Cross Creek Care

Allegation investigated: - Staff physically abused client - Staff emotionally abused client - Staff sexually abused client

On this day, Licensing Program Analyst (LPA) Michael Tea made an unannounced visit to conclude and deliver findings for a complaint investigation. LPA Tea was greeted and granted entry by Administrator (AD) Disney Reed and Administrator Assistant (AA) Franco Puzon and explained the reason for the visit. The Department received a complaint on January 28, 2026. LPA Tea spoke to residents, facility staff, and other witnesses and reviewed and collected pertinent documents and information. Licensing Program Analyst (LPA) conducted an investigation regarding allegations that staff physically abused, emotionally abused, and sexually abused Resident 1 (R1). During the investigation, LPA spoke to a witness who recalled R1 was unable to provide details regarding the allegations and responded, “I don’t know.” They also mention that R1 was compliant with medication, R1 presents as calm, but has a history of psychiatric instability, including prior 51/50 psychiatric holds. (Complaint report continued on LIC9099C) Unsubstantiated LPA interviewed eight out of eight staff members. All staff denied physically, emotionally, or sexually abusing R1 or any other residents. Staff also reported they have never witnessed any other staff engaged in abusive behavior. Staff consistently described R1 as displaying paranoid and aggressive behaviors, including accusing staff of stealing personal belongings. Staff reported that to prevent misunderstandings, they allow R1 to be present while cleaning the room. Staff further stated they attempt to accommodate R1 despite frequent demands and accusations. Several staff indicated that R1 may require a higher level of care, such as a facility equipped to manage psychiatric needs. Staff also reported that R1 has refused prescribed medications, which impacts R1’s mood and behavior. LPA interviewed two out of two residents who were able to participate in interviews. Both residents stated they have never witnessed staff physically, emotionally, or sexually abuse R1 or any other residents. They reported that staff treat residents well and provide appropriate care. Both residents also described R1 as having demanding and aggressive behaviors. LPA interviewed multiple witnesses who frequently visit the facility. One witness reported never observing any abuse and described staff as patient and caring. The witness stated they are familiar with mandated reporting requirements and would report any concerns if observed. Another witness reported that R1 appeared mentally unstable and agitated during visits, including an incident where R1 threw an object at staff. This witness stated staff appeared understanding and supportive toward R1 and reported that R1 never disclosed any sexual abuse. The witness stated that based on their observations, the allegation of sexual abuse did not appear likely. Another witness reported that R1 mentioned having consensual sexual contact with a staff member but also acknowledged that R1 was not mentally stable at the time. LPA interviewed four male staff regarding this claim, and all denied any sexual contact with R1. The Administrator (AD) Jarren Manalo stated that staff are not permitted to be alone with R1 and that any inappropriate conduct would result in immediate termination. Documentation was provided showing that R1 sent unsolicited text messages to a staff member, which made the staff uncomfortable. The staff member confirmed this and reported they blocked R1 to maintain professional boundaries. LPA reviewed R1’s records. Documentation indicates that R1 has a diagnosis of schizoaffective disorder. The (Complaint report continued on LIC9099C) most recent medical assessment, dated December 22, 2025, notes symptoms including mood instability, delusional thinking, paranoia, memory impairment, and disorganized behavior. The assessment also documents behaviors such as aggression toward caregivers, yelling, throwing objects, emotional distress, and impulsive actions. Incident reports from October 2025 through January 2026 show a pattern of aggressive behavior and elopement. Records also indicate that R1 has refused prescribed medications, including Lithium and Seroquel, which may affect mental stability. R1’s care plan reflects challenges with emotional regulation, social interactions, and maintaining relationships, and shows that the facility has been monitoring and attempting to support R1’s needs. Based on interviews conducted and records reviewed, there is insufficient evidence to support the allegations that staff physically, emotionally, or sexually abused R1. Information obtained from staff, residents, and witnesses consistently indicates no observed abuse. Additionally, R1 was unable to provide details, and records reviewed indicate significant mental health concerns that may impact R1’s statements. Therefore the allegations mentioned above have been determined unsubstantiated meaning that although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violations occurred. No deficiencies cited at this time and an exit interview was conducted with the facility. A copy of the report was to provided to the facility.the state’s words, verbatim · CDSS document, Apr 21, 2026 · control 22-AS-20260128141526

Type of visit: Required - 1 Year

On this day Licensing Program Analysts (LPAs) Fred Arias and Nancy Guillen made an unannounced visit to conduct a required annual visit. LPAs were greeted and granted entry into the facility by staff and explained the reason for the visit. Facility is licensed for 14 residents of which 11 may be non-ambulatory and bedridden. Facility has an approved hospice waiver for 6 residents and the home currently has 12 residents. Assistant Administrator (AAD) Franco Puzon assisted with facility tour. AAD provided updated liability insurance that expires on 7/13/2026. LPAs along with AAD toured the facility at 9AM. LPAs toured the physical plant, checked food service, and facility documentation. The facility is a two story building and consists of 8 resident bedrooms, living room, dining room, 3 staff rooms, staff kitchen, and resident kitchen as well as 3 resident bathrooms. At 9:05AM, LPAs observed a small refrigerator with resident medications that is unlocked and accessible to residents. At 9:07AM LPAs observed one of the exit doors in resident room 8 locked, preventing the resident from leaving through that door. At 9:17AM, LPAs observed a padlock placed on the exit door for room 1, preventing residents from leaving through that door. At 9:45AM, LPAs observed a resident bed in room 6 that was partially blocking access to the exit door, making it inaccessible to residents. Resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. Resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure and shower was free of mold/mildew. Water temperature measured between 107.6 degrees F and 119.1 degrees F in all bathrooms. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked. Common areas were clean and clear of hazards. LPAs toured the kitchen and observed sharps locked in a cabinet during today's visit. Perishable and non-perishable food supply was checked and adequately stocked at time of visit. Kitchen appliances were operational during today's visit. Smoke detectors tested operational during today's visit. Fire extinguishers were fully charged. LPAs reviewed the infection control and emergency disaster plans and plans are complete and thorough. Facility conducts quarterly emergency drills with the last drill conducted on 1/9/2026. Outside grounds were toured. Walkways around the facility were clear of hazards. There is shaded outdoor seating for residents. Exit gate is unlocked and operational. LPAs observed the emergency food and water supply. First aid kit contained all required items including tweezers, scissors and thermometer. Facility conducts activities in the form of exercise and games. LPAs reviewed five resident files and five staff files. All resident files contained required documentation including admission agreements, physician reports, and resident appraisals. Four out of five staff files reviewed contained required documentation including required annual training, medical assessment/ TB, criminal record clearance and proof of CPR training. One staff file did not include evidence of initial 40 hours of required training upon hire. LPAs reviewed medication storage and administration. Medications are stored in a locked cabinet. Medications are being administered per physician order. Based on the observations made during today’s visit, deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. This report was discussed with the facility representative and a copy was provided along with appeal rights.the state’s words, verbatim · CDSS document, Apr 7, 2026

Type of visit: Case Management - Incident

Licensing Program Analyst (LPA) Fred Arias made an unannounced visit to the facility to conduct a case management visit. LPA was greeted and granted entry into the facility by staff after explaining the purpose for the visit. Assistant Administrator (AA) Franco Puzon was present and assisted on today's visit. LPA is following up on a self reported incident report that was received by the Orange County Regional Office on January 5, 2025, regarding an elopement by Resident 1 (R1). The incident reported R1 left the facility at 11:10pm on January 4, 2025. Staff called R1 on their phone and R1 stated they had fallen and a passerby called 911 to take R1 to the hospital. R1 was treated at the hospital for intoxication. R1 returned to the facility at 1:07am on January 5, 2025. LPA, accompanied by AA, conducted a tour of the physical plant. LPA observed the facility to be clear of any obstructions and hazards. No health or safety concerns were observed. LPA conducted one staff interview. LPA additionally reviewed and obtained resident records. R1's physician report dated September 3, 2025 indicates R1 cannot leave the facility unassisted. Interview conducted confirmed the incident report that was received by the Orange County Regional Office was accurate. Based on LPA's review of records, observations and interview, the facility failed to supervise resident in which the resident left the facility unassisted. A deficiency and immediate $500 civil penalty are being given per California Code of Regulations 87464(f)(1). An exit interview was conducted with the facility and a copy of this report, along with the LIC809D, LIC421IM, and appeals right was provided at exit.the state’s words, verbatim · CDSS document, Jan 16, 2026

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87464(f)(1) · Plan of correction due date: Jan 17, 2026

Basic Services 87464(f)(1) Basic services shall at a minimum include: Care and supervision as defined in Section 87101(c)(3) and Health and Safety Code section 1569.2(c). This requirement was not met as evidence by: Based on LPA's review of records Resident 1 (R1) is unable to leave the facility unassisted and eloped from the facility which led the resident to be hospitalized. This poses an immediate health and safety risk to persons in care.the state’s words, verbatim · CDSS document, Jan 16, 2026

Plan of correction: AA stated R1 will be informed anytime R1 wants to leave the facility, they will be supervised by a staff member. In-service training will be conducted with all staff. AA to provide proof to LPA by POC due date.

Allegation investigated: Staff do not provide proper medication assistance to resident in care Staff do not treat resident with respect Staff is sleeping with resident in care

On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility for the purpose of following up on the investigation of the three allegations listed above, LPA was greeted and granted entry by facility caregiving staff after introducing himself and stating the purpose of the visit. Assistant administrator Baylon Rhadzivil was present on the premises and assisted with the visit. Findings for complaint 22-AS-20230424163715 under closed license #306000888 were also delivered during the visit. The initial investigation visit was conducted by licensing staff on May 4, 2023. During the visit, LPA reviewed and obtained copies of facility and resident records. For this visit, LPA conducted interviews with staff, and reviewed and requested copies of the pertinent records. Additional interviews conducted during a separate visit. Follow-up investigation conducted on October 25, 2023. LPA requested and obtained the facility's census and current roster as well as staff schedules for the months of October and November 2023. CONTINUED ON FORM LIC9099-C Unsubstantiated CONTINUED FROM FORM LIC9099 Administrator demonstrated the newly operational Medication Administration Records on a tablet and provided the records generated in the previous paper system for the period of January 2023 until October 2023. During the present visit, LPA conducted or attempted a total of four resident interviews in addition to eight staff interviews. Facility resident census and staff roster were requested and obtained. LPA also requested and reviewed records maintained at the facility for five residents, one of which is no longer admitted. Regarding the allegation that Staff do not provide proper medication assistance to resident in care, the following has been concluded: A majority of statements gathered from residents interviewed demonstrated satisfaction with the assistance provided with the self-administration of medication. None of the residents interviewed stated they had not been provided their medication as prescribed during their admission at the facility. Staff interviews also confirmed the organisation of the medication services and corroborated their ability to provide medication adequately. Regarding the allegation that Staff do not treat resident with respect, the following has been concluded: Based on interviews conducted with a total of five residents along with multiple staff members, it was determined that a majority of statements gathered did not report any occurrence of inappropriate verbal comments from staff towards residents. No staff members interviewed stated they had ever witnessed inappropriate comments from their co-workers. Regarding the allegation that Staff is sleeping with resident in care, the following has been concluded: Based on interviews conducted with a total of five residents along with multiple staff members, it was determined that a majority of statements gathered did not report any inappropriate relationships or contacts from staff members with fellow residents. No staff members interviewed stated they had ever witnessed, heard of or gained knowledge of any inappropriate relationships or contacts from staff members with fellow residents. Based on the evidence gathered, the allegations listed above are found to be Unsubstantiated, meaning that although the allegations may have happened or are valid, there is not a preponderance of evidence to prove that the alleged violations occurred. No deficiencies cited. An exit interview was conducted and a copy of this report was provided to a facility representative. This report was amended to correct the allegations investigated.the state’s words, verbatim · CDSS document, Nov 20, 2025 · control 22-AS-20230502161524

Allegation investigated: Staff caused injuries to resident Staff failed to treat residents with dignity and respect

Licensing Program Analyst (LPA) Fred Arias conducted an unannounced complaint visit to finalize an investigation into the above allegations. LPA was greeted and granted entry into the facility and explained the reason for the visit. An initial investigation visit was conducted on September 23, 2023 by LPA Andrea Mendevil. During the course of the initial visit, LPA Mendivil interviewed staff and residents and obtained pertinent documents. It was alleged staff caused injuries to resident and staff failed to treat residents with dignity and respect. During the investigation, LPA conducted interviews with residents in care and staff. LPA reviewed resident records and staff records. The investigation determined as follows: regarding the allegation staff caused injuries to resident, seven residents and five staff were interviewed. Seven out of seven residents stated they are treated well by the caregivers and have never been physically abused in any way. Continued on LIC9099-C dated 07/03/2025 Unsubstantiated Three out of seven residents added they have never witnessed any resident being physically abused by care staff. Five out of five staff interviewed stated they have never hit a resident. Two out of five staff added they have never witnessed other staff hit residents. Five out of five staff members stated they have received mandated reporting training. LPA reviewed staff records for nine staff members. The staff records included mandated reporting acknowledgments for each staff member. Regarding the allegation staff failed to treat residents with dignity and respect, LPA interviewed seven residents and five staff. Seven out of seven residents stated they have never been yelled at. Five out of five staff interviewed stated they have never yelled at residents. Therefore, based on resident interviews, staff interviews, records observed, and LPA observations, the allegations of staff caused injuries to a resident and allegation staff failed to treat residents with dignity and respect are therefore deemed unsubstantiated meaning that although the allegations may have happened or are 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.the state’s words, verbatim · CDSS document, Jul 3, 2025 · control 22-AS-20230802100821

Type of visit: Required - 1 Year

On this day Licensing Program Analyst (LPA) Fred Arias made an unannounced visit to conduct a required annual visit. LPA was greeted and granted entry into the facility by staff and explained the reason for the visit. Facility is licensed for 14 ambulatory residents of which 11 may be non-ambulatory and bedridden. Facility has an approved hospice waiver for 6 residents and the home currently has 12 residents. Administrator (AD) Jarren Manalo and Assistant Administrator Rhadzivil Bayon conducted facility tour. AD Manalo has a valid certificate that expires on 4/19/2025. LPA along with Administrators toured the facility at 2:10 PM. LPA toured the physical plant, checked food service, facility documentation and the first aid kit. The facility consists of 8 resident bedrooms, living room, dining room, 2 staff rooms, staff kitchen, and resident kitchen as well as 3 resident bathrooms. Resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. Resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure and shower was free of mold/mildew. Water temperature measured between 107.7 degrees F and 113.9 degrees F in all bathrooms. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked. Common areas were clean and clear of hazards. At 2:15pm, LPA observed 2 laundry detergent containers accessible in the second floor balcony through an unlocked door. LPA toured the kitchen and observed sharps locked in a cabinet during today's visit. Perishable and non-perishable food supply was checked and adequately stocked at time of visit. Kitchen appliances were operational during today's visit. Smoke detectors tested operational during today's visit. Fire extinguishers were fully charged. Fire sprinkler system was serviced April 2024. LPA reviewed the emergency disaster plans and plan is complete and thorough. Facility conducts quarterly emergency drills with the last drill conducted on 1/17/2025. Outside grounds were toured. There are no observed security bars or weapons on the premises. First aid kit contained all required items including tweezers, scissors and thermometer. Facility conducts activities in the form of exercise, games, and music therapy. There is shaded outdoor seating for residents. LPAs observed the emergency food and water supply. LPA reviewed five resident files and three staff files. Continued on LIC809C dated 3/14/2025 All resident files contained required documentation including admission agreements, physician reports, resident appraisals, and physician orders for bed rails as indicated. Staff files reviewed contained required documentation including required annual training, medical assessment/ TB, criminal record clearance and proof of CPR training. LPA reviewed medication storage and administration. Medications are stored in a locked cabinet in the first floor and extra medication is locked in a secondary cabinet upstairs. Based on the observations made during today’s visit, the following deficiency is being cited per Title 22 Division 6 of the California Code of Regulations. This report was discussed with the facility representative and a copy was provided along with appeal rights.the state’s words, verbatim · CDSS document, Mar 14, 2025

The state marks this report as 5 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.

Type of visit: POC

Licensing Program Analyst (LPA) Rose Ruppert conducted an unannounced case management visit to follow up on a Plan of Correction (POC) due on May 22, 2024. LPA was greeted and granted entry into the facility by Assistant Administrator (AAD), Rhadzivil Baylon, and explained the reason for the visit. The purpose of our visit is follow-up on a Type B Deficiency that was cited on an annual required visit on May 15, 2024. One of three resident bathrooms has a sink that does not allow residents to change the water temperature. Licensee is currently negotiating contracts with two different contractors for all three bathrooms in the facility. LPA requested proof or documentation that the bathroom sink will be fixed and contractors are being contacted. Administrator (AD) Jarren Manalo stated that they had not chosen a contractor as of their POC date and that most of the conversations are through text messaging directly with owners. LPA requested screenshots with time stamps of contractor texts. AD has provided text conversations regarding the renovations. AD will continue to update LPA with facility renovations once a contractor is chosen and the work is done. An exit interview was conducted with AD Manalo and AAD Baylon and a copy of this report was provided at exit.the state’s words, verbatim · CDSS document, May 29, 2024

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Rose Ruppert made an unannounced visit to the facility today to conduct an Annual Required Evaluation. LPA was greeted and granted entry by Suani Manuhut, Resident Care Coordinator. During today’s visit, LPA met with Jarren Manalo, Administrator and Rhadzivil Baylon, Assistant Administrator. The facility is a two story building with an approved fire clearance of fourteen ambulatory; eleven non-ambulatory residents of which eleven may be bedridden. The facility currently has a census of ten residents in care. During today’s visit, LPA toured the facility and inspected the physical plant, including but not limited to testing all smoke detectors, testing hot water temperature in three resident bathrooms, and testing auditory devices on all exits. The hot water temperature measured between 112.5 and 118.2 degrees Fahrenheit and smoke detectors were operational. The facility’s last fire drill was conducted on April 1, 2024. LPA inspected the facility food supply and observed the facility retained a minimum of two days perishable and seven days non-perishable food on hand. LPA observed medication storage and reviewed the centrally stored medications. Per review completion medications appear to be being given as prescribed. LPA reviewed six of twelve staff training and fingerprint records. LPA reviewed seven of ten resident records. LPA interviewed five alert residents regarding their quality of care and spoke to staff present regarding care provided. LPA confirmed that administrator has a current administrator certificate which expires on April 19, 2025. The following deficiency is being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted with Jarren Manalo and a copy of this report was given to the facility along with a copy of the LIC 858; 859;809-D and Appeal Rights.the state’s words, verbatim · CDSS document, May 15, 2024