<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306006565
Report Date: 05/14/2025
Date Signed: 05/14/2025 12:05:26 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
05/08/2025 and conducted by Evaluator Claudia Gutierrez
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20250508111720
FACILITY NAME:HILLS OF SIERRA MAJORCA, THEFACILITY NUMBER:
306006565
ADMINISTRATOR:LADIA, BHONALYNFACILITY TYPE:
740
ADDRESS:19105 SIERRA MAJORCATELEPHONE:
(949) 316-4654
CITY:IRVINESTATE: CAZIP CODE:
92603
CAPACITY:6CENSUS: 4DATE:
05/14/2025
UNANNOUNCEDTIME BEGAN:
11:18 AM
MET WITH:Bhonalyn LadiaTIME COMPLETED:
12:20 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility is in financial distress
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
An unannounced Complaint Investigation was conducted on this day by Licensing Program Analyst (LPA) Claudia Gutierrez regarding the allegation mentioned above. LPA met with Administrator (AD) Bhonalyn Ladia and explained the purpose of the inspection.

LPA and AD conducted a tour of the facility. LPA observed the facility has electricity, gas, water, internet and phone service. LPA observed a two-day supply of perishable and a seven-day supply of non-perishable food. Medication was observed to be centrally stored and locked in a kitchen cabinet. Sharps were observed to be locked in a kitchen drawer.

Interviews were conducted with two staff and Licensee Allen Medina. During their interview, two of two staff denied any knowledge of the facility’s financial status and stated the utilities have been and continue to be operational and food supply is maintained as observed during today’s visit. (Cont. LIC9099-C)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Claudia Gutierrez
LICENSING EVALUATOR SIGNATURE:

DATE: 05/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2025
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-20250508111720
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME: HILLS OF SIERRA MAJORCA, THE
FACILITY NUMBER: 306006565
VISIT DATE: 05/14/2025
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
During their interview, Licensee stated that although all financial costs for operating the facility are current, they are not always paid timely. Per Licensee, funds need to be allocated prior to financial costs being covered, and the rental payment for the facility is often late. Per Licensee, if a resident is late or does not pay their monthly rent, they are unable to cover the cost of operating the facility. Licensee stated that currently a significant amount of their funds is going to legal fees.

No health or safety concerns were observed during today's visit.

Based Licensee interview, the preponderance of evidence standard has been met; therefore the above allegation is found to be substantiated. Deficiencies are being cited per Title 22 Division 6 of the California Code of regulations. (See LIC9099-D). An exit interview was conducted. A copy of this report, and appeal rights were left at the facility.
SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Claudia Gutierrez
LICENSING EVALUATOR SIGNATURE:

DATE: 05/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 22-AS-20250508111720
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

FACILITY NAME: HILLS OF SIERRA MAJORCA, THE
FACILITY NUMBER: 306006565
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/14/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/15/2025
Section Cited
CCR
87213
1
2
3
4
5
6
7
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:
1
2
3
4
5
6
7
Licensee stated they will submit a written plan of action to LPA via email by POC date, that ensures Licensee will have sufficient resources to meet the operating costs for care of the residents.
8
9
10
11
12
13
14
Based on Licensee interview, the Licensee did not comply with the section cited above as Licensee does not have sufficient resources to meet opeating costs for care of the residents, which poses an immediate health, safety, and personal rights risk to persons in care.
8
9
10
11
12
13
14
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
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: Armando J Lucero
LICENSING EVALUATOR NAME: Claudia Gutierrez
LICENSING EVALUATOR SIGNATURE:

DATE: 05/14/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3