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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306005907
Report Date: 03/14/2024
Date Signed: 03/14/2024 04:59:43 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
03/11/2024 and conducted by Evaluator Jessica Cho
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20240311172243
FACILITY NAME:TESSA'S PLACE 1FACILITY NUMBER:
306005907
ADMINISTRATOR:AVENDANO, ELEONORFACILITY TYPE:
740
ADDRESS:26075 ARCADA DRIVETELEPHONE:
(949) 331-3822
CITY:MISSION VIEJOSTATE: CAZIP CODE:
92691
CAPACITY:6CENSUS: 5DATE:
03/14/2024
UNANNOUNCEDTIME BEGAN:
12:55 PM
MET WITH:Mark Cruz- AdministratorTIME COMPLETED:
05:00 PM
ALLEGATION(S):
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Staff did not prevent facility from being hazardous to residents in care.
Staff did not ensure facility is kept clean.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Jessica Cho arrived at the facility unannounced for the purpose to conduct the complaint into the above allegations. LPA was greeted and granted entry by Caregiver/Reliever Regine Maglanque. Administrator Mark Cruz arrived on premise and conducted the tour of the facility with LPA approximately 1:20pm. LPA and Admin Cruz inspected the inside and outside grounds and the following was determined:

It is alleged that the staff did not prevent the faclity from being hazardous to the residents in care. LPA observed that no trees in the backyard were supported by a wooden pole or rope. It appeared that at the time of the inspection, approximately 1:12pm, the trees were observed to be safe with the severe high wind warning issued in Orange County. LPA walked through the lawn and observed that the right side of the lawn is on an uneven ground. The right side is overwatered evidenced by soft and wet soil which may potentially cause a safety hazard to the residents. Based on the review of the lease agreement signed and dated on October 26, 2020, facility is responsible for watering and maintaining the garden,
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Jessica Cho
LICENSING EVALUATOR SIGNATURE:

DATE: 03/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/14/2024
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 3
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
03/11/2024 and conducted by Evaluator Jessica Cho
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20240311172243

FACILITY NAME:TESSA'S PLACE 1FACILITY NUMBER:
306005907
ADMINISTRATOR:AVENDANO, ELEONORFACILITY TYPE:
740
ADDRESS:26075 ARCADA DRIVETELEPHONE:
(949) 331-3822
CITY:MISSION VIEJOSTATE: CAZIP CODE:
92691
CAPACITY:6CENSUS: 5DATE:
03/14/2024
UNANNOUNCEDTIME BEGAN:
12:55 PM
MET WITH:Mark Cruz- AdministratorTIME COMPLETED:
05:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff did not prevent the facility from being unkempt.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Jessica Cho arrived at the facility unannounced for the purpose to conduct the complaint into the above allegation. LPA was greeted and granted entry by Caregiver/Reliever Regine Maglanque. Administrator Mark Cruz arrived on premise and conducted the tour of the facility with LPA approximately 1:20pm. LPA and Admin Cruz inspected the inside and outside grounds and the following was determined:

It is alleged that the staff did not prevent the facility from being unkempt. LPA observed that no holes and cameras were in the facility. All ventilation vents were stable and attached properly.

Therefore, this agency has investigated the complaint and based on the observations made, the above allegation is deemed UNFOUNDED. We have found that the complaint was unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. We have therefore dismissed the complaint. An exit interview was conducted with Administrator Mark Cruz, and a copy of this report was provided at the end of the visit.
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Jessica Cho
LICENSING EVALUATOR SIGNATURE:

DATE: 03/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/14/2024
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 3
Control Number 22-AS-20240311172243
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: TESSA'S PLACE 1
FACILITY NUMBER: 306005907
VISIT DATE: 03/14/2024
NARRATIVE
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landscaping, trees, and shrubs; however, the lease agreement does not clearly evidence the chain of liability with respect to waterlogging issues. In addition, it is documented on page 5 of the lease agreement that the tenant shall not make any repairs, alterations, or improvements without the landlord's prior written consent. One out of one staff interview reavealed that there were no issues until the heavy rain the past month. Staff also indicated that the water sprinkler system is being controlled.

It is alleged that the staff did not ensure facility is kept clean. Facility appeared clean and sanitary. The kitchen and bathroom sinks were also clean and sanitary. The porcelain coating in the sinks of the kitchen and Bedroom #1 are chipped in few areas of the wash basin however does not pose a health risk to the residents in care.

Therefore, based on the observations made, interview, and the records that were reviewed, although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the following allegations: Staff did not prevent facility from being hazardous to residents in care and Staff did not ensure facility is kept clean are deemed UNSUBSTANTIATED.

An exit interview was conducted with Administrator Mark Cruz, and a copy of this report was provided at the end of the visit.
SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Jessica Cho
LICENSING EVALUATOR SIGNATURE:

DATE: 03/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/14/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3