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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306006495
Report Date: 04/03/2026
Date Signed: 04/04/2026 11:12:05 AM

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
03/27/2026 and conducted by Evaluator Eboni Bentley
COMPLAINT CONTROL NUMBER: 22-AS-20260327115632
FACILITY NAME:HILLS OF SANTA TERESA, THEFACILITY NUMBER:
306006495
ADMINISTRATOR:MIRANDA, ROSENDO CARLAFACILITY TYPE:
740
ADDRESS:17698 SANTA TERESA CIRCLETELEPHONE:
(714) 430-7672
CITY:FOUNTAIN VALLEYSTATE: CAZIP CODE:
92708
CAPACITY:6CENSUS: 4DATE:
04/03/2026
UNANNOUNCEDTIME BEGAN:
04:15 PM
MET WITH:Nadia Morales - CaregiverTIME COMPLETED:
05:00 PM
ALLEGATION(S):
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Facility is in financial distress.
INVESTIGATION FINDINGS:
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On April 3, 2026, Licensing Program Analyst (LPA) Eboni Bentley arrived unannounced for the purpose of conducting an initial complaint investigation visit into the above allegation and delivering findings. Administrator (AD) Rosendo Carla Miranda was contacted via telephone, unable to be present during the visit, and designated Caregiver Nadia Morales to sign the facility report.

During the course of the investigation, LPA conducted a tour of the facility with staff and reviewed documentation which consists of the Resident/Staff Rosters, Staff Contacts, Rent payments, and payroll records. Interviews were conducted with four residents and four staff.

The following was determined during the investigation:
Regarding the allegation, Facility is in financial distress, it is alleged that the facility experiencing financial problems, resulting in staff not being paid on time.
CONTINUE TO LIC9099-C....
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kevin Saborit-Guasch
LICENSING EVALUATOR NAME: Eboni Bentley
LICENSING EVALUATOR SIGNATURE:

DATE: 04/03/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2026
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-20260327115632
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: 04/03/2026
NARRATIVE
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During the course of the investigation, interviews were conducted with four residents and four staff. Four out of four staff confirmed the allegation, stating they received paychecks late that were due on March 13 and March 27, 2026. One staff stated they resigned after receiving late paychecks and another staff reported taking a leave of absence for the same reason. Two staff reported receiving paychecks that bounced when first deposited into their bank accounts and stated the checks cleared, after being told by facility staff to deposit the payroll check a second time and on a later date. Two out of four residents stated they are aware that staff have received paychecks late on multiple occasions, one staff resigned, and another staff has taken a leave of absence due to late payroll payments and bounced checks. One resident stated the facility is using different caregivers to cover shifts for staff that are no longer working at the facility and they are frustrated that previous caregivers are no longer working there. A record review revealed that March and April rent payments were returned by the bank and not paid. The licensee confirmed the transactions were returned multiple times but did not clear and rent was not paid.

Based on observations made, interviews that were conducted, and record reviewed, the preponderance of evidence standard has been met, therefore the allegation, Facility is in financial distress is deemed SUBSTANTIATED. See the attached LIC9099-D.

An exit interview was conducted with staff, and a copy of this report, LIC9099-D, and appeals rights were provided at the end of the visit.
SUPERVISORS NAME: Kevin Saborit-Guasch
LICENSING EVALUATOR NAME: Eboni Bentley
LICENSING EVALUATOR SIGNATURE:

DATE: 04/03/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 22-AS-20260327115632
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: 04/03/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
04/04/2026
Section Cited
CCR
87213
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87213 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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Licensee will pay staff in a timely manner, ensure checks are paid in full, and cleared. Licensee stated they will resubmit rent payments for March and April and provide proof via email to eboni.bentley@dss.ca.gov by POC due date.
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Based on observations, interviews, and record review, the paychecks due to staff were paid late, two staff paychecks bounces, and March and April rent payments were returned. This poses a immediate 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: Kevin Saborit-Guasch
LICENSING EVALUATOR NAME: Eboni Bentley
LICENSING EVALUATOR SIGNATURE:

DATE: 04/03/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3