306006386-2-20-2026-22-AS-APAO-DRNNCW-20260226092122

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306006386
Report Date: 02/19/2026
Date Signed: 02/20/2026 02:09:33 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
01/23/2026 and conducted by Evaluator Eboni Bentley

COMPLAINT CONTROL NUMBER: 22-AS-20260123165706

FACILITY NAME:	SEASIDE TERRACE		FACILITY NUMBER:	306006386
ADMINISTRATOR:	PEDROZA, TRICIA		FACILITY TYPE:	740
ADDRESS:	9925 LA ALAMEDA AVE		TELEPHONE:	(714) 962-5531
CITY:	FOUNTAIN VALLEY	STATE: CA	ZIP CODE:	92708
CAPACITY:	250	CENSUS: 162	DATE:	02/19/2026
		UNANNOUNCED	TIME BEGAN:	04:30 PM
MET WITH:	Ephantus Warui- Administrator		TIME COMPLETED:	05:00 PM

ALLEGATION(S):

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Facility is violating resident's personal rights.

INVESTIGATION FINDINGS:

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On February 19, 2026, Licensing Program Analyst (LPA) Eboni Bentley arrived at the facility for an unannounced subsequent complaint investigation into the above allegation. LPA was greeted and granted entry after stating the purpose of the visit to Administrator (AD) Ephantus Warui.

The investigation into the above allegation revealed the following:

During the course of the investigation, LPA conducted a tour of the physical plant and obtained pertinent documentation which includes Resident/Personnel Rosters, Personnel Reports, Staff Contacts, Resident 1 Face Sheets, Physician’s Report, Progress Note, Community Policy Violation Warnings, Residency Agreement, Theft and Loss Policy and Procedure, Resident Personal Property and Valuables (LIC621) and House Rules.

CONTINUE TO LIC9099-C....

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Eboni Bentley
LICENSING EVALUATOR SIGNATURE:	DATE: 02/19/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/19/2026

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-20260123165706

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: SEASIDE TERRACE	FACILITY NUMBER: 306006386
	VISIT DATE: 02/19/2026

NARRATIVE

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Regarding the allegation, Facility is violating resident's personal rights, it is alleged that staff violated Resident 1’s (R1's) personal rights by removing cooking appliances from R1's room and taking possession of R1's cooking appliance upon delivery to the facility, without resident’s permission. During the course of the investigation, LPA conducted interviews with five residents and five staff. Five out of five staff denied the allegation stating R1 was given verbal and written notice that cooking and cooking appliances were not permitted in R1's room, as they were considered a hazard and Healthy & Safety risk. Based on records reviewed, the facility provided all residents with notice on two separate occasions, that hazardous items and items that may create a risk to residents’ health and safety, would be removed from resident rooms, following inspection. Record review revealed, fire alarms in R1s room were activated on August 28, 2025 and September 28, 2025. The resident was initially provided with a verbal warning and then written notice following the second incident. When interviewed, R1 stated they received notices regarding upcoming room inspections by the facility and items considered hazardous to residents' health and safety, however, R1 stated they intentionally hid cooking appliances from staff as they knew these items were not permitted. Upon inspection, cooking appliances and cookware were removed from R1's room. House Rules signed by R1 dated March 1, 2024, state "22. Residents are prohibited from cooking or having any cooking equipment in their room besides the microwave that is provided by the facility." During interview, R1 stated they reordered a cooking appliance that was delivered to the facility on October 8, 2025, and S1 intercepted the delivery. Staff denied the allegation, stating they delivered the item to R1's room and R1 then came downstairs with S1, to the facility office to store the item, as they agreed it was prohibited. S1 stated the item will be returned to resident upon move-out. Photos were taken of the item in facility storage.

Therefore, based on the observations made, interviews which were conducted, and the records that were reviewed, although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the following allegation, Facility is violating resident's personal rights., is deemed UNSUBSTANTIATED.

An exit interview was conducted with Administrator Ephantus Warui, and a copy of this report was provided at exit.

SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Eboni Bentley
LICENSING EVALUATOR SIGNATURE:	DATE: 02/19/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/19/2026

LIC9099 (FAS) - (06/04)

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