<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306005478
Report Date: 01/09/2023
Date Signed: 01/09/2023 03:48:41 PM

Unfounded


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
12/30/2022 and conducted by Evaluator Rosie Quiroz
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20221230121116
FACILITY NAME:SAINT BENEDICT CARE LLCFACILITY NUMBER:
306005478
ADMINISTRATOR:ALMIRANEZ, ULDARICOFACILITY TYPE:
740
ADDRESS:8925 CANARY AVENUETELEPHONE:
(949) 290-6006
CITY:FOUNTAIN VALLEYSTATE: CAZIP CODE:
92708
CAPACITY:6CENSUS: 6DATE:
01/09/2023
UNANNOUNCEDTIME BEGAN:
08:54 AM
MET WITH:Kristine Guevarra, Lead Care Giver and Uldarico "Rico" Almiranez (Via telephone). TIME COMPLETED:
01:40 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Resident's grooming needs are not being met.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
 On today's date, Licensing Program Analyst (LPA) Rosie Quiroz conducted an unannounced visit for the purpose of conducting a 10 day visit complaint investigation to address the allegation noted above. LPA Quiroz arrived to the facility and was greeted, COVID-19 screened and met wtih Lead Caregiver 1 (LCG1). (LCG1) called Licensee/Administrator Uldarico Almiranez via facility telephone on speaker phone. LPA Quiroz discussed purpose of today's call with L/AD Almiranez via telephone.
During today's visit, LPA Quiroz toured the interior and exterior of the facility. During today's visits, six of six residents appeared groomed with hair combed, dressed weather appropriately and wearing clean clothes. Five of six residents indicated having personal hygiene supplies readily available when needed. Due to cognitive impairment one of six residents was unable to be interviewed regarding this allegation. Personal hygiene supplies, but not limited to shaving cream, razors, body wash, shampoo, tooth brushes, tooth paste, wash towels, bath towels were observed by LPA Quiroz during today's visit.

CONTINUED...
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Rosie Quiroz
LICENSING EVALUATOR SIGNATURE:

DATE: 01/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/09/2023
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-20221230121116
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME: SAINT BENEDICT CARE LLC
FACILITY NUMBER: 306005478
VISIT DATE: 01/09/2023
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
CONTINUED...

Based on observation, six of six residents appeared to be well groomed as evidence by hair combed, clothes appeared clean and absence of foul odors. Based on the evidence gathered from interviews conducted with interviewees and today's facility inspection observations, the allegation of "Resident's grooming needs are not being met" is deemed Unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis; Therefore complaint is dismissed.

An exit interview was conducted with (lCG1) and with L/AD Almiranez via telephone, and a copy of this report along with LIC 811- Confidential Names list was provided to (CG1) at exit.
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Rosie Quiroz
LICENSING EVALUATOR SIGNATURE:

DATE: 01/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/09/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2