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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306005447
Report Date: 08/29/2025
Date Signed: 08/29/2025 02:28:01 PM

Substantiated


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
08/08/2022 and conducted by Evaluator Celine Rodriguez
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20220808114712
FACILITY NAME:LAMBERT HOME CAREFACILITY NUMBER:
306005447
ADMINISTRATOR:ASAWADILO, YANINEEFACILITY TYPE:
740
ADDRESS:8191 LAMBERT DRIVETELEPHONE:
(714) 848-1982
CITY:HUNTINGTON BEACHSTATE: CAZIP CODE:
92647
CAPACITY:6CENSUS: 3DATE:
08/29/2025
UNANNOUNCEDTIME BEGAN:
12:01 PM
MET WITH:Facility Administrator- Yaniee Asawadilo TIME COMPLETED:
02:50 PM
ALLEGATION(S):
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Staff did not dispense medications
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Celine Rodriguez conducted an unannounced 10-day visit to the facility for the complaint and to deliver the findings. LPA Rodriguez explained the purpose of today's visit, was greeted, and granted entry by staff on duty, who informed facility administrator (AD) Yaniee Asawadilo about visit.

During the investigation, LPA Rodriguez toured the physical plant of the facility, conducted interviews, and requested copies of pertinent records reviewed.

It was alleged that staff did not dispense medications. LPA conducted 1 out of 1 resident interview, of which did not corroborate with the allegation, and the remaining 2 residents declined in wanting to be interviewed. 1 out of 1 staff interview did not corroborate with the allegation by stating that staff are to document when medications are given to each resident via medication distribution log.

Continued on LIC9099-C...
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Celine Rodriguez
LICENSING EVALUATOR SIGNATURE:

DATE: 08/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2025
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 5
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
08/08/2022 and conducted by Evaluator Celine Rodriguez
COMPLAINT CONTROL NUMBER: 22-AS-20220808114712

FACILITY NAME:LAMBERT HOME CAREFACILITY NUMBER:
306005447
ADMINISTRATOR:ASAWADILO, YANINEEFACILITY TYPE:
740
ADDRESS:8191 LAMBERT DRIVETELEPHONE:
(714) 848-1982
CITY:HUNTINGTON BEACHSTATE: CAZIP CODE:
92647
CAPACITY:6CENSUS: 3DATE:
08/29/2025
UNANNOUNCEDTIME BEGAN:
12:01 PM
MET WITH:Facility Administrator- Yaniee Asawadilo TIME COMPLETED:
02:50 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff are not providing snacks for resident dietary needs
Staff left residents unattended
Staff did not safeguard residents personal property
Staff are not providing grooming assistance
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Celine Rodriguez conducted an unannounced 10-day visit to the facility for the complaint and to deliver the findings. LPA Rodriguez explained the purpose of today's visit, was greeted, and granted entry by staff on duty, who informed facility administrator (AD) Yaniee Asawadilo about visit.

During the investigation, LPA Rodriguez toured the physical plant of the facility, conducted interviews, and requested copies of pertinent records reviewed.

It was alleged that staff are not providing snacks for resident dietary needs. LPA conducted 1 out of 1 resident interview, of which did not corroborate with the allegation, and the remaining 2 residents declined in wanting to be interviewed.

Continued on LIC9099-C...
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Celine Rodriguez
LICENSING EVALUATOR SIGNATURE:

DATE: 08/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 22-AS-20220808114712
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: LAMBERT HOME CARE
FACILITY NUMBER: 306005447
VISIT DATE: 08/29/2025
NARRATIVE
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 The 1 resident interview stated that there is “enough food” at the facility and provided confirmation that staff will offer snacks throughout the day. 1 out of 1 staff interview did not corroborate with the allegation by stating that three meals are provided to each resident daily, and snacks are also provided. LPA observed that the facility had a 2-day supply of perishable foods and 7-day supply of non-perishable foods, of which included fruits, vegetables, dairy, proteins and carbs.

It was alleged that staff left residents unattended. LPA conducted 1 out of 1 resident interview, of which did not corroborate with the allegation, and the remaining 2 residents declined in wanting to be interviewed. The 1 resident interview provided confirmation that there is always a staff on duty. Per record review, facility has a staff member scheduled every day. During the tour of the facility, LPA observed that the facility is a two-level structure and observed that there is a live-in caregiver residing on the second floor at tall times.

It was alleged that staff did not safeguard residents personal property. LPA conducted 1 out of 1 resident interview, of which did not corroborate with the allegation by stating that they are responsible for their own property, and the remaining 2 residents declined in wanting to be interviewed. Per record review, all three residents declined in wanting facility to conduct an inventory check-list of their belongings. 1 out of 1 staff interview stated that the facility is not responsible for the resident’s belongings.

It was alleged that staff are not providing grooming assistance. LPA conducted 1 out of 1 resident interview, of which did not corroborate with the allegation, and the remaining 2 residents declined in wanting to be interviewed. 1 out of 1 staff interview did not corroborate with the allegation by stating that 2 out of the 3 current residents are able to bathe, and dress themselves, without needing assistance, of which this was confirmed by both their physician reports. Resident 1 (R1) however, is bedridden, and requires assistance with bathing, dressing and grooming. During the tour of the facility, LPA observed staff on duty changing and bathing R1. All residents were observed to be clean.

Based on LPA’s interviews which were conducted, review of documents obtained, and observations, LPA 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, this allegation is deemed UNSUBSTANTIATED.

An exit interview was conducted with AD Asawadilo. A copy of this report was explained, and appeal rights were provided during the visit..

SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Celine Rodriguez
LICENSING EVALUATOR SIGNATURE:

DATE: 08/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 22-AS-20220808114712
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: LAMBERT HOME CARE
FACILITY NUMBER: 306005447
VISIT DATE: 08/29/2025
NARRATIVE
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However, per record review, LPA observed that the medication log was incomplete due to some days not being filled out, despite residents being on a daily medication. Staff on duty were unable to provide confirmation to LPA if the medication was given to resident.

Based on LPA’s interviews which were conducted, review of documents obtained, and observations, the preponderance of evidence standard has been met, therefore the allegation is SUBSTANTIATED.

An exit interview was conducted with AD Asawadilo.

A copy of this report and appeal rights were provided and explained.

SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Celine Rodriguez
LICENSING EVALUATOR SIGNATURE:

DATE: 08/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 22-AS-20220808114712
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: LAMBERT HOME CARE
FACILITY NUMBER: 306005447
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/29/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/29/2025
Section Cited
CCR
87465
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87465 Incidental Medical and Dental Care
(c)...facility staff...shall...
(3) ...record...each dose... in the resident's record.
This requirement is not met and evidence by:
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As a plan of correction (POC), facility administrator will provide an in-service training to all staff on how to document medications, will ensure all medications logs for current residents are up to date, and provide proof of POC to assigned LPA on or by 9/1/25.
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Based on LPAs interviews, review of documents obtained and observations, facility had incomplete documentation of medications given to each resident. Facility administrator was unable to provide confirmation whether or not medications were given. This poses an immediate health and safety risk to residents in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Celine Rodriguez
LICENSING EVALUATOR SIGNATURE:

DATE: 08/29/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 5