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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306005704
Report Date: 12/14/2023
Date Signed: 12/14/2023 12:10:18 PM

Unfounded


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
12/11/2023 and conducted by Evaluator Alvaro Ramirez Jr.
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20231211124121
FACILITY NAME:STERLING SENIOR COMMUNITY 4FACILITY NUMBER:
306005704
ADMINISTRATOR:MICHELLE KELLOGGFACILITY TYPE:
740
ADDRESS:150 N WHEELER STREETTELEPHONE:
(714) 912-3004
CITY:ORANGESTATE: CAZIP CODE:
92869
CAPACITY:6CENSUS: 4DATE:
12/14/2023
UNANNOUNCEDTIME BEGAN:
08:35 AM
MET WITH:Alberto Pimentel-Administrator, Kian Pascual-StaffTIME COMPLETED:
12:25 PM
ALLEGATION(S):
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Facility is in disrepair.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Alvaro Ramirez, Jr. conducted an unannounced initial 10-Day complaint visit to initiate the investigation into the above allegation and to deliver the findings of the investigation. LPA was greeted and granted entry into the facility and met with Caregiver Ruben Guzman. LPA explained the reason for the visit. Administrator (AD) Alberto Pimentel arrived shortly after.

On today’s visit LPA Ramirez conducted file reviews and interviews and obtained copies of pertinent documents. Regarding the allegation, the following was revealed: Four of five individuals interviewed denied the allegation. During the initial visit on 12/14/23 LPA toured the facility and observed the facility to be clean, safe, sanitary and in good repair. At 8:58 AM LPA toured the facility kitchen and observed that the kitchen cabinets where the medications, knives, detergent and cleaning supplies are stored are in good repair. During interviews conducted with residents it was reported that they have not witnessed the facility being in disrepair. Per Resident 1 (R1) if anything in the facility breaks the owner will fix it as soon as possible.
CONTINUED ON 9099-C...
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Alvaro Ramirez Jr.
LICENSING EVALUATOR SIGNATURE:

DATE: 12/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2023
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 3
Control Number 22-AS-20231211124121
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: STERLING SENIOR COMMUNITY 4
FACILITY NUMBER: 306005704
VISIT DATE: 12/14/2023
NARRATIVE
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Per R1 things are kept pretty good at the facility.

Therefore, the allegation is deemed UNFOUNDED, meaning the allegation is false, could not have happened and/or is without a reasonable basis.

LPA Ramirez conducted an exit interview with staff Pascual, 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: 12/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 3