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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306006495
Report Date: 08/21/2026
Date Signed: 08/21/2026 12:43:38 PM

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
08/19/2026 and conducted by Evaluator Jessica Cho
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20260819141836
FACILITY NAME:HILLS OF SANTA TERESA, THEFACILITY NUMBER:
306006495
ADMINISTRATOR:MIRANDA, ROSENDO CARLAFACILITY TYPE:
740
ADDRESS:17698 SANTA TERESA CIRCLETELEPHONE:
(714) 430-7672
CITY:FOUNTAIN VALLEYSTATE: CAZIP CODE:
92708
CAPACITY:6CENSUS: 6DATE:
08/21/2026
UNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Rian De Leon- Caregiver
Kristilyn Opinion- Caregiver		TIME COMPLETED:
12:43 PM
ALLEGATION(S):
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Facility is in financial distress.
INVESTIGATION FINDINGS:
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On August 21, 2026, Licensing Program Analyst (LPA) Jessica Cho made an unannounced visit for the purpose of initiating the complaint investigation into the above allegation. LPA was greeted and granted entry by Caregiver Rian De Leon followed by Caregiver Kristilyn Opinion after stating the reason for the visit. LPA attempted to contact Chief Executive Officer Allen Medina by telephone at 8:30AM and Chief Officer of Operations/Co-Founder Maricel Nepomuceno at 8:31AM; however calls went unanswered, and voice messages were left requesting a call back. LPA observed six residents in care and two staff on duty during today's visit.

During the course of the investigation, LPA conducted a tour of the physical plant, interviewed two staff, five of six residents, and obtained the following documentation for review: Resident Roster, Personnel Report Summary, Face Sheets, Physician's Reports, Admission Agreements, and payroll records.

Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Jessica Cho
LICENSING EVALUATOR SIGNATURE:

DATE: 08/21/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/21/2026
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-20260819141836
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: HILLS OF SANTA TERESA, THE
FACILITY NUMBER: 306006495
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/21/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/22/2026
Section Cited
CCR
87213
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87213 Finances "The licensee shall have a financial plan...that assures sufficient resources to meeting operating costs of residents."

This requirement was not met as evidenced by:
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Licensee to take immediate action in resolving the outstanding financial obligation owed to the landlord, totaling approximately $23,302 as of July 15, 2026 as well as $10,230 for both staff from July 16 to August 15, 2026. The licensee will submit a payment plan also agreed by the landlord or provide proof of lump sum payment owed to landlord and staff to LPA Cho via email by POC due date. Please copy Eboni Bentley on the email.
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Based on interivews and record review, licensee had been unable to cover operating costs related to the delinquency of rental dues, late fees, outstanding judgement balance, damage and repair claims, and staff wages which poses an immediate Health, Safety, and/or Personal Rights risk to persons in care.
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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: Jessica Cho
LICENSING EVALUATOR SIGNATURE:

DATE: 08/21/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/21/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 22-AS-20260819141836
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: HILLS OF SANTA TERESA, THE
FACILITY NUMBER: 306006495
VISIT DATE: 08/21/2026
NARRATIVE
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The investigation is as follows: Regarding the allegation, Facility is in financial distress, it is alleged the licensee owes the landlord $40,000.00 in outstanding rent and other payments related to damages, and drain pipes being unnecessarily removed by a plumber hired by the licensee. Additionally, it has been reported that the staff had not received wages owed to them. LPA toured the physical plant and observed the utilities were operating, indoor temperature was within range, sufficient supply of food was maintained, and the facility land line remains available. LPA observed two meal services approximately 8AM and 12PM and observed residents having cereal with toast, banana, and apple juice for breakfast and rice, burger patty, steamed mixed vegetables, and sliced watermelon for lunch. LPA observed the indoor temperature was at a comfortable range of 74.8 degrees Fahrenheit, and the hot water temperature in the three resident bathrooms measured at 114.2, 115.3, and 112.4 degrees Fahrenheit. LPA observed the presence of mold in the grout and ceiling of the large shower room, shower head needs to be reattached in Bedroom #4, and the toilet water is leaking in Bedroom #4. Based on interviews, five of six residents and two of two staff reported three meals were served daily, no interruptions with electricity and water, and no issues with the residents' care. However, five of six residents and two of two staff confirmed that the staff had not been paid since July 16, 2026. LPA was unable to qualify the statement of one resident due to their medical condition. Based on the review of the lease agreement signed by both licensee and landlord on June 1, 2023, licensee owes $4,525 per month. The summary of amounts claimed by the landlord, documents that the licensee owes $23,302 of which $13,877 is attributed to unpaid rent, late fees from March 2026 to July 15, 2026, and an outstanding judgement balance that is still owed. Text messages between staff and licensee on August 17, 2026 at 12PM and August 20, 2026 at 5:53PM confirms the licensee owing staff. Evidence corroborates financial distress.

Therefore, based on interviews and record review, the preponderance of evidence standard has been met, and the allegation of Facility is in financial distress, is deemed SUBSTANTIATED. A deficiency is being cited on the attached LIC9099-D.

As of this exit interview, Chief Executive Officer Allen Medina and Chief Officer of Operations/Co-Founder Maricel Nepomuceno did not appear and did not return the telephone call despite the attempted contact. An exit interview was conducted with Caregivers Rian De Leon and Kristilyn Opinion, and a copy of this report including the appeal rights were discussed and provided to the facility representatives.
SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Jessica Cho
LICENSING EVALUATOR SIGNATURE:

DATE: 08/21/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/21/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3