306005196-7-28-2026-22-AS-LMOA-DXH873-20260831221517

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306005196
Report Date: 07/28/2026
Date Signed: 07/28/2026 05:08:12 PM

Unsubstantiated

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
12/29/2023 and conducted by Evaluator Jessica Cho

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20231229160237

FACILITY NAME:	CASA DEL SOL		FACILITY NUMBER:	306005196
ADMINISTRATOR:	MENDOZA, IRVIN		FACILITY TYPE:	740
ADDRESS:	6486 EAST CALLE DEL NORTE		TELEPHONE:	(714) 602-8234
CITY:	ANAHEIM HILLS	STATE: CA	ZIP CODE:	92807
CAPACITY:	6	CENSUS: 4	DATE:	07/28/2026
		UNANNOUNCED	TIME BEGAN:	01:15 PM
MET WITH:	Irvin Mendoza- Administrator		TIME COMPLETED:	05:00 PM

ALLEGATION(S):

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Staff dropped resident in care resulting in an injury.
Staff slapped resident in care.
Staff threatened to fight resident in care.
Staff did not meet resident's diapering needs.
Staff fell asleep while on shift.
Staff threatened to evict resident in care.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Jessica Cho made an unannounced visit to continue the investigation into the above allegations. LPA was greeted and granted entry after explaining the reason for the visit. During the course of the investigation, interviews with two current residents, five staff, and one witness were conducted. LPA attempted to interview the remaining current two residents, Resident #1 (R1), and two former staff but statements could not be obtained. LPA also obtained the following documentation for review: Resident Rosters, Personnel Schedule, Face Sheets, Physician's Reports for current residents, and R1's Preplacement Appraisal, Care Plan, Physician's Report, Admission Agreement, and text message receipts.

The investigation is as follows: Regarding the allegation, Staff dropped resident in care resulting in an injury, it is alleged two staff had dropped R1 twice in one day approximately June 2023. R1 was admitted to the facility on February 1, 2023 and moved out approximately January 2024.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Jessica Cho
LICENSING EVALUATOR SIGNATURE:	DATE: 07/28/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/28/2026

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-20231229160237

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: CASA DEL SOL	FACILITY NUMBER: 306005196
	VISIT DATE: 07/28/2026

NARRATIVE

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R1 had advanced stage of Dementia per Physician's Report dated February 11, 2023 and was disoriented to person, place, and time. LPA was unable to interview R1 as R1 passed away on May 23, 2026 at another licensed facility per incident report. In review of the monthly nursing notes, there are no documentation of a fall that had occurred in June 2023. The current residents and staff were not present during the period in which R1 resided at the facility. Based on the interviews with two staff who had provided care to R1, denied working the same shift and dropping R1. Both staff denied the allegation.

Regarding the allegation, Staff slapped resident in care, it is alleged Staff #1 (S1) slapped R1 on the head. S1 and Witness #1 (W1) denied the allegation. Due to R1's passing, LPA was unable to obtain a R1's statement. The current residents and staff were not present during the period in which R1 resided at the facility.

Regarding the allegation, Staff threatened to fight the resident in care, Staff #2 (S2) tried to incite a fight with R1 who was frightened and asked their representative to come over. Based on an interview with W1, W1 did not witness S2 inciting a fight with R1. LPA was unable to obtain R1's statement due to their passing. LPA was also unable to interview the current residents and staff as they were not present during the period in which R1 resided at the facility.

Regarding the allegation, Staff did not meet resident's diapering needs, it is alleged R1's soiled brief with feces was not changed timely, and R1 was not assisted to the bathroom twice a day to empty their bladder causing a urinary tract infection. Based on the review of the care plan dated March 19, 2023, R1 requires total assistance including toileting. R1 is incontinent and requires change of briefs and toileting schedule is needed day and night. Based on record reviews and interviews, the current residents and staff were not present during the period in which R1 resided at the facility. R1 moved out of the facility approximately January 2024, and R1 could not be interviewed due to R1's passing. Interviews with two staff who were employed at the time R1 resided at the facility, denied the allegation indicating that diapers were changed every 2 hours or as needed for all residents. One of the two interviewed staff indicated being assigned to female residents at the time. Current three of three staff and one of four residents who require changes did not corroborate with the allegation indicating that diapers are changed upon request and in a timely manner.

SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Jessica Cho
LICENSING EVALUATOR SIGNATURE:	DATE: 07/28/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/28/2026

LIC9099 (FAS) - (06/04)

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Control Number 22-AS-20231229160237

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: CASA DEL SOL	FACILITY NUMBER: 306005196
	VISIT DATE: 07/28/2026

NARRATIVE

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Regarding the allegation, Staff fell asleep while on shift, Staff #3 (S3) was observed sleeping sitting on the couch during the middle of the day making it difficult to assist R1 to get by with their wheelchair. LPA did not observe any staff sleeping upon arrival. Investigation revealed S3 is no longer employed at the facility, so LPA was unable to interview S3. Based on interviews, two of four current residents and three of three staff denied the allegation.

Regarding the allegation, Staff threatened to evict resident in care, it is alleged Staff #4 (S4) called R1's representative by phone stating that they had been doing nothing but complaining and would send an eviction notice the same day. Based on the interviews, S4 confirmed not getting along with R1's representative and had advised them that they would be able to look for other facilities. The text message receipts between S4 and R1's representative reveal that on December 9, 2023 at 1:38pm, S4 indicated that they will provide an eviction notice with the accurate terms however R1 moved out before an eviction notice was ever iissued. S4 denied threatening to evict R1, thus denied the allegation.

Therefore, based on interviews and record review, although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore all allegations are deemed UNSUBSTANTIATED.

An exit interview was conducted with Administrator Irvin Mendoza, and a copy of this report was provided at exit.

SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Jessica Cho
LICENSING EVALUATOR SIGNATURE:	DATE: 07/28/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/28/2026

LIC9099 (FAS) - (06/04)

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