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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306006311
Report Date: 02/24/2024
Date Signed: 02/24/2024 11:50:57 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
12/18/2023 and conducted by Evaluator Kimberly Lyman
COMPLAINT CONTROL NUMBER: 22-AS-20231218074941
FACILITY NAME:KAYLA'S BOARD & CAREFACILITY NUMBER:
306006311
ADMINISTRATOR:RINGOR, ELVIE B.FACILITY TYPE:
740
ADDRESS:6593 E CALLE DEL NORTETELEPHONE:
(714) 600-7269
CITY:ANAHEIM HILLSSTATE: CAZIP CODE:
92807
CAPACITY:6CENSUS: 5DATE:
02/24/2024
UNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Rommel RingorTIME COMPLETED:
12:10 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
uncleared individuals staying at the facility over the weekend
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Kimberly Lyman conducted an unannounced complaint visit to deliver findings on the above allegation. LPA was greeted and granted entry into the facility and explained the reason for the visit.
During the course of the investigation, LPA toured the facility, interviewed staff, residents and witness. Regarding the allegation that uncleared individuals staying at the facility over the weekend, the investigation revealed the following: LPA observed no uncleared individuals at the facility on two different occasions including a weekend visit. All staff observed are fingerprint cleared and associated. Three out of three residents, witness and five out of five staff deny any visitors spending the night at the facility and indicate the only weekend visitors are resident family members. Based on observation and interview, LPA is unable to corroborate the allegation. Therefore, the allegation is deemed to be Unsubstantiated, meaning that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violation did occur.
An exit interview was conducted and a copy of this report was provided to a facility representative.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Kimberly Lyman
LICENSING EVALUATOR SIGNATURE:

DATE: 02/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/24/2024
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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