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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306005927
Report Date: 03/18/2024
Date Signed: 03/18/2024 03:35:56 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 Kevin Saborit-Guasch
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20240311121916
FACILITY NAME:ELEONOR'S PLACE 4FACILITY NUMBER:
306005927
ADMINISTRATOR:AVENDANO, DARYLLFACILITY TYPE:
740
ADDRESS:24431 ZANDRA DRIVETELEPHONE:
(949) 547-5377
CITY:MISSION VIEJOSTATE: CAZIP CODE:
92691
CAPACITY:6CENSUS: 6DATE:
03/18/2024
UNANNOUNCEDTIME BEGAN:
12:31 PM
MET WITH:Mark Cruz, AdministratorTIME COMPLETED:
03:45 PM
ALLEGATION(S):
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9
Staff did not ensure the back gate self-latches

Facility is in disrepair
INVESTIGATION FINDINGS:
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On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility for the purpose of conducting the initial investigation and deliver findings into the investigation of the two allegations listed above. LPA was greeted and granted entry by caregiving staff after stating the reason for the visit. Administrator Mark Cruz was notified and arrived later to assist with the visit.

LPA accompanied by administrator conducted a tour of the facility's physical plant, both indoor and outdoors. Administrator demonstrated the current operation of the gate located on the evacuation route on the left side of the house.

CONTINUED ON FORM LIC9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Kevin Saborit-Guasch
LICENSING EVALUATOR SIGNATURE:

DATE: 03/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/18/2024
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 2
Control Number 22-AS-20240311121916
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: ELEONOR'S PLACE 4
FACILITY NUMBER: 306005927
VISIT DATE: 03/18/2024
NARRATIVE
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CONTINUED FROM FORM LIC9099

Regarding the allegation that Staff did not ensure the back gate self-latches, the following has been concluded: Based on observation made during the tour of the physical plant, the facility's administrator was able to demonstrate on multiple occasions that the self-latching mechanism for the outside gate was operating properly. A spring ensures that the gate is pulled back close whenever it is opened and the latch engages adequately. Administrator indicated that the slab under the gate had recently shifted lightly but current operations do not appear to be affected. As a result, the allegation is found to be Unsubstantiated, meaning that although the allegation may have happened or is valid; there is not a preponderance of evidence to prove that the alleged violation did or did not occur.

Regarding the allegation that Facility is in disrepair, LPA was unable to identify any major items of maintenance appearing to be neglected in the facility's physical plant. There is an apparent sprinkler system installed but facility staff confirms that it is not operational at this time. An application might be submitted to the Fire Marshall in the future. Existing sprinkler heads do not show any signs of disrepair. There are loose wires on the right side of the house, however they are observed to be connected to a satellite dish that is not currently in use and do not represent a safety issue for the residents in care. Outlet covers are also verified to be present throughout the premises. The allegation is also found to be Unsubstantiated, meaning that although the allegation may have happened or is valid; there is not a preponderance of evidence to prove that the alleged violation did or did not occur.

An exit interview was conducted and a copy of this report was provided to a facility representative.
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Kevin Saborit-Guasch
LICENSING EVALUATOR SIGNATURE:

DATE: 03/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/18/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2