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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306006495
Report Date: 10/23/2025
Date Signed: 10/23/2025 03:15:38 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
10/14/2025 and conducted by Evaluator Eboni Bentley
COMPLAINT CONTROL NUMBER: 22-AS-20251014152840
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: 6DATE:
10/23/2025
UNANNOUNCEDTIME BEGAN:
11:35 AM
MET WITH:Rosendo Carlo Miranda/Carla - AdministratorTIME COMPLETED:
03:30 PM
ALLEGATION(S):
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Facility is in disrepair.
INVESTIGATION FINDINGS:
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On October 23, 2025, Licensing Program Analyst (LPA) Eboni Bentley arrived unannounced for the purpose of conducting a subsequent complaint investigation visit into the above allegation. LPA announced self and stated the purpose of the visit to Administrator Rosendo Carlo Miranda/Carla.

During the course of the investigation, LPA inspected the backyard and obtained documentation which consists of the Resident/Staff Rosters, Staff Contacts, Personnel Report, Lease Agreement, and Administrator Email/Statement.

The following was determined during the investigation:
Regarding the allegation, Facility is in disrepair, it was reported that there is an overgrown, big banana tree on the grounds that may cause damage to the fence and possibly encroach the neighboring property, as well as a Cherimoya tree that could damage the roof.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Eboni Bentley
LICENSING EVALUATOR SIGNATURE:

DATE: 10/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2025
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-20251014152840
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: 10/23/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/30/2025
Section Cited
CCR
87303(a)
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87303(a)The facility shall be clean, safe sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors.
This requirement is not met as evidenced by:
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The administer stated the plan is to have all over grown trees trimmed and will provide proof to CCLD by POC due date.
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Based on observation and record review, the facility failed to comply with the section cited above by failing to trim two overgrown trees in the backyard, which poses a potential 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: Lourdes Montoya
LICENSING EVALUATOR NAME: Eboni Bentley
LICENSING EVALUATOR SIGNATURE:

DATE: 10/23/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 22-AS-20251014152840
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: 10/23/2025
NARRATIVE
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It was reported that attempts to contact the facility regarding tree maintenance were made by the landlord but no response was received.

During the tour of the exterior of the facility with Administrator Miranda, LPA observed an overgrown banana tree that was growing over the fence and into the neighboring property, as well as a large banana tree with over a dozen leaves that have fallen, covering a six foot area of the ground. There is also a cherimoya tree growing within one foot of the roof, evidenced by photos attached. A record review of the lease agreement dated May 31, 2023, states in 11. Maintenance Use and Reportingthat it is the tenants/facility’s responsibility to maintain the landscape of the property, specifically the garden, bushes, and shrubs. Email correspondence dated October 23, 2025 at 3:04pm stated the facility’s plans to schedule tree trimming and notify the department when complete.

The investigation revealed the facility failed to maintain the landscape in the backyard which includes the trimming of the banana and cherimoya trees. Based on observations made and record review, the preponderance of evidence standard has been met, therefore the allegation, The Facility is in disrepair is deemed SUBSTANTIATED. See the attached LIC9099-D.

An exit interview was conducted with Administrator Rosendo Carlo Miranda/Carla, and a copy of this report, LIC9099-D, and appeals rights were provided at the end of the visit.
SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Eboni Bentley
LICENSING EVALUATOR SIGNATURE:

DATE: 10/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3