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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306005999
Report Date: 07/16/2025
Date Signed: 07/16/2025 10:11:57 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
07/17/2023 and conducted by Evaluator Alvaro Ramirez Jr.
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20230717111722
FACILITY NAME:COTTAGES AT ARTESIA, THEFACILITY NUMBER:
306005999
ADMINISTRATOR:OLAIS, AURELIAFACILITY TYPE:
740
ADDRESS:6041 KINGMAN AVENUETELEPHONE:
(800) 570-2273
CITY:BUENA PARKSTATE: CAZIP CODE:
90621
CAPACITY:55CENSUS: 50DATE:
07/16/2025
UNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Aurelia Olais-AdministratorTIME COMPLETED:
10:30 AM
ALLEGATION(S):
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Staff hit residents
Staff handled residents in a rough manner
Staff spoke inappropriately to residents
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Alvaro Ramirez, Jr. conducted an unannounced visit to deliver findings on an investigation completed by the Department. LPA was greeted and granted entry into the facility by Administrator (AD) Aurelia Olais.

During the course of the investigation, the Department interviewed staff and witnesses as well as reviewed and obtained pertinent documentation. This Department has investigated the complaint alleging that staff hit residents. Resident 1 (R1) was admitted to the facility on September 29, 2022. R1’s Physician Report (LIC602A) dated September 23, 2022, lists R1 as having a diagnosis of Dementia. R2 was admitted to the facility on April 10, 2021. R2’s Physician report dated December 30, 2022, lists R2 as having a diagnosis of Alzheimer’s Disease. R3 was admitted to the facility on May 27, 2021. R3’s Physician report dated July 20, 2022, lists R3 as having a diagnosis of Alzheimer’s Disease. During the course of the investigation LPA reviewed documents including the Unusual Incident/Injury Report (UIIR) dated July 17, 2023, for R1.
CONTINUED ON LIC9099-C...
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Alvaro Ramirez Jr.
LICENSING EVALUATOR SIGNATURE:

DATE: 07/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2025
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 5
Control Number 22-AS-20230717111722
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: COTTAGES AT ARTESIA, THE
FACILITY NUMBER: 306005999
VISIT DATE: 07/16/2025
NARRATIVE
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Per UIIR this morning care staff reported that resident was noted with a swollen right side of face. R1 was sent out to the Hospital for evaluation. LPA reviewed documents including The Cottages at Artesia employee warning notice form dated July 19, 2023, for Staff 1 (S1). Per employee warning notice it states unwarranted yelling aggravated by previous written warnings of S1’s uncalled attitude. During the investigation LPA reviewed documents including the Report of Elder of Suspected Dependent Adult/Elder Abuse (SOC341) dated July 19, 2023. Per Report of Elder of Suspected Dependent Adult/Elder Abuse it states that S1 committed elderly abuse by pushing R1’s wheelchair hard leading to the dining room. Per Report of Elder of Suspected Dependent Adult/Elder Abuse states that S1 denied committing physical abuse on the residents. During the course of the interviews with staff, S2 reported that she has not witness staff hit the residents. S2 stated that she never witnessed S1 mistreat the residents and reported that S1 had a rough and loud voice and spoke with the same tone to both caregivers and residents. S3 reported that she has not witnessed staff hitting the residents and stated that she only witnessed S1 assisting the residents by pushing their wheelchair but that she never witnessed S1 treating the residents bad. During the course of the interviews with witnesses, Witness 1 (W1) W1 reported that the current staff are pleasant. Per W2 she has no concerns with staff or the facility. W3 stated that he received an incident report from the AD stating that a staff member had grabbed his father in a rough manner. W3 reported that the caregiver involved in the incident was fired.

Regarding the allegation that staff handled residents in a rough manner, the following was revealed: During the course of the interviews with witnesses, W1 reported that she received an incident report where it mentioned that a staff member was being too rough with her grandfather. W2 stated that she has no complaints about the facility. Per W3 when his father sustains a fall, the cuts are consistent with the fall. During the course of the interviews with staff, S2 reported that she has not witness staff handling the residents in a rough manner. S3 stated that she has not witnessed residents being handled in a rough manner. Per S4 she has not witness staff treating residents in a rough manner and reported that staff assist the residents with standing and sitting. During the course of the interviews AD stated that she never witnessed S1 handling residents in a rough manner.

CONTINUED ON LIC9099-C...

SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Alvaro Ramirez Jr.
LICENSING EVALUATOR SIGNATURE:

DATE: 07/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 22-AS-20230717111722
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: COTTAGES AT ARTESIA, THE
FACILITY NUMBER: 306005999
VISIT DATE: 07/16/2025
NARRATIVE
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Regarding the allegation that staff spoke inappropriately to residents, the following was revealed: During the course of the interviews with witnesses, W2 reported that she has not heard staff speaking inappropriately to residents and stated that she has no complaints about the facility. Per W3 he has not witness staff speaking inappropriately to residents and stated that he has no concerns with the facility and/or staff. During the course of the interviews with staff, S2 reported that she has not seen and/or heard staff speaking inappropriately to residents. S2 stated that no caregiver reported witnessing staff being abusive towards the residents. Per S3 she has not seen staff speaking to the residents inappropriately. S3 reported that she has never heard staff speaking inappropriately to the residents and stated that she has seen how staff speak to the residents with respect. During the course of the interviews AD reported that she never witnessed S1 speak inappropriately to residents.

Based on the information gathered during the investigation and review of documents obtained, LPA is unable to ascertain if the allegations occurred as reported due to insufficient evidence. Therefore, the allegations have been deemed to be UNSUBSTANTIATED.

LPA Ramirez conducted an exit interview with AD Olais, and a copy of this report was provided to the facility

SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Alvaro Ramirez Jr.
LICENSING EVALUATOR SIGNATURE:

DATE: 07/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 5
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
07/17/2023 and conducted by Evaluator Alvaro Ramirez Jr.
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20230717111722

FACILITY NAME:COTTAGES AT ARTESIA, THEFACILITY NUMBER:
306005999
ADMINISTRATOR:OLAIS, AURELIAFACILITY TYPE:
740
ADDRESS:6041 KINGMAN AVENUETELEPHONE:
(800) 570-2273
CITY:BUENA PARKSTATE: CAZIP CODE:
90621
CAPACITY:55CENSUS: 50DATE:
07/16/2025
UNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Aurelia Olais-AdministratorTIME COMPLETED:
10:30 AM
ALLEGATION(S):
1
2
3
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5
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9
Licensee failed to report abuse as mandated
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Alvaro Ramirez, Jr. conducted an unannounced subsequent visit to deliver the findings of the investigation received on July 17, 2023. LPA was greeted and granted entry into the facility and met with Administrator (AD) Aurelia Olais. LPA explained the reason for the visit.

This agency has investigated the complaint alleging that Licensee failed to report abuse as mandated. Regarding the allegation, the following was revealed: During the course of the investigation LPA reviewed documents including the Report of Suspected Dependent Adult/Elder Abuse (SOC341) dated July 19, 2023, for Resident 1 (R1). Per Report of Suspected Dependent Adult/Elder Abuse the Orange County Regional Office received the report on July 20, 2023. During the course of the interviews with witnesses, Witness 1 (W1) reported that overall the facility is good at updating her of any incident. During the course of the interviews with staff, Staff 1 (S1) stated that the AD is in charge of submitting unusual incident reports to Licensing and reported that the incident reports are submitted on-time.
CONTINUED ON LIC9099-C...
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Alvaro Ramirez Jr.
LICENSING EVALUATOR SIGNATURE:

DATE: 07/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 22-AS-20230717111722
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: COTTAGES AT ARTESIA, THE
FACILITY NUMBER: 306005999
VISIT DATE: 07/16/2025
NARRATIVE
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 S2 reported that the AD submits the incident reports as mandated and stated that the facility submits incident reports in a timely manner. S3 stated that the Licensee submits the unusual incident reports as mandated.

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

For today’s visit, there were no citations issued per Title 22, Division 6 of the California Code of Regulations.
LPA Ramirez conducted an exit interview with AD Olais, and a copy of this report was provided to the facility.
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Alvaro Ramirez Jr.
LICENSING EVALUATOR SIGNATURE:

DATE: 07/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 5