300603257-6-5-2025-22-AS-LMUZ-DHLRQS-20250613131358

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 300603257
Report Date: 06/05/2025
Date Signed: 06/05/2025 10:36:38 AM

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
03/26/2024 and conducted by Evaluator Cassandra Mikkelson

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20240326103120

FACILITY NAME:	REGENTS POINT		FACILITY NUMBER:	300603257
ADMINISTRATOR:	FORNEY, MELINDA M		FACILITY TYPE:	741
ADDRESS:	19191 HARVARD AVENUE		TELEPHONE:	(949) 854-9500
CITY:	IRVINE	STATE: CA	ZIP CODE:	92612
CAPACITY:	399	CENSUS:	DATE:	06/05/2025
		UNANNOUNCED	TIME BEGAN:	10:15 AM
MET WITH:	Melinda Forney		TIME COMPLETED:	10:45 AM

ALLEGATION(S):

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Resident sustained multiple falls due to lack of care and supervision
Facility failed to obtain timely medical attention for residents exhibiting medical distress
Facility double billed residents
Staff are discouraging other staff to report incidents involving residents in care.

INVESTIGATION FINDINGS:

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On 06/05/2025, Licensing Program Analyst (LPA) Cassandra Mikkelson contacted the licensee via phone and email to deliver final findings regarding a complaint that was received on 03/26/2024.

**Report continued on 9099-D page**

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Laura Munoz	TELEPHONE: (916) 709-6317
LICENSING EVALUATOR NAME: Cassandra Mikkelson	TELEPHONE: (916) 709-6830
LICENSING EVALUATOR SIGNATURE:	DATE: 06/05/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2025

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 22-AS-20240326103120

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: REGENTS POINT	FACILITY NUMBER: 300603257
	VISIT DATE: 06/05/2025

NARRATIVE

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Resident sustained multiple falls due to lack of care and supervision

Records reviewed indicated that facility staff had documentation of daily charting for residents in care including any incidents that occurred. Interviews conducted indicated that the facility had appropriate staffing to meet the care needs of the residents in care. The facility completed the appropriate assessments for residents in care and documented all care plan meeting with resident families or power of attorneys. The allegation that resident sustained multiple falls due to lack of care and supervision is unsubstantiated.

Facility failed to obtain timely medical attention for residents exhibiting medical distress

Records reviewed indicated that staff conducted status checks and observations for residents in care. Staff adequately provided timely medical care and initiated emergency services in a timely manner. Interviews conducted indicated that staff obtained timely medical attention for residents in care. Records reviewed and interviews conducted support that staff obtained timely medical attention for residents, therefore the allegation is unsubstantiated.

Facility double billed residents

Interviews conducted indicated that resident’s responsible party were content with the care that was being received at the facility. The resident’s responsible party did not mention that the facility had double billed for services provided. Interviews with facility management indicated that there was no discrepancy in billing or payments. The allegation facility double billed resident is unsubstantiated.

**Report continued on 9099-D2 page**

SUPERVISOR'S NAME: Laura Munoz	TELEPHONE: (916) 709-6317
LICENSING EVALUATOR NAME: Cassandra Mikkelson	TELEPHONE: (916) 709-6830
LICENSING EVALUATOR SIGNATURE:	DATE: 06/05/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2025

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 22-AS-20240326103120

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: REGENTS POINT	FACILITY NUMBER: 300603257
	VISIT DATE: 06/05/2025

NARRATIVE

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Staff are discouraging other staff to report incidents involving residents in care.

Records reviewed indicated that staff were reporting and sending incident reports to The Department. Staff checked on residents in care based on their care needs and care plan. The staff would then report their observations and document for each resident. The allegation staff are discouraging other staff to report incidents is unsubstantiated.

Licensee was advised a copy of this report will be sent via certified mail. Two copies of this report will be sent. The Licensee is to sign and return a copy to the Orange County Regional office.

SUPERVISOR'S NAME: Laura Munoz	TELEPHONE: (916) 709-6317
LICENSING EVALUATOR NAME: Cassandra Mikkelson	TELEPHONE: (916) 709-6830
LICENSING EVALUATOR SIGNATURE:	DATE: 06/05/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2025

LIC9099 (FAS) - (06/04)

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