306004520-11-8-2022-22-AS-MSTC-CLP7QV-20221130205232

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306004520
Report Date: 11/08/2022
Date Signed: 11/08/2022 11:38:36 AM

Unfounded

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
08/04/2021 and conducted by Evaluator Ruth Martinez

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20210804162018

FACILITY NAME:	MERIDIAN AT LAGUNA HILLS		FACILITY NUMBER:	306004520
ADMINISTRATOR:	MALLIKA PURI		FACILITY TYPE:	740
ADDRESS:	24552 PASEO DE VALENCIA		TELEPHONE:	(949) 581-6111
CITY:	LAGUNA HILLS	STATE: CA	ZIP CODE:	92653
CAPACITY:	150	CENSUS: 84	DATE:	11/08/2022
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Fred Paoli		TIME COMPLETED:	11:15 AM

ALLEGATION(S):

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-Facility is in disrepair.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Ruth Martinez visited the facility to deliver findings for the investigation into the above identified complaint allegations. LPA arrive at facility was greeted by receptionist and granted entry. LPA spoke with Fred Paoli, Administrator and explained the purpose of the visit.

Findings are based upon this investigation which included interviews conducted, tour of physical plant of facility and review of records.

It is alleged facility is in disrepair by laundry facilities are inoperable. Per notice sent to residents indicate as follows: As our laundry rooms in A tower is out of service we will continue to provide laundry service for all AL resident. IL residents may use the laundry room in B tower floors 1-7. If this would be any inconvenience for you please notify housekeeping and we will be able to assist you with the your laundry needs. Interview

Continued on LIC9099-C

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Sheila Santos	TELEPHONE: (714) 334-2062
LICENSING EVALUATOR NAME: Ruth Martinez	TELEPHONE: (657) 285-1397
LICENSING EVALUATOR SIGNATURE:	DATE: 11/08/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2022

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-20210804162018

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

FACILITY NAME: MERIDIAN AT LAGUNA HILLS	FACILITY NUMBER: 306004520
	VISIT DATE: 11/08/2022

NARRATIVE

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conducted with S1 revealed that that as part of the monthly housing fee laundry service is provided to all residents. Caregivers pick up the laundry and takes it to building B as the laundry units in that building are not down. If a resident requires additional laundry service, they submit a request and caregivers pick up their laundry. S1 indicates that residents have been kept in the loop with information for the laundry units. Base on the information received from interviews, information received by records and the lack of corroborating witnesses to the incidents, LPA is unable to determine if the alleged violations occurred as reported.

Therefore, the Department determined the complaint to be unfounded, meaning that the allegations was false, could not have happened and/or is without a reasonable basis. The Department has therefore dismissed the complaint.

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

SUPERVISOR'S NAME: Sheila Santos	TELEPHONE: (714) 334-2062
LICENSING EVALUATOR NAME: Ruth Martinez	TELEPHONE: (657) 285-1397
LICENSING EVALUATOR SIGNATURE:	DATE: 11/08/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2022

LIC9099 (FAS) - (06/04)

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