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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306006343
Report Date: 12/02/2025
Date Signed: 12/02/2025 04:39:06 PM

Substantiated


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
11/24/2025 and conducted by Evaluator Brandon Lopez
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20251124155742
FACILITY NAME:HEILEND HANDS HOMEFACILITY NUMBER:
306006343
ADMINISTRATOR:SALAZAR, MARLYNFACILITY TYPE:
740
ADDRESS:1331 EAST GREENVIEW DRIVETELEPHONE:
(909) 904-3052
CITY:ORANGESTATE: CAZIP CODE:
92866
CAPACITY:2CENSUS: 2DATE:
12/02/2025
UNANNOUNCEDTIME BEGAN:
01:10 PM
MET WITH:Licensee Maryln SalazarTIME COMPLETED:
04:56 PM
ALLEGATION(S):
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Facility did provide proper notice of rate increase
INVESTIGATION FINDINGS:
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On December 2, 2025, Licensing Program Analyst (LPA) Brandon Lopez made an unannounced visit to the facility to initiate the investigation into the allegation listed above and to deliver the complaint findings. LPA was greeted and granted entry into the facility by staff after explaining the purpose for the visit. Licensee (LI) Maryln Salazar was notified via telephone and later arrived to assist with the inspection.

During the visit, LPA, accompanied by the LI, conducted a tour of the physical plant. LPA observed the facility to be free of any obstructions or hazards. LPA conducted one resident interview and one staff interview. LPA additionally reviewed and obtained pertinent documents to the complaint such as the Admission Agreement, Pre-Admission Appraisal, and Physician's Report for R1.

It was alleged that the facility did provide proper notice of rate increase to R1. LPA reviewed the file for R1 and observed there was no written notice of rate increase on file for R1. CONTINUED ON LIC9099-C
Substantiated
Estimated Days of Completion: 90
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Brandon Lopez
LICENSING EVALUATOR SIGNATURE:

DATE: 12/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2025
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 3
Control Number 22-AS-20251124155742
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: HEILEND HANDS HOME
FACILITY NUMBER: 306006343
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/02/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/19/2025
Section Cited
HSC
1569.655(a)
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1569.655 Increase in fee rates ... (a) If a licensee ... increases the rates of fees ... the licensee shall provide no less than 90 days’ prior written notice to the residents or the residents’ representatives ...
This was not evidenced by:
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The Licensee stated that they will provide a refund to R1 for the rate increase amount for November 2025. The Licensee stated that they will provide R1 a prior written 90-day notice for any futute rate increases. The Licensee agreed to provide LPA proof of the refund via email or fax by POC date.
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Based on records reviewed and interviews conducted, the Licensee did not provided R1 a written notice prior to issuing a rate increase. This poses a potential health, safety, and personal rights risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Brandon Lopez
LICENSING EVALUATOR SIGNATURE:

DATE: 12/02/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 22-AS-20251124155742
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: HEILEND HANDS HOME
FACILITY NUMBER: 306006343
VISIT DATE: 12/02/2025
NARRATIVE
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LPA conducted an interview with R1 who confirmed that he paid an increased rate amount for the month of November 2025. R1 stated that he did not receive a written notice prior to paying the rate increase for the month of November 2025 and that he was only advised of the increase in rate verbally. LPA conducted an interview with R1's Responsible Party, Witness #1 (W1). W1 confirmed that they did not receive a written notice prior to R1 paying an increased rate for the month of November 2025. LPA conducted an interview with the LI. The LI confirmed a written notice was not given to R1, or W1, prior to charging an increased rate amount for the month of November 2025. The LI stated that an agreement was made with R1 to pay an increase rate amount was made in October 2025, however, the agreement was made solely verbally. Per Health and Safety Code 1569.655(a), it states, If a licensee of a residential care facility for the elderly increases the rates of fees for residents or makes increases in any of its rate structures for services, the licensee shall provide no less than 90 days’ prior written notice to the residents or the residents’ representatives setting forth the amount of the increase and the reason or reasons for the increase, including a description of the additional costs, except for an increase in the rate due to a change in the level of care of the resident.

Based on the evidenced gathered during this investigation, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. An exit interview was conducted with Licensee Maryln Salazar. A copy of the report and Appeal Rights were provided.
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Brandon Lopez
LICENSING EVALUATOR SIGNATURE:

DATE: 12/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3