<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306006242
Report Date: 01/06/2026
Date Signed: 01/06/2026 05:03:33 PM

Unfounded


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
12/29/2025 and conducted by Evaluator RoseMarie Ruppert
COMPLAINT CONTROL NUMBER: 22-AS-20251229115217
FACILITY NAME:CAPRIANAFACILITY NUMBER:
306006242
ADMINISTRATOR:REYNOLDS, TONYAFACILITY TYPE:
741
ADDRESS:460 LA FLORESTA DRIVETELEPHONE:
(714) 985-5500
CITY:BREASTATE: CAZIP CODE:
92821
CAPACITY:200CENSUS: 145DATE:
01/06/2026
UNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Tonya Reynolds, Executive Director and Lizette Flores, Health Services DirectorTIME COMPLETED:
05:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff are not ensuring accurate information is on resident's physician's orders for medication
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Rose Ruppert made an unannounced visit to investigate a complaint received in the Regional Office. LPA was greeted and granted entry and met with Executive Director (ED) Tonya Reynolds and Lizette Flores, Health Services Director (HSD) and explained the purpose of the visit. LPA conducted a joint visit with the Long Term Care Ombudsman (LTCO).

LPA requested a copy of Resident #1 (R1)'s lease agreement, Physician's Orders for R1's medications, a medical assessment from December 12, 2025 and email communication from the facility to the responsible party regarding medications.

LPA and LTCO audited medication bottles to confirm the prescribing physicians. Per review, the correct prescribing physicians were on the medication bottles and complies with Title 22 regulations.

LPA reviewed the bi-annual Medical Assessment, which was reviewed on December 12, 2025 and is effective January 1, 2026.
(Continued on LIC 9099)

Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: RoseMarie Ruppert
LICENSING EVALUATOR SIGNATURE:

DATE: 01/06/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/06/2026
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 2
Control Number 22-AS-20251229115217
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: CAPRIANA
FACILITY NUMBER: 306006242
VISIT DATE: 01/06/2026
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
(Continued by LIC 9099)

It was explained that the Physician's Orders medication record is "profile only" since the pharmacy R1 uses an outside pharmacy. For medications to be inputted to the electronic Medication Administration Record, all medication lists go through the in-house pharmacy. The prescribing physician shown does not change on the profile only. The in-house pharmacy does not actively fill R1's routine medications, thus, the physician on record is the last prescribing physician. R1 came in August 22, 2024 and some medications have not changed and thus, there have been no changes in the prescribing physician unless the prescription changed.

LPA interviewed three of three staff members and three of three witnesses. Based on staff and witness interviews, it was agreed the medication record discrepancy from the medication bottle is confusing. It was determined the licensee is complying with regulations. The allegation that Staff are not ensuring accurate information on the resident's physician's orders for medication is Unfounded. The allegation is false, could not have happened, and/or is without a reasonable basis.

An exit interview was conducted with Tonya Reynolds, Executive Director and Lizette Flores, Health Services Director and a copy of this report was provided to the facility.
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: RoseMarie Ruppert
LICENSING EVALUATOR SIGNATURE:

DATE: 01/06/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/06/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2