidents that would have failed to be reported were evidenced during the investigation.

Regarding the allegation that Facility staff did not notify a resident's responsible party of a serious health incident, the following has been concluded: Based on staff interviews and a review of text and email communications between staff and R1's responsible party, licensing staff was able to establish a clear pattern of updates and communication regarding R1's health condition and management of the diabetes diagnosis.

As a result, the allegations are found to be Unsubstantiated, meaning that although the allegations may have happened or are valid, there is not a preponderance of evidence to prove or refute the alleged violations occurred.
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Kevin Saborit-Guasch
LICENSING EVALUATOR SIGNATURE:

DATE: 01/15/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2026
LIC9099 (FAS) - (06/04)
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