306006342-3-12-2025-22-AS-SSAS-DES2QG-20250314173556

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306006342
Report Date: 03/12/2025
Date Signed: 03/12/2025 05:27:56 PM

Unsubstantiated

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
12/31/2024 and conducted by Evaluator Kevin Saborit-Guasch

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20241231115747

FACILITY NAME:	MARIGOLD BOARD AND CARE		FACILITY NUMBER:	306006342
ADMINISTRATOR:	TRANAE QUATICE GATLIN		FACILITY TYPE:	740
ADDRESS:	8601 SAN ROMOLO WAY		TELEPHONE:	(661) 236-6787
CITY:	BUENA PARK	STATE: CA	ZIP CODE:	90620
CAPACITY:	6	CENSUS: 6	DATE:	03/12/2025
		UNANNOUNCED	TIME BEGAN:	02:47 PM
MET WITH:	Tranae Gatlin, Administrator		TIME COMPLETED:	04:15 PM

ALLEGATION(S):

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Staff does not ensure resident's dietary needs are being met.

Staff does not ensure resident is administered the correct prescribed medications.

Staff does not ensure resident's hygiene needs are being met.

INVESTIGATION FINDINGS:

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On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility to follow up and deliver findings in the investigation of the three allegations listed above. LPA was greeted and granted entry by facility staff after introducing himself and stating the purpose of the visit. Administrator Tranae Gatlin was notified via telephone and arrived later to assist with the visit.

An initial complaint investigation visit took place on January 10, 2025. During the visit, LPA accompanied by staff conducted a tour of the facility's physical plant. There are currently six residents in care. LPAs requested and obtained resident records for all six individuals. Two staff and three resident interviews conducted during the visit. Additional witness interviews were conducted over the course of the investigation.
During the follow-up investigation visit, LPA conducted one additional resident interview.

CONTINUED ON FORM LIC9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Kevin Saborit-Guasch
LICENSING EVALUATOR SIGNATURE:	DATE: 03/12/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2025

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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Control Number 22-AS-20241231115747

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: MARIGOLD BOARD AND CARE	FACILITY NUMBER: 306006342
	VISIT DATE: 03/12/2025

NARRATIVE

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CONTINUED FROM FORM LIC9099
Regarding the allegation that Staff does not ensure resident's dietary needs are being met, the following has been concluded: Based on observation and interviews conducted with residents present at the facility, it was confirmed that a variety of food was present at the facility and being offered to residents. Additional evidence showed occasional refusals to eat formulated by a resident due to health and/or gastro-intestinal concerns. A majority of the statements gathered demonstrated satisfaction in the meals provided by the facility in terms of quantity and variety, and confirmed the availability of snacks upon demand.

Regarding the allegation that Staff does not ensure resident is administered the correct prescribed medications, the following has been concluded: A majority of the statements made by residents confirmed that they believed they were receiving their medication timely and adequately from facility staff. A review of the medication administration records provided by facility staff appeared to corroborate the statements made by residents, staff and witnesses.

Regarding the allegation that Staff does not ensure resident's hygiene needs are being met, the following has been concluded: Most of the residents interviewed expressed their satisfaction with the toileting care and assistance provided by facility staff. One resident stated that their roommate's hygiene was occasionally problematic but denied that it was due to staff negligence as she described toileting care being offered on regular instances by staff.

On the basis of the evidence gathered during the present investigation, all three allegations are found to be Unsubstantiated, meaning that although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur.

An exit interview was conducted and a copy of the present report was provided to a facility representative.

SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Kevin Saborit-Guasch
LICENSING EVALUATOR SIGNATURE:	DATE: 03/12/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2025

LIC9099 (FAS) - (06/04)

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