306005494-9-3-2026-22-AS-KSGH-DY9QHU-20260925121142

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306005494
Report Date: 09/03/2026
Date Signed: 09/03/2026 03:50:18 PM

Unfounded

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
03/20/2023 and conducted by Evaluator Jerome Haley

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20230320144037

FACILITY NAME:	SILVER LINING MANOR		FACILITY NUMBER:	306005494
ADMINISTRATOR:	FADDOUL, LACY		FACILITY TYPE:	740
ADDRESS:	425 ARCHER ST		TELEPHONE:	(949) 682-5229
CITY:	ANAHEIM	STATE: CA	ZIP CODE:	92804
CAPACITY:	0	CENSUS: 0	DATE:	09/03/2026
		UNANNOUNCED	TIME BEGAN:	12:00 PM
MET WITH:	Miriam Esquivel Lacy Faddoul via telephone		TIME COMPLETED:	04:05 PM

ALLEGATION(S):

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Licensee has resident's power of attorney.
Resident was admitted to the facility without an admission agreement.
Staff are unqualified to meet residents needs.
Staff is denying residents' access to make and receive confidential calls.

INVESTIGATION FINDINGS:

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Regarding the allegation: Licensee has resident's power of attorney.
S1 denied the complaint allegation. According to S1, all the clients at Silver Lining Manor were Regional Center clients and the Regional Center was the Responsible Party for them. During document review there were no Power of Attorney (POA) documents for 4 of 5 residents. One resident did have a POA for Health Care. S1 also denied being the POA for R1 and explained R1 was never a resident at Silver Lining Manor. During record review for R1 there were no POA documents observed. S1 is listed as the responsible party for R1. S1 explained the Public Guardian released R1’s case and the residnent has no family.

Regarding the allegation: Resident was admitted to the facility without an admission agreement
During the investigation 5 of 5 resident records reviewed revealed an admission agreement. Furthermore, although R1 was not a resident at Silver Lining Manor, document review of R1’s file revealed a completed admission agreement. LPA received copies of R1’s completed admission agreement during the visit.
Continued on LIC9099C

Unfounded

Estimated Days of Completion:

SUPERVISORS NAME: Kevin Saborit-Guasch
LICENSING EVALUATOR NAME: Jerome Haley
LICENSING EVALUATOR SIGNATURE:	DATE: 09/03/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2026

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 22-AS-20230320144037

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: SILVER LINING MANOR	FACILITY NUMBER: 306005494
	VISIT DATE: 09/03/2026

NARRATIVE

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Regarding the allegation: Staff are unqualified to meet residents needs.
During the investigation 4 of 4 staff record reviews revealed current training records. According to S1, staff receive 20 hours of initial hands on training, and they complete 16 hours of continuing education training a year through an online Assistant Living training program they use. Training records were observed in the files including current CPR training. Copies of training records were provided for S2 and S3.

Regarding the allegation: Staff is denying residents' access to make and receive confidential calls.
8 of 10 individuals denied the complaint allegation and/or could not provide any corroborating information or evidence to support the complaint allegation. 2 individuals were unresponsive during attempted interviews. According to Resident 3 (R3), they had their own personal cell phone and did not need to use the facility phone. S3 denied anyone listens to their phone calls. Resident 5 (5) confirmed they can make personal calls on the facility phone and Resident 4 (4) says they just tell the staff when they need to use the phone. S1, S2, and S3 all denied the allegation and confirmed the phone is available to all the residents.

Based on the information gathered through interviews, and document review, the following allegations: Licensee has resident's power of attorney, Resident was admitted to the facility without an admission agreement, Staff are unqualified to meet residents needs, and Staff is denying residents' access to make and receive confidential calls, are deemed unfounded, meaning the allegations are false, could not have happened and/or is without a reasonable basis.

An exit interview was conducted, and a copy of this report was provided to staff.

SUPERVISORS NAME: Kevin Saborit-Guasch
LICENSING EVALUATOR NAME: Jerome Haley
LICENSING EVALUATOR SIGNATURE:	DATE: 09/03/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2026

LIC9099 (FAS) - (06/04)

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