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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306006201
Report Date: 04/17/2026
Date Signed: 04/17/2026 04:47:26 PM

Substantiated


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 Fred Arias
COMPLAINT CONTROL NUMBER: 22-AS-20231211124258
FACILITY NAME:STERLING SENIOR COMMUNITY 9FACILITY NUMBER:
306006201
ADMINISTRATOR:LALAP, DONNAVEEFACILITY TYPE:
740
ADDRESS:10448 NIGHTINGALE CIRCLETELEPHONE:
(714) 594-3568
CITY:FOUNTAIN VALLEYSTATE: CAZIP CODE:
92708
CAPACITY:6CENSUS: 6DATE:
04/17/2026
UNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Sheryl TongolTIME COMPLETED:
04:50 PM
ALLEGATION(S):
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9
Facility is in disrepair.
Facility staff failed to properly administer resident’s medications.
Facility failed to maintain a complete and accurate resident’s records.
INVESTIGATION FINDINGS:
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13
Licensing Program Analyst (LPA) Fred Arias conducted an unannounced complaint visit to finalize an investigation into the above allegations. LPA was greeted and granted entry into the facility and explained the reason for the visit.

It was alleged facility is in disrepair, facility staff failed to properly administer resident's medications, and facility failed to maintain a complete and accurate resident’s records. LPA conducted interviews with staff and residents. LPA reviewed records obtain.

The investigation determined as follows: Regarding the allegation the facility is in disrepair, LPA toured the facility with staff to determine if the facility is clean, safe, sanitary and in good repair. At 9:25AM, LPA observed the auditory exit alarm for the sliding door across the way from room 5 to be non-operational. In addition, the auditory exit alarm for the sliding door in room 5 is not functioning optimally. Interviews with two out of six residents stated the facility has remained in good repair overall. The remaining four residents could not be qualified for interviews.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Fred Arias
LICENSING EVALUATOR SIGNATURE:

DATE: 04/17/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2026
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 8
Control Number 22-AS-20231211124258
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 9
FACILITY NUMBER: 306006201
VISIT DATE: 04/17/2026
NARRATIVE
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 Interviews with three out of three staff stated there are maintenance persons who are available to make repairs to the facility as needed. LPA did not observe any other physical plant issues during the visit.

Regarding the allegation facility failed to properly administer resident's medications, it was reported medications are not administered per Title 22 regulations. Interviews with two out of six residents stated they are assisted with medications. One out of the two residents stated they receive medications three times every day after meals. The remaining four residents could not be qualified for interviews.

Two out of two staff stated they assist residents with medication administration and record medication administration daily. The two staff added there has never been an instance where medications were not available or delayed. LPA audit of medications revealed two prescription creams (Fluocinonide cream and hydrocortisone cream) for R1 are not available at the facility. After LPA made staff aware, the staff placed an order for the creams.

Regarding the allegation facility failed to maintain a complete and accurate resident’s records, it was reported resident records and not maintained per Title 22 regulations. LPA review of six out of six centrally stored medication and destruction records revealed R1's prescription hydrocortisone cream was not listed under medications. The remaining resident records were complete.

Based on interviews conducted, records reviewed, and observations, the preponderance of evidence standard has been met. Therefore, the above allegations are found to be SUBSTANTIATED.

California Code of Regulations, (Title 22, Division 6), are being cited on the attached LIC 9099D.

An exit interview was conducted and a copy of the report was left with the facility representative along with appeal rights.
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Fred Arias
LICENSING EVALUATOR SIGNATURE:

DATE: 04/17/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 8
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 Fred Arias
COMPLAINT CONTROL NUMBER: 22-AS-20231211124258

FACILITY NAME:STERLING SENIOR COMMUNITY 9FACILITY NUMBER:
306006201
ADMINISTRATOR:LALAP, DONNAVEEFACILITY TYPE:
740
ADDRESS:10448 NIGHTINGALE CIRCLETELEPHONE:
(714) 594-3568
CITY:FOUNTAIN VALLEYSTATE: CAZIP CODE:
92708
CAPACITY:6CENSUS: 6DATE:
04/17/2026
UNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Sheryl TongolTIME COMPLETED:
04:50 PM
ALLEGATION(S):
1
2
3
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5
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8
9
Facility is not adequately staffed.
INVESTIGATION FINDINGS:
1
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5
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7
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9
10
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13
Licensing Program Analyst (LPA) Fred Arias conducted an unannounced complaint visit to finalize an investigation into the above allegation. LPA was greeted and granted entry into the facility and explained the reason for the visit.

It was alleged facility is not adequately staffed. LPA conducted interviews with staff and residents. LPA reviewed records obtained.

The investigation determined as follows:

Regarding the allegation facility is not adequately staffed, it was reported there is insufficient staff to meet the needs of the residents. LPA interviews with two out of six residents stated their needs are being met by staff and there has not been an issue with staffing. One of the two residents added there is usually two staff during the day. The four remaining residents could not be qualified for interviews. Three out of three staff stated there is sufficient staff coverage and several back up staff is available when needed.
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Fred Arias
LICENSING EVALUATOR SIGNATURE:

DATE: 04/17/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 8
Control Number 22-AS-20231211124258
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 9
FACILITY NUMBER: 306006201
VISIT DATE: 04/17/2026
NARRATIVE
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LPA record review of the LIC500 indicates there are six caregivers available or on call with at least two caregivers scheduled to work from 7AM to 7PM and one caregiver scheduled to work from 7PM to 7AM. LPA reviewed schedule indicating two staff during the day shift and one staff during the night shift from May to April 2026.

Based on interviews and record review, LPA is unable to corroborate the allegation. Therefore, the allegation is deemed to be UNFOUNDED, meaning that the allegation was false, could not have happened and/or is without a reasonable basis.

An exit interview was conducted and a copy of the report was left with the facility.
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Fred Arias
LICENSING EVALUATOR SIGNATURE:

DATE: 04/17/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2026
LIC9099 (FAS) - (06/04)
Page: 4 of 8
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 Fred Arias
COMPLAINT CONTROL NUMBER: 22-AS-20231211124258

FACILITY NAME:STERLING SENIOR COMMUNITY 9FACILITY NUMBER:
306006201
ADMINISTRATOR:LALAP, DONNAVEEFACILITY TYPE:
740
ADDRESS:10448 NIGHTINGALE CIRCLETELEPHONE:
(714) 594-3568
CITY:FOUNTAIN VALLEYSTATE: CAZIP CODE:
92708
CAPACITY:6CENSUS: 6DATE:
04/17/2026
UNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Sheryl TongolTIME COMPLETED:
04:50 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility failed to maintain a complete and accurate staff records.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Fred Arias conducted an unannounced complaint visit to finalize an investigation into the above allegation. LPA was greeted and granted entry into the facility and explained the reason for the visit.

It was alleged facility failed to maintain a complete and accurate staff records. LPA conducted interviews with staff. LPA reviewed records obtained.

Regarding the allegation facility failed to maintain a complete and accurate staff records, it was reported staff records were not compliant with Title 22 regulations. LPA reviewed six out of six staff records. Six out of six staff records included but not limited to evidence of health screening, training including First Aid, background clearance, TB testing, and job applications. Administrator (AD) Sheryl Tongol stated she does training in person or virtual training. AD was unable to produce training material at the request of the LPA and stated those materials were at a different facility. Interviews with two out of two staff stated they have received training recently.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Fred Arias
LICENSING EVALUATOR SIGNATURE:

DATE: 04/17/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 5 of 8
Control Number 22-AS-20231211124258
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 9
FACILITY NUMBER: 306006201
VISIT DATE: 04/17/2026
NARRATIVE
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One of the two staff added they had training on April 14, 2026 but could not recall who led the training or what topics were covered.

Based on interviews and records observed, the allegations is therefore deemed unsubstantiated meaning that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.

An exit interview was conducted and a copy of the report was left with the facility representative.
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Fred Arias
LICENSING EVALUATOR SIGNATURE:

DATE: 04/17/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2026
LIC9099 (FAS) - (06/04)
Page: 6 of 8
Control Number 22-AS-20231211124258
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 9
FACILITY NUMBER: 306006201
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/17/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/30/2026
Section Cited
CCR
87303(a)
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87303(a) Maintenance and Operation

The facility shall be clean, safe, sanitary and in good repair at all times.

This requirement is not met as evidenced by:
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AD stated battery have been ordered and will be replaced. AD to provide proof to LPA by POC due date.
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LPA observed audio exit alarm across from room 5 not operational which poses a potential health and safety risk to persons in care.
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Type B
04/30/2026
Section Cited
CCR
87465(h)(6)(C)
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87465(h)(6)(C)Incidental Medical and Dental Care
The licensee shall be responsible for assuring that a record of centrally stored prescription medications for each resident...and includes: The drug name, strength and quantity
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This requirement is not met as evidenced by:

Hydrocortisone cream for R1 was not listed the R1's Centrally Store Medication and Destruction record which poses a potential health and safety risk to persons in care.
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AD stated centrally store medication list will be updated with current medications. In-service training will be provided to staff and proof will be sent to LPA by POC due date
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: Alisa Ortiz
LICENSING EVALUATOR NAME: Fred Arias
LICENSING EVALUATOR SIGNATURE:

DATE: 04/17/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2026
LIC9099 (FAS) - (06/04)
Page: 7 of 8
Control Number 22-AS-20231211124258
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 9
FACILITY NUMBER: 306006201
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/17/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
04/18/2026
Section Cited
CCR
87465(a)(1)
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7
Incidental Medical and Dental Care 87465(a)(1) The licensee shall arrange, or assist in arranging, for medical and dental care appropriate to the conditions and needs of residents.

The requirement is not met as evidenced by:
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AD stated creams will be ordered and adminstered to R1. In service training will be completed and proof sent to LPA by POC due date.
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R1 has a prescription for two creams used daily that are not availabled at the facility which poses an immediate health and safety risk to persons 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: Alisa Ortiz
LICENSING EVALUATOR NAME: Fred Arias
LICENSING EVALUATOR SIGNATURE:

DATE: 04/17/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2026
LIC9099 (FAS) - (06/04)
Page: 8 of 8