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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306005500
Report Date: 02/03/2023
Date Signed: 02/03/2023 12:00:59 PM

Unfounded


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE & INLAND A/SC, 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
01/23/2023 and conducted by Evaluator Alvaro Ramirez Jr.
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20230123111444
FACILITY NAME:CARE JULIET 1FACILITY NUMBER:
306005500
ADMINISTRATOR:DEL ROSARIO, LESTERFACILITY TYPE:
740
ADDRESS:479 S WELLINGTON RDTELEPHONE:
(209) 914-1153
CITY:ORANGESTATE: CAZIP CODE:
92869
CAPACITY:6CENSUS: 6DATE:
02/03/2023
UNANNOUNCEDTIME BEGAN:
11:36 AM
MET WITH:Julieta Cervania-Caregiver, Lester A. Del Rosario-AdministratorTIME COMPLETED:
12:15 PM
ALLEGATION(S):
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Staff are forcing the residents to participate in undesired activities.
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPAs) Alvaro Ramirez, Jr. and Andrea Mendivil conducted an unannounced complaint visit to deliver findings on the above allegation received on 01/23/23. LPAs were greeted and granted entry into the facility and initially met with caregiver Julieta Cervania. LPAs explained the reason for the visit. Administrator (AD) Lester A. Del Rosario arrrived shortly after.

This agency has investigated the complaint alleging that facility staff are forcing the residents to participate in undesired activities. LPA Ramirez conducted interviews and obtained copies of pertinent documents. Regarding the allegation, the following was revealed: Four of six residents interviewed reported that activities are “always voluntary” and “never” feel forced to participate in activities. The remaining two residents interviewed either could not be qualified and/or refused to answer questions. Four of four staff interviewed reported “never” witnessing residents being forced to participate in undesired activities. Records reviewed included the Activities calendar. LPA obtained Activities calendar for January and February, which includes numerous activities including but not limited to Zumba, music therapy, stretching exercises and social time.

Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Alvaro Ramirez Jr.
LICENSING EVALUATOR SIGNATURE:

DATE: 02/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2023
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-20230123111444
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE & INLAND A/SC, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME: CARE JULIET 1
FACILITY NUMBER: 306005500
VISIT DATE: 02/03/2023
NARRATIVE
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Therefore, the allegation is deemed UNFOUNDED, meaning the allegation is false, could not have happened and/or is without a reasonable basis.

For today’s visit, there were no citations issued per Title 22, Division 6 of the California Code of Regulations.
LPA Ramirez conducted an exit interview with AD Del Rosario, and a copy of this report was provided to the facility.
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Alvaro Ramirez Jr.
LICENSING EVALUATOR SIGNATURE:

DATE: 02/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2