306000289-6-2-2026-22-AS-KSGH-DUPU5L-20260603151657

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306000289
Report Date: 06/02/2026
Date Signed: 06/02/2026 12:38:25 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
08/21/2025 and conducted by Evaluator Ruth Martinez

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20250821110613

FACILITY NAME:	LAGUNA PALMS		FACILITY NUMBER:	306000289
ADMINISTRATOR:	MICHAEL MILO		FACILITY TYPE:	740
ADDRESS:	24571 KINGS ROAD		TELEPHONE:	(949) 859-7929
CITY:	LAGUNA NIGUEL	STATE: CA	ZIP CODE:	92677
CAPACITY:	6	CENSUS: 4	DATE:	06/02/2026
		UNANNOUNCED	TIME BEGAN:	11:15 AM
MET WITH:	Michael Milo		TIME COMPLETED:	01:00 PM

ALLEGATION(S):

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Staff did not seek immediate medical assistance for resident.
Lack of care and supervision resulted in resident sustaining pressure injuries.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Ruth Martinez conducted an unannounced visit to the facility to conclude investigation into the above identified complaint allegations. LPA spoke with Michael Milo, Administrator and explained the purpose of the visit.

Findings are based upon this investigation which included tour of the facility, facility file review, resident file review, interviews conducted, and copies of pertinent records.

It is alleged staff did not seek immediate medical assistance for resident. Record review for LIC624 incident report submitted to the department states resident (R1) was significantly sleepy while family was visiting. This behavior is not unusual for her diagnosis. Family decided to call 911 and when paramedics arrived insisted on R1 to being transferred to the hospital for further evaluation. Interview with 4 of 4 staff

continued on LIC9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Kevin Saborit-Guasch
LICENSING EVALUATOR NAME: Ruth Martinez
LICENSING EVALUATOR SIGNATURE:	DATE: 06/02/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/02/2026

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-20250821110613

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: LAGUNA PALMS	FACILITY NUMBER: 306000289
	VISIT DATE: 06/02/2026

NARRATIVE

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stated that R1’s baseline was not concerning as this was usual for R1. Vitals for R1 were good and did not have any indications medical services needed to be called.

It is alleged that lack of care and supervision resulted in resident sustaining pressure injuries. Records review revealed that discharge paperwork for visit July 8, 2025, reason for visit was back pain. Shift notes state Monday August 4, 2025, 10:00am gave R1 a shower because they had bowel movement while eating breakfast. Caregivers helped residents with incontinence care. Skin checked were assessed and there were no redness, wounds or sores on R1’s buttocks. Interview with 4 of 4 staff no redness noted or injuries from staff. Staff do a skin assessment every time they changed or give R1 a bath.

Based on the information mentioned above, the Department is unable to ascertain if the allegations occurred as reported. Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove or refute the alleged violation occurred; therefore, the allegations are deemed Unsubstantiated.

An exit interview was conducted with the Administrator and a copy of this LIC9099 report was left at facility.

SUPERVISORS NAME: Kevin Saborit-Guasch
LICENSING EVALUATOR NAME: Ruth Martinez
LICENSING EVALUATOR SIGNATURE:	DATE: 06/02/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/02/2026

LIC9099 (FAS) - (06/04)

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