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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306005478
Report Date: 06/17/2024
Date Signed: 06/17/2024 01:57:41 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
09/19/2023 and conducted by Evaluator Rosie Quiroz
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20230919143528
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:
06/17/2024
UNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Rhodora Cabrera, Caregiver and Uldarico Almiranez, Licensee/Administrator (Via Telephone)TIME COMPLETED:
12:45 PM
ALLEGATION(S):
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-Facility staff yelled at residents.
-Facility staff do not respond timely for assistance.
-Facility staff provided alcohol to resident who cannot have alcohol.
INVESTIGATION FINDINGS:
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On today's date, Licensing Program Analyst (LPA) Rosie Quiroz conducted an unannounced visit for the purpose of delivering findings to address the allegations listed above for a complaint initiated on 9/19/2023. The 10-day visit complaint investigation visit was conducted by LPA Quiroz on 09/26/2023. On today's date, LPA Quiroz arrived to the facility and was greeted by Caregiver Rhodora Cabrera. LPA Quiroz called Licensee/Administrator (L/AD) Uldarico Almiranez and discussed purpose of today's visit.
Regarding the allegation, “Facility staff yelled at residents,” the investigation revealed the following: LPA Quiroz conducted multiple interviews consisting of residents, staff and witnesses. Interviews conducted with eleven of eleven interviewees reported denying ever witnessing staff yelling at residents at this facility. Four of four interviewees consisting of residents reported Resident 1 (R1) would be the one to yell at staff indicating staff employed at the facility are nice to all residents in care. During the course of the investigation, LPA Quiroz concluded that the video of staff yelling at resident provided to Orange County Regional Office (OCRO) during initiation of complaint was addressed during investigation of Complaint Control #22-AS-20230413150926 pertaining...CONTINUED ON LIC 9099-C PAGE...
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Rosie Quiroz
LICENSING EVALUATOR SIGNATURE:

DATE: 06/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/17/2024
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-20230919143528
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: 06/17/2024
NARRATIVE
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CONTINUED...to Fountain Valley Senior Homes 2 facility #306005475. The Investigation concluded that resident being yelled at in video provided to OCRO as evidence was not a resident residing at Saint Benedict Care LLC.
Regarding the allegation, “Facility staff do not respond timely for assistance,” four of four residents denied the allegation indicating staff are very helpful and respond to assistance requests timely. Two of two witnessed who reported frequently visiting the facility indicated witnessing staff responding to resident’s request for assistance timely.
Regarding the allegation, “Facility staff provided alcohol to resident who cannot have alcohol,” the investigation revealed the following: LPA Quiroz conducted multiple interviews consisting of residents, staff and witnesses. Interviews conducted with eleven of eleven interviewees reported denying ever witnessing staff providing alcohol to residents in the facility. During the course of the investigation, LPA Quiroz reviewed physician report for Resident 2 (R2) dated 2/11/2021, page 4 under 14. Mental Condition indicating (R2) is able to leave the facility unassisted. During the course of the investigation, (R2) admitted to leaving the facility on their own during the day indicating “I would sometimes go and buy my own beer from the liquor store without telling staff, but not anymore.” Administrator Almiranez indicated meeting with (R2s) responsible party and discussing reassessment of needs and services plan and physician report to address need for increased supervision for (R2) due to admitting drinking alcohol when leaving the facility unassisted.
Therefore, based on the preponderance of evidence gathered through interviews, documentation review and observations conducted by LPA Quiroz, the allegations that the “Facility staff yelled at residents,” “Facility staff do not respond timely for assistance,” and “Facility staff provided alcohol to resident who cannot have alcohol” are deemed UNFOUNDED, meaning that the allegations were false, could not have happened and/or are without a reasonable basis; Therefore complaint is dismissed.
This agency has investigated this complaint. No deficiencies cited during today's visit.

An exit interview was conducted with Caregiver Rhodora Cabrera and with (L/AD) Uldarico Almiranez via telephone, and a copy of report and LIC 811-Confidential Names were provided at exit.
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Rosie Quiroz
LICENSING EVALUATOR SIGNATURE:

DATE: 06/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2024
LIC9099 (FAS) - (06/04)
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