306006253-2-13-2025-22-AS-AORZ-DE9N7T-20250226091313

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306006253
Report Date: 01/17/2025
Date Signed: 02/13/2025 04:31:55 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
01/10/2025 and conducted by Evaluator RoseMarie Ruppert

COMPLAINT CONTROL NUMBER: 22-AS-20250110110403

FACILITY NAME:	SENIOR'S RETREAT OF BREA, INC., THE		FACILITY NUMBER:	306006253
ADMINISTRATOR:	SMITH, LORNA		FACILITY TYPE:	740
ADDRESS:	311 GUAVA PL		TELEPHONE:	(562) 746-7899
CITY:	BREA	STATE: CA	ZIP CODE:	92821
CAPACITY:	6	CENSUS: 0	DATE:	01/17/2025
		UNANNOUNCED	TIME BEGAN:	01:03 PM
MET WITH:	Lorna Smith, Administrator		TIME COMPLETED:	01:26 PM

ALLEGATION(S):

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Wrongful Eviction

INVESTIGATION FINDINGS:

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LIcensing Program Analyst (LPA) Rose Ruppert made an unannouced visit to conduct a complaint investigation, received by our Regional Office on January 10, 2025, regarding a wrongful eviction of a resident. Upon arrival, LPA was told by contractors, who were installing solar panels on the home, that the residents and staff were at the home across the street.

LPA spoke with Lorna Smith, Administrator, and confirmed the resident does not live at this location and was never a resident of this facility. Resident resided at Senior's Retreat #306005914. LPA requested copies of the resident's file, including the signed Admissions Agreement; which reflects the address of #306005914.

The Department has investigated the complaint alleging the resident was wrongfully evicted. The agency has found that the complaint was unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. An exit interview was conducted with Lorna Smith, Administrator and a copy of this report was provided to the facility.
****This is an amended report****

Unfounded

Estimated Days of Completion:

SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: RoseMarie Ruppert
LICENSING EVALUATOR SIGNATURE:	DATE: 01/17/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/17/2025

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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