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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306004668
Report Date: 05/18/2026
Date Signed: 05/18/2026 11:22:58 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
05/13/2026 and conducted by Evaluator Sean Haddad
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20260513153352
FACILITY NAME:PRIMROSE RESIDENTAL CAREFACILITY NUMBER:
306004668
ADMINISTRATOR:LACY FADDOULFACILITY TYPE:
740
ADDRESS:651 PRIMROSE STREET S.TELEPHONE:
(949) 682-5229
CITY:ANAHEIMSTATE: CAZIP CODE:
92804
CAPACITY:6CENSUS: 4DATE:
05/18/2026
UNANNOUNCEDTIME BEGAN:
07:37 AM
MET WITH:Miriam EsquivelTIME COMPLETED:
11:37 AM
ALLEGATION(S):
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Staff yells at residents
INVESTIGATION FINDINGS:
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This unannounced inspection is being conducted by Licensing Program Analyst (LPA) Sean Haddad for the purpose of investigating the above-mentioned complaint allegation. LPA met with Staff #1 (S1) Miriam Esquivel, discussed the purpose of the inspection, and explained the allegation. Administrator (AD) Lacy Faddoul appeared via telephone.

The investigation into the allegation that staff yells at residents revealed the following: During the course of the investigation, LPA inspected the facility, interviewed residents and staff, and obtained and reviewed copies of the resident roster and staff roster.

It was alleged that staff yell at residents. LPA inspected the facility, conducted health and safety checks, and observed no health and safety issues. LPA interviewed the three staff present who denied the allegation. LPA interviewed all four clients and obtained information corroborating that staff yell at residents but that it is a minor issue.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Sean Haddad
LICENSING EVALUATOR SIGNATURE:

DATE: 05/18/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/18/2026
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-20260513153352
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: PRIMROSE RESIDENTAL CARE
FACILITY NUMBER: 306004668
VISIT DATE: 05/18/2026
NARRATIVE
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During the course of the investigation, the Department obtained sufficient evidence to substantiate the allegation mentioned above. The preponderance of evidence standard has been met; therefore, the above allegation is Substantiated. See LIC9099D for cited deficiencies per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted and a copy of this report and appeal rights was discussed with and provided to facility representative.
SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Sean Haddad
LICENSING EVALUATOR SIGNATURE:

DATE: 05/18/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/18/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 22-AS-20260513153352
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: PRIMROSE RESIDENTAL CARE
FACILITY NUMBER: 306004668
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/18/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/01/2026
Section Cited
CCR
87468.1(a)(3)
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87468.1 Personal Rights … (a) … (3) To be free from punishment, humiliation, intimidation, abuse, or other actions of a punitive nature… This requirement was not met as evidenced by:
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Licensee stated they will conduct staff training on personal rights and interacting with residents and submit proof to LPA by POC due date.
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Based on interviews, the licensee did not ensure staff did not yell at residents which residents described as a minor issue, which poses a potential 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.
SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Sean Haddad
LICENSING EVALUATOR SIGNATURE:

DATE: 05/18/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/18/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3