306005927-9-23-2026-22-AS-KSGH-DYCQSZ-20260928122618

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306005927
Report Date: 09/23/2026
Date Signed: 09/23/2026 01:50:56 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
09/14/2026 and conducted by Evaluator Jerome Haley

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20260914153555

FACILITY NAME:	ELEONOR'S PLACE 4		FACILITY NUMBER:	306005927
ADMINISTRATOR:	AVENDANO, DARYLL		FACILITY TYPE:	740
ADDRESS:	24431 ZANDRA DRIVE		TELEPHONE:	(949) 547-5377
CITY:	MISSION VIEJO	STATE: CA	ZIP CODE:	92691
CAPACITY:	6	CENSUS: 6	DATE:	09/23/2026
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Mark Cruz		TIME COMPLETED:	02:05 PM

ALLEGATION(S):

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Facility staff is not providing comfortable accommodations

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Jerome Haley made unannounced visit to begin the investigation into the complaint received September 14, 2026. LPA Haley was greeted by staff and explained the reason for the visit upon entry.
Regarding the allegation: Facility staff is not providing comfortable accommodations
During the investigation 4 of 8 interview attempts were successful. 4 individuals were unresponsive and interviews could not be conducted. Of the 4 interviews that were conducted, no corroborating information or evidence was provided. During interviews it was discovered, Resident 2 (R2) speaks mandarin and will shout/yell when trying to communicate. It is unclear what the resident is saying but according to Staff 1 (S1) the resident wants something when they begin shouting. The resident can not talk, so it's how the resident is trying to communicate.
According to S1, Resident 2 (R2) was prescribed a new medication for the shouting.
Since the medication was prescribed it has been increased and a new medication, Quetiapine was prescribed to assist with the shouting.
Continued on LIC9099C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Kevin Saborit-Guasch
LICENSING EVALUATOR NAME: Jerome Haley
LICENSING EVALUATOR SIGNATURE:	DATE: 09/23/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/23/2026

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-20260914153555

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: ELEONOR'S PLACE 4	FACILITY NUMBER: 306005927
	VISIT DATE: 09/23/2026

NARRATIVE

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When Staff 3 (S3) was interviewed about the situation, they explained when they hear R2 shouting at night, they go check on the resident and see if R2 needs to be changed. During an interview with Resident 1 (R1), they confirmed staff are responding to R2, and doing all they can. R1 said, God bless the caregivers. They're doing all they can. R1 explained staff has done different things to address R2's shouting including rubbing the resident and putting R2 in their wheelchair and taking them to the living room area. S1 explained that when staff use the iPad translation and talk to R2 in their native language, R2 will stop the yelling/shouting.

Based on the information gathered 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’s 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 to staff.

SUPERVISORS NAME: Kevin Saborit-Guasch
LICENSING EVALUATOR NAME: Jerome Haley
LICENSING EVALUATOR SIGNATURE:	DATE: 09/23/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/23/2026

LIC9099 (FAS) - (06/04)

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