306005691-9-30-2026-22-AS-KSGH-DYNQXL-20261008123340

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306005691
Report Date: 09/30/2026
Date Signed: 09/30/2026 12:02:42 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
06/10/2026 and conducted by Evaluator Jerome Haley

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20260610153653

FACILITY NAME:	SILVERADO SENIOR LIVING-SAN JUAN CAPISTRANO		FACILITY NUMBER:	306005691
ADMINISTRATOR:	SHEILA FIKE		FACILITY TYPE:	740
ADDRESS:	30311 CAMINO CAPISTRANO		TELEPHONE:	(949) 240-0550
CITY:	SAN JUAN CAPISTRANO	STATE: CA	ZIP CODE:	92675
CAPACITY:	96	CENSUS: 80	DATE:	09/30/2026
		UNANNOUNCED	TIME BEGAN:	11:25 AM
MET WITH:	Casey Lambert		TIME COMPLETED:	12:10 PM

ALLEGATION(S):

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Neglect/lack of care and supervision resulting in sexual abuse

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Jerome Haley made an unannounced visit to the facility to deliver findings on the compliant allegation listed above. LPA was greeted and granted entry by staff after an introduction and explaining the reason for the visit.

The complaint investigation was initiated by LPA Jerome Haley on June 11, 2026, regarding a complaint allegation filed on June 10, 2026. The complaint was investigated by the Department and consisted of the following: a tour of the physical plant, record review, and interviews with facility staff, residents, and a family member of a resident.

During the investigation 4 of 4 individuals could not provide any corroborating information or evidence to support the complaint allegation. The investigation revealed an individual observed Resident 1
Continued on LIC9099C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Kevin Saborit-Guasch
LICENSING EVALUATOR NAME: Jerome Haley
LICENSING EVALUATOR SIGNATURE:	DATE: 09/30/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/30/2026

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-20260610153653

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: SILVERADO SENIOR LIVING-SAN JUAN CAPISTRANO	FACILITY NUMBER: 306005691
	VISIT DATE: 09/30/2026

NARRATIVE

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(R1) sitting on a bench in a common area near the wellness room and Resident 2 (R2) was observed sitting in front of R1.

R1’s shirt was lifted and R2’s hand was on R1’s chest. The residents were immediately redirected away from each other and a responsible party for both residents was contacted. The Orange County Sheriff, and the Ombudsman were contacted as well.

A family member of R1 confirmed they received a phone call on June 7, 2026, notifying them of the incident. The family member was initially upset about the situation; however, after processing the events, the family member does not blame the facility for what took place.

R1 and R2 have a diagnosis of dementia and are housed in the dementia unit. R1 is nonverbal and could not answer any questions regarding the incident that took place on June 7, 2026. R2 initially denied the incident, before saying the incident could have happened, but the resident could not recall the incident. R2 denied touching anyone without permission. According to S1, R2 has not received any complaints of a sexual nature in the past and does not have a history of sexually acting out.

Based on the information gathered during the investigation through interviews and document review, the Department is unable to ascertain if the allegation occurred as reported. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove or refute the alleged violation occurred; therefore, the allegation is deemed Unsubstantiated.

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

SUPERVISORS NAME: Kevin Saborit-Guasch
LICENSING EVALUATOR NAME: Jerome Haley
LICENSING EVALUATOR SIGNATURE:	DATE: 09/30/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/30/2026

LIC9099 (FAS) - (06/04)

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