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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306006424
Report Date: 07/10/2026
Date Signed: 07/10/2026 11:10:31 AM

Substantiated


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
06/30/2026 and conducted by Evaluator Michael Tea
COMPLAINT CONTROL NUMBER: 22-AS-20260630083352
FACILITY NAME:CHAPMAN ROSE, INCFACILITY NUMBER:
306006424
ADMINISTRATOR:DANG, ROSIEFACILITY TYPE:
740
ADDRESS:10461 CHAPMAN AVENUETELEPHONE:
(714) 595-9880
CITY:GARDEN GROVESTATE: CAZIP CODE:
92840
CAPACITY:6CENSUS: 5DATE:
07/10/2026
UNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Rosie DangTIME COMPLETED:
11:25 AM
ALLEGATION(S):
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- Facility failed to provide a refund preadmission fee to applicant
INVESTIGATION FINDINGS:
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On this day, Licensing Program Analyst (LPA) Michael Tea conducted an unannounced complaint investigation visit. LPA Tea was greeted and granted entry by facility staff and explained the purpose of the visit. Administrator (AD) Rosie Dang arrived shortly to assist with the visit.

The Department received the complaint on June 30, 2026. LPA Tea conducted the initial 10-day complaint visit on July 10, 2026. During the investigation, LPA Tea interviewed facility staff and other pertinent witnesses and reviewed and obtained relevant documents and information.

LPA Tea interviewed Administrator (AD) Rosie Dang, who confirmed the facility received a $500 preadmission deposit to reserve a room for a prospective resident. AD Dang stated the prospective resident later decided not to move into the facility after the room had been prepared. AD Dang confirmed the family requested
(Complaint report continued on LIC9099C)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Michael Tea
LICENSING EVALUATOR SIGNATURE:

DATE: 07/10/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2026
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-20260630083352
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: CHAPMAN ROSE, INC
FACILITY NUMBER: 306006424
VISIT DATE: 07/10/2026
NARRATIVE
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 a refund; however, she did not return the deposit because she continued to hold the room for the prospective resident. AD Dang also confirmed there was no written agreement identifying the deposit as non-refundable and that no Admission Agreement had been signed prior to admission.

LPA reviewed the facility's Admission Agreement, which states that a 100 percent refund of a preadmission fee shall be provided if the resident decides not to enter the facility and a preadmission appraisal has not been completed. The investigation determined that the prospective resident was never admitted to the facility and that no preadmission appraisal had been completed prior to the request for a refund.

Based on interviews and records reviewed, the facility failed to refund the $500 preadmission fee in accordance with its Admission Agreement after the prospective resident decided not to enter the facility and no preadmission appraisal had been completed. Therefore, the allegation is SUBSTANTIATED, meaning the complaint allegation is valid and that a violation has occurred.

The following deficiency is being cited pursuant to the California Health and Safety Code.

An exit interview was conducted with Administrator (AD) Rosie Dang, and a copy of this report and appeal rights was provided to the facility.
SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Michael Tea
LICENSING EVALUATOR SIGNATURE:

DATE: 07/10/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 22-AS-20260630083352
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: CHAPMAN ROSE, INC
FACILITY NUMBER: 306006424
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/10/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/31/2026
Section Cited
HSC
1569.651(g)
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Preadmission fee or deposit for elderly at residential care facilities ... If the applicant decides not to enter the facility prior to the facility’s completion of a preadmission appraisal or if the facility fails to provide full written disclosure of the preadmission fee charges and refund conditions, the applicant or the applicant’s representative shall be entitled to a refund of 100 percent of the preadmission fee. This requirement is not met as evidenced by:
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Licensee shall refund the $500 preadmission fee to the applicant or the applicant's representative and submit proof of the refund to LPA by POC due date. Licensee shall submit a signed statement of understanding acknowledging the requirements of Health and Safety Code § 1569.651 and ensure future preadmission fees and refunds are handled in accordance with applicable law.
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The facility accepted a $500 preadmission fee and failed to provide the required refund after the prospective resident declined admission before a preadmission appraisal was completed, despite the requirements of the facility's Admission Agreement and applicable regulation. This poses a potential personal rights risk to prospective residents and their representatives.
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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: Lourdes Montoya
LICENSING EVALUATOR NAME: Michael Tea
LICENSING EVALUATOR SIGNATURE:

DATE: 07/10/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3