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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306005636
Report Date: 06/16/2025
Date Signed: 06/16/2025 04:43:27 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
03/01/2023 and conducted by Evaluator Celine Rodriguez
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20230301101840
FACILITY NAME:MAINPLACE SENIOR LIVINGFACILITY NUMBER:
306005636
ADMINISTRATOR:PHAT T. NGUYENFACILITY TYPE:
740
ADDRESS:1800 1832 W. CULVER AVENUETELEPHONE:
(714) 978-2534
CITY:ORANGESTATE: CAZIP CODE:
92868
CAPACITY:153CENSUS: 107DATE:
06/16/2025
UNANNOUNCEDTIME BEGAN:
02:03 PM
MET WITH:Wellness Director Ruby Racca-Magao
Business Office Manager- Briana Garcia 		TIME COMPLETED:
05:00 PM
ALLEGATION(S):
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Insufficient staff to meet residents needs.
Bathrooms are being made inaccessible to residents.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Celine Rodriguez conducted an unannounced visit to the facility to continue the investigation and to deliver the findings. LPA De Perio explained the purpose of today's visit, was greeted by Wellness Director Ruby Racca-Magao and Business Office Manager- Briana Garcia.

It was alleged that there is insufficient staff to meet resident’s needs. LPA Rodriguez conducted a total of 6 resident interviews, all of which did not corroborate with the allegation. 3 out of the 6 resident interviews stated that there has been improvement with staffing and confirmed that there was never a time where only one staff member was present. LPA Rodriguez conducted an interview with 2 staff members, of which both interviews did not corroborate with the allegation by stating that if the facility was in need of additional staffing, the wellness coordinator would assist. For this visit, LPA Rodriguez observed that there was a total of 5 direct care staff members on the assisted living side, and 4 direct care staff members on the memory care unit.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Celine Rodriguez
LICENSING EVALUATOR SIGNATURE:

DATE: 06/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2025
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 2
Control Number 22-AS-20230301101840
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: MAINPLACE SENIOR LIVING
FACILITY NUMBER: 306005636
VISIT DATE: 06/16/2025
NARRATIVE
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Per record review, in the month of February 2023 and March 2023, LPA Rodriguez observed the clock in times for staff in February 2023 and March 2023 and observed that there were multiple staff members present, and verified that there was never just one staff member present.

It was alleged that bathrooms are being made inaccessible to residents. LPA Rodriguez conducted a total of 6 resident interviews, all of which did not corroborate with the allegation. LPA Rodriguez conducted a total of 2 staff interviews, of which both did not corroborate with the allegation. LPA Rodriguez observed that on the assisted living side, there are two bathrooms designated for staff, which remained unlocked, and one bathroom designated for the public, which also was unlocked. LPA Rodriguez observed that each resident room had their own bathroom and was made accessible to the resident(s) living in that room. LPA Rodriguez observed that on the memory care unit, there are bathrooms in each resident’s room, and one extra shared bathroom located in the hallway, that is designated only for residents. LPA Rodriguez observed that the memory care bathroom in the hallway was locked, however it is due to safety concerns, to prevent the residents from entering the bathroom on their own since per physician reports, the memory care residents are unable to use the bathroom independently and require assistance.

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.

For this visit, there were no citations were issued.

An exit interview was conducted with Wellness Director Ruby Racca-Magao and Business Office Manager- Briana Garcia.

A copy of this report was provided and explained.

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

DATE: 06/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2