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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306002964
Report Date: 05/07/2026
Date Signed: 05/19/2026 02:22:14 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
05/07/2026 and conducted by Evaluator Fred Arias
COMPLAINT CONTROL NUMBER: 22-AS-20260507095259
FACILITY NAME:JOHN VILLA'S HOME CARE IFACILITY NUMBER:
306002964
ADMINISTRATOR:VILLA D. DIAZFACILITY TYPE:
740
ADDRESS:219 HANOVERTELEPHONE:
(714) 435-9257
CITY:COSTA MESASTATE: CAZIP CODE:
92626
CAPACITY:6CENSUS: 6DATE:
05/07/2026
UNANNOUNCEDTIME BEGAN:
09:50 AM
MET WITH:Villa DiazTIME COMPLETED:
04:02 PM
ALLEGATION(S):
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9
Staff did not allow resident to meet privately with a visitor
INVESTIGATION FINDINGS:
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12
13
Licensing Program Analyst (LPA) Fred Arias conducted an unannounced complaint visit to finalize an investigation into the above allegation. LPA was greeted and granted entry into the facility and explained the reason for the visit.

It was alleged staff did not allow resident to meet privately with a visitor. During the investigation, LPA conducted interviews with residents in care and staff. LPA reviewed records obtained.

The investigation determined as follows: Regarding the allegation staff did not allow resident to meet privately with a visitor, it was reported Staff 1 (S1) repeatedly disrupted a visit between Resident 1 (R1) and their visitor on April 26, 2026. LPA interview with R1 stated they recall the incident and does not believe S1 was intentionally disrupting the visit. R1 added S1 entered the room to inform R1 they had a caller on the phone and wanted to speak with them. R1 stated they did not want to speak to the caller during that moment and S1 exited the room. R1 stated staff respects their privacy during visits.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Fred Arias
LICENSING EVALUATOR SIGNATURE:

DATE: 05/07/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/07/2026
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 4
Control Number 22-AS-20260507095259
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: JOHN VILLA'S HOME CARE I
FACILITY NUMBER: 306002964
VISIT DATE: 05/07/2026
NARRATIVE
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 Interviews with four out of the remaining five residents stated their privacy is respected during visits and staff do not interfere with those visits. The remaining resident could not be interviewed. Interviews with three out of four staff stated when residents receive visitors, the door to the resident room is closed to provide privacy to the resident and their visitor. Two of those three staff stated if they need to enter the room during the visit, they will knock first to gain permission to enter. The remaining staff stated during the incident when R1 had a visitor on April 26, 2026, S1 knocked on the door before entering R1's room. Record review revealed R1 is cognitive based on their medical assessment.

Based on interviews and record review, the allegation of staff did not allow resident to meet privately with a visitor is therefore deemed unsubstantiated meaning that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violations occurred.

An exit interview was conducted and a copy of the report was left with the facility representative.
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Fred Arias
LICENSING EVALUATOR SIGNATURE:

DATE: 05/07/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/07/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 4
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
05/07/2026 and conducted by Evaluator Fred Arias
COMPLAINT CONTROL NUMBER: 22-AS-20260507095259

FACILITY NAME:JOHN VILLA'S HOME CARE IFACILITY NUMBER:
306002964
ADMINISTRATOR:VILLA D. DIAZFACILITY TYPE:
740
ADDRESS:219 HANOVERTELEPHONE:
(714) 435-9257
CITY:COSTA MESASTATE: CAZIP CODE:
92626
CAPACITY:6CENSUS: 6DATE:
05/07/2026
UNANNOUNCEDTIME BEGAN:
09:50 AM
MET WITH:Villa DiazTIME COMPLETED:
04:02 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff is financially abusing resident
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Fred Arias conducted an unannounced complaint visit to finalize an investigation into the above allegation. LPA was greeted and granted entry into the facility and explained the reason for the visit.

It was alleged staff is financially abusing resident. During the investigation, LPA conducted interviews with residents in care and staff.

The investigation determined as follows: Regarding the allegation staff is financially abusing resident, it was reported staff is inquiring about Resident 1 (R1)'s finances. Interviews with five out of six residents stated staff has never inquired about their finances. The five residents added staff has not asked for money or loans and do not have access to their financial records. The remaining resident could not be interviewed. Interviews with four out of four staff stated they have not inquired about resident finances and have never asked for money from residents nor do they have access to resident bank accounts.
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Fred Arias
LICENSING EVALUATOR SIGNATURE:

DATE: 05/07/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/07/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 22-AS-20260507095259
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: JOHN VILLA'S HOME CARE I
FACILITY NUMBER: 306002964
VISIT DATE: 05/07/2026
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
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Based on interviews, LPA is unable to corroborate the allegation. Therefore, the allegation is deemed to be UNFOUNDED, meaning that the allegation was false, could not have happened and/or is without a reasonable basis.

An exit interview was conducted and a copy of the report was left with the facility representative.
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Fred Arias
LICENSING EVALUATOR SIGNATURE:

DATE: 05/07/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/07/2026
LIC9099 (FAS) - (06/04)
Page: 4 of 4