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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306006495
Report Date: 10/16/2025
Date Signed: 10/16/2025 03:56:37 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
04/08/2025 and conducted by Evaluator Michael Tea
COMPLAINT CONTROL NUMBER: 22-AS-20250408152753
FACILITY NAME:HILLS OF SANTA TERESA, THEFACILITY NUMBER:
306006495
ADMINISTRATOR:NEPOMUCENO, MARICELFACILITY TYPE:
740
ADDRESS:17698 SANTA TERESA CIRCLETELEPHONE:
(714) 430-7672
CITY:FOUNTAIN VALLEYSTATE: CAZIP CODE:
92708
CAPACITY:6CENSUS: 5DATE:
10/16/2025
UNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Carla Miranda, Joanna GomezTIME COMPLETED:
04:10 PM
ALLEGATION(S):
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- Facility is in financial distress
INVESTIGATION FINDINGS:
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On this day, Licensing Program Analyst (LPA) Michael Tea made an unannounced visit to conclude and deliver findings for a complaint investigation. LPA Tea was greeted and granted entry by facility staff and explained the reason for the visit. Administrator (AD) Carla Miranda and Director of Operations (DO) Joanna Gomez arrived shortly to assist with the visit.

The Department received a complaint on April 8, 2025, and LPA Tea conducted the initial 10-day visit on April 11, 2025. LPA Tea spoke to facility staff and residents and reviewed and collected pertinent documents and information.

It was alleged the facility is in financial distress. The investigation determined the following: During the initial visit LPA observed the facility to be operating normally, with no health and safety concerns. However, LPA gathered information that the facility was behind on rent for the property and payments were missed as
(Complaint Investigation report continued on LIC9099-C)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Michael Tea
LICENSING EVALUATOR SIGNATURE:

DATE: 10/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2025
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-20250408152753
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: HILLS OF SANTA TERESA, THE
FACILITY NUMBER: 306006495
VISIT DATE: 10/16/2025
NARRATIVE
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promised by the licensee.

Per interviews with the staff, initially they were paid on time and later around April and May, staff were not getting paid. The facility owed back pay to the staff and employee checks bounced. At one point, staff had a hard time purchasing groceries for the facility due to insufficient funds for the card used to purchase groceries. LPA also received information that the previous administrator for the facility quit due to non-payment of salary. One resident interviewed admitted there was a lack of staffing during a brief period, staff would quit and leave because they did not get paid.

LPA received court documents regarding a stipulated judgement and settlement agreement between the Plaintiff being the property owner and the Defendant, the Licensee, The Hills of Santa Teresa, asserting breach of contract due to unpaid rent, late fees and legal expenses related to the property. The judgement and settlement were in favor of the plaintiff, the property owner, in which the back pay amount of total fees was due along with the ongoing monthly rent.

Per interview with one of the licensees of The Hills of Santa Teresa, Maricel Nepomuceno, she admitted the company was going through financial hardship and trying to maintain operations. She admitted that they had hit a wall with legal troubles and were trying to seek other investors. Their business decisions had created a financial snowball effect in which the property owners of their facilities received the brunt end. During a meeting at the Regional Office on May 22, 2025 , Licensee Allen Medina admitted to financial struggles as a result of legal fees and loans and the rent and bills begin backing up.

Therefore, based on LPA Tea's observations, review of records and interviews conducted, the allegation that facility is in financial distress has been determined to be SUBSTANTIATED, meaning the complaint allegation is valid and that a violation has occurred.

The following deficiency is being cited per California Code of Regulations Title 22 Division 6 Chapter 8.

An exit interview was conducted with Administrator Carla Miranda and Director of Operations Joanna Gomez and a copy of this report and appeal rights were provided to the facility.
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Michael Tea
LICENSING EVALUATOR SIGNATURE:

DATE: 10/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 22-AS-20250408152753
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: HILLS OF SANTA TERESA, THE
FACILITY NUMBER: 306006495
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/16/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/17/2025
Section Cited
CCR
87213
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The licensee shall have a financial plan that conforms to the requirements of Section 87155, Application for License, and that assures sufficient resources to meet operating costs for care of residents.

This requirement is not met as evidenced by:
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Facility has already made arrangements for backpay through legal settlement. Facility stated they will submit a written detailed plan of action to LPA via email by POC due date, that ensures solutions and transparency to meet resources and operating costs for care of the residents.
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Based on LPA's observation, records obtained and interviews conducted, facility was unable to cover operating costs due to deliquency in rental property payments and staff salary as a result of legal and financial troubles. This poses an immediate risk to the health and safety of residents 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: Alisa Ortiz
LICENSING EVALUATOR NAME: Michael Tea
LICENSING EVALUATOR SIGNATURE:

DATE: 10/16/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2025
LIC9099 (FAS) - (06/04)
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