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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306006204
Report Date: 05/13/2025
Date Signed: 05/13/2025 09:50:06 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
05/07/2025 and conducted by Evaluator Kimberly Lyman
COMPLAINT CONTROL NUMBER: 22-AS-20250507101501
FACILITY NAME:WILLOW VIEW GARDENS MEMORY CARE & ASSISTED LIVINGFACILITY NUMBER:
306006204
ADMINISTRATOR:ESPINAL, ALMAFACILITY TYPE:
740
ADDRESS:2025 N BUSH STTELEPHONE:
(714) 541-3357
CITY:SANTA ANASTATE: CAZIP CODE:
92706
CAPACITY:130CENSUS: 70DATE:
05/13/2025
UNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Tony RuizTIME COMPLETED:
10:10 AM
ALLEGATION(S):
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Facility did not safeguard resident's personal belongings
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Kimberly Lyman made an unannounced visit on this day for the purpose of initiating an investigation into the above allegation. On this day, LPA was greeted and met with Maintenance Director Tony Ruiz. LPA met with Administrator Alma Espinal via telephone.
During the course of the investigation, LPA toured the facility and interviewed staff and residents. Regarding the allegation that facility did not safeguard resident's personal belongings, the investigation revealed the following: Facility indicates a pipe repair occurred in the facility on 04/07/2025 which resulted in Resident 1 (R1) being unable to use the resident's toilet for a couple hours. On 04/08/2025, Staff 1 (S1) unclogged the resident's toilet which took about four hours. S1 denies taking any items out of the resident's room. R1's roommate, R2, denies ever having anything taken out of the resident's room and states that R1 did not have any of the noted stolen items in the room at any time. Review of R1's inventory list did not mention any of the noted missing items. Facility documentation indicates six instances between 11/2024 and 03/2025 of resident accusing others of stealing cash or documents. Administrator indicates the documents were found in the resident's room. CONTINUED ON LIC 9099C DATED 05/13/2025
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Kimberly Lyman
LICENSING EVALUATOR SIGNATURE:

DATE: 05/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/13/2025
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 2
Control Number 22-AS-20250507101501
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME: WILLOW VIEW GARDENS MEMORY CARE & ASSISTED LIVING
FACILITY NUMBER: 306006204
VISIT DATE: 05/13/2025
NARRATIVE
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LPA interviewed three residents who stated having items go missing from time to time with sometimes the items would be found or misplaced. All three could not confirm if missing items had been stolen or misplaced. Due to conflicting information, LPA is unable to corroborate the allegation. Therefore, the allegation is deemed unsubstantiated, meaning that although the allegation may have happened or are 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 this report was provided to facility.
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Kimberly Lyman
LICENSING EVALUATOR SIGNATURE:

DATE: 05/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/13/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2