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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306002955
Report Date: 09/18/2026
Date Signed: 09/18/2026 01:36:03 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
06/11/2026 and conducted by Evaluator Andrea Mendivil
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20260611133245
FACILITY NAME:BROOKDALE NOHL RANCHFACILITY NUMBER:
306002955
ADMINISTRATOR:SARAH DEVOREFACILITY TYPE:
740
ADDRESS:380 S ANAHEIM HILLS RDTELEPHONE:
(714) 974-1616
CITY:ANAHEIM HILLSSTATE: CAZIP CODE:
92807
CAPACITY:266CENSUS: 111DATE:
09/18/2026
UNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Sarah Devore - Executive Director TIME COMPLETED:
01:45 PM
ALLEGATION(S):
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Staff verbally abused resident
INVESTIGATION FINDINGS:
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On this day, Licensing Program Analyst (LPA) Andrea Mendivil made an unannounced visit to deliver complaint findings. LPA was greeted and granted entry into the faciltiy and explained the reason for the visit.

The Department received the complaint on June 8th, 2026. During the initial visit conducted on June 16th, 2026 the Department walked through the facility and interviewed staff and residents. Regarding the allegation Staff verbally abused resident, the investigation revealed the following:

It was reported that on June 7th, 2026 during a hoyer lift transfer Resident 1 (R1) was refusing assistance. It was then reported that Staff 1 (S1) and Staff 2 (S2) continued with the transifer despite R1's refusals. Per incident report provided S1 was training S2 and S1 advised S2 to continue with the transfer. It was reported S1 made remarks to R1. Per Report of Suspected Depedent Adult/Edler Abuse dated June 07, 2026 the facility reported the issue to Community Care Licensing, Ombudsman, Hopsice and the local police department.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Andrea Mendivil
LICENSING EVALUATOR SIGNATURE:

DATE: 09/18/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2026
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 5
Control Number 22-AS-20260611133245
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: BROOKDALE NOHL RANCH
FACILITY NUMBER: 306002955
VISIT DATE: 09/18/2026
NARRATIVE
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Executive Director Sarah DeVore stated that S1 was suspended pending investigation and ultimately was terminated. Sarah stated that resident's rights are of utmost importance and the facility does not tolerate abuse. Sarah reported the police were at the facility twice and no other follow up was conducted regarding the incident.

Therefore based on the preponderance of evidence through interviews and reports reviewed the allegation that staff verbally abused resident is determined to be SUBSTANTIATED, meaning the complaint allegation as valid and that a violation has occurred.

Based on above findings deficiencies are being cited per California Code of Regulations Title 22 Division 6 chapter 8.

An exit interview was conducted and a copy of this report was provided.
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Andrea Mendivil
LICENSING EVALUATOR SIGNATURE:

DATE: 09/18/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 5
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
06/11/2026 and conducted by Evaluator Andrea Mendivil
COMPLAINT CONTROL NUMBER: 22-AS-20260611133245

FACILITY NAME:BROOKDALE NOHL RANCHFACILITY NUMBER:
306002955
ADMINISTRATOR:SARAH DEVOREFACILITY TYPE:
740
ADDRESS:380 S ANAHEIM HILLS RDTELEPHONE:
(714) 974-1616
CITY:ANAHEIM HILLSSTATE:CAZIP CODE:
92807
CAPACITY:266CENSUS: DATE:
09/18/2026
UNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Sarah DeVore - Executive Director TIME COMPLETED:
01:45 PM
ALLEGATION(S):
1
2
3
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9
Staff physically restrained resident against their will
INVESTIGATION FINDINGS:
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13
On this day, Licensing Program Analyst (LPA) Andrea Mendivil made an unannounced visit to deliver complaint findings. LPA was greeted and granted entry into the faciltiy and explained the reason for the visit.

The Department received the complaint on June 8th, 2026. During the initial visit conducted on June 16th, 2026 the Department walked through the facility and interviewed staff and residents. Regarding the allegation staff physically restrained resident against their will, the investigaiton revealed the following:

It was reported that on June 7th, 2026 during a hoyer lift transfer Resident 1 (R1) was refusing assistance. It was then reported that Staff 1 (S1) and Staff 2 (S2) continued with the transition despite R1's refusals. Per incident report provided S1 was training S2 and S1 advised S2 to continue with the transfer. It was reported S1 made remarks to R1. Per Report of Suspected Depedent Adult/Edler Abuse dated June 07, 2026 the facility reported the incident to Community Care Licensing, Ombudsman, Hopsice and the local police department.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Andrea Mendivil
LICENSING EVALUATOR SIGNATURE:

DATE: 09/18/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 22-AS-20260611133245
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: BROOKDALE NOHL RANCH
FACILITY NUMBER: 306002955
VISIT DATE: 09/18/2026
NARRATIVE
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Per interviews with Executive Director Sarah DeVore, that S2 had to move their body across R1 to roll R1 over and place the hoyer lift net for transfer. Sarah stated that S2 did not restrain R1 by placing their body over R1. 2 out of 2 staff stated deny restraining any residents. Per hospice notes dated June 8, 2026 a body assessment was conducted and no injuries were noted.

Therefore based on the preponderance of evidence through records reviewed and interviews the allegation Staff physically restrained resident against their will is determined to be UNSUBSTANTIATED, meaning that although the allegation may have happened or is valid, there is no preponderance of evidence to prove the alleged violations did or did not occur as reported.

An exit interview was conducted and a copy of this report was provided.
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Andrea Mendivil
LICENSING EVALUATOR SIGNATURE:

DATE: 09/18/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2026
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 22-AS-20260611133245
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: BROOKDALE NOHL RANCH
FACILITY NUMBER: 306002955
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/18/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/24/2026
Section Cited
CCR
87468.1(a)(1)
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(a) Residents in all residential care facilities for the elderly shall have all of the following personal rights:(1) To be accorded dignity in their personal relationships with staff, residents, and other persons. This requirement was not met as evidence by
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S1 was terminated and staff discussion conducted
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S1 making remarks while continue care that R1 had refused or did not want. This poses a potential personal rights risks 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.
SUPERVISOR'S NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Andrea Mendivil
LICENSING EVALUATOR SIGNATURE:

DATE: 09/18/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2026
LIC9099 (FAS) - (06/04)
Page: 5 of 5