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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306005780
Report Date: 04/21/2025
Date Signed: 04/21/2025 10:19:56 AM

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
02/24/2023 and conducted by Evaluator William Vanegas
COMPLAINT CONTROL NUMBER: 22-AS-20230224131142
FACILITY NAME:CANDLEBERRY CAREFACILITY NUMBER:
306005780
ADMINISTRATOR:ROSARIO, ROBERTO DELFACILITY TYPE:
740
ADDRESS:4216 CANDLEBERRY AVE.TELEPHONE:
(949) 290-6006
CITY:SEAL BEACHSTATE: CAZIP CODE:
90740
CAPACITY:6CENSUS: 5DATE:
04/21/2025
UNANNOUNCEDTIME BEGAN:
08:10 AM
MET WITH:Socrates YturraldeTIME COMPLETED:
09:45 AM
ALLEGATION(S):
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-Facility staff stole resident's laptop from them.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) William Vanegas made an unannounced inspection for the purposes of delivering findings regarding the above-mentioned allegations. Upon arrival LPA Vanegas was greeted and granted entry by Care Giver (CG) Shellad Yturralde. LPA Vanegas explained the nature of the inspection. During the course of the inspection, LPA Vanegas obtained and reviewed copies of records pertinent to resident 1 (R1). Interviews were conducted with three staff members, and three residents in care; interviews, and record review revealed the following.
Regarding the allegation stating that facility staff stole resident’s laptop from them; Interviews conducted with three out of three staff stated that R1 did not enter the facility with a laptop. Per LPA Vanegas review of R1’s personal property, and valuables record. There is no documentation of a laptop that belonged to R1 at the time of admission to the facility. Interviews with four out of four residents revealed that residents in care did not observe R1 with a laptop. LPA attempted to contact R1 twice to conduct an interview regarding allegations being investigated, however LPA was unable to contact R1. CONTINUED ON LIC9099C.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: William Vanegas
LICENSING EVALUATOR SIGNATURE:

DATE: 04/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/21/2025
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 4
Control Number 22-AS-20230224131142
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: CANDLEBERRY CARE
FACILITY NUMBER: 306005780
VISIT DATE: 04/21/2025
NARRATIVE
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Based on interviews conducted with staff and residents in care, the preponderance of evidence has not been met, and this allegation is deemed to be unsubstantiated. An exit interview was conducted with CG Socrates Yturralde, and a copy of this report was provided to the facility.
SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: William Vanegas
LICENSING EVALUATOR SIGNATURE:

DATE: 04/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/21/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 4
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
02/24/2023 and conducted by Evaluator William Vanegas
COMPLAINT CONTROL NUMBER: 22-AS-20230224131142

FACILITY NAME:CANDLEBERRY CAREFACILITY NUMBER:
306005780
ADMINISTRATOR:ROSARIO, ROBERTO DELFACILITY TYPE:
740
ADDRESS:4216 CANDLEBERRY AVE.TELEPHONE:
(949) 290-6006
CITY:SEAL BEACHSTATE: CAZIP CODE:
90740
CAPACITY:6CENSUS: DATE:
04/21/2025
UNANNOUNCEDTIME BEGAN:
08:10 AM
MET WITH:Socrates YturraldeTIME COMPLETED:
09:45 AM
ALLEGATION(S):
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-Facility staff does not provide a comfortable environment for resident.
INVESTIGATION FINDINGS:
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Regarding the allegation stating that facility staff does not provide a comfortable environment for resident, interviews conducted with one out of three staff corroborated the allegation. Interview with S2 revealed that they witnessed S1 to have yelled at R1. Interviews with R2 and R3 revealed that they did not witness the allegation due to the residents not living at the facility in the time the incident occurred.

Interview with R4 revealed that R4 did witness S1 arguing with clients in care. Based on interviews conducted with staff and residents in care, the preponderance of evidence has been met, and this allegation is deemed to be substantiated. A deficiency will be citied per title 22-chapter 8 division 6 of the California Code of Regulations. An exit interview was conducted with CG Socrates Yturralde, and a copy of this report was left at the facility.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: William Vanegas
LICENSING EVALUATOR SIGNATURE:

DATE: 04/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/21/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 22-AS-20230224131142
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: CANDLEBERRY CARE
FACILITY NUMBER: 306005780
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/21/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/30/2025
Section Cited
CCR
87468.1(a)(1)
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87468.1 Personal Rights of Residents in all Facilities (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (1)To be accorded dignity in their personal relationships with staff, residents, and other persons.
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Administrator will conduct an all staff in service training in regards to personal rights, harrasement, and job functions of all staff. Licensee will send proof of correction to LPA Vanegas via email by P.O.C due date.
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Regulation was not met by licensee as evedenced by interviews conducted with staff and residents in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: William Vanegas
LICENSING EVALUATOR SIGNATURE:

DATE: 04/21/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/21/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 4