306004520-4-18-2024-22-AS-AJLO-D4TS9F-20240430134037

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306004520
Report Date: 04/18/2024
Date Signed: 04/18/2024 12:45:14 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
04/16/2024 and conducted by Evaluator Ruth Martinez

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20240416112024

FACILITY NAME:	MERIDIAN AT LAGUNA HILLS		FACILITY NUMBER:	306004520
ADMINISTRATOR:	TIERRE THORNTON		FACILITY TYPE:	740
ADDRESS:	24552 PASEO DE VALENCIA BLDG A		TELEPHONE:	(949) 581-6111
CITY:	LAGUNA HILLS	STATE: CA	ZIP CODE:	92653
CAPACITY:	150	CENSUS: 77	DATE:	04/18/2024
		UNANNOUNCED	TIME BEGAN:	08:40 AM
MET WITH:	Karen Enciso, Continuous Improvement Specialist		TIME COMPLETED:	01:00 PM

ALLEGATION(S):

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Staff did not provide adequate food service
Facility is in disrepair

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Ruth Martinez made an unannounced visit to conduct the required 10-day visit to begin the investigation into the allegation listed above. LPA arrived at the facility was greeted by receptionist and granted entry. LPA met with Karen Enciso, Continuous Improvement Specialist and explained the nature of today’s visit.

Findings are based upon this investigation which included a tour of the physical plant of the facility, interviews, and copy of pertinent documents (microbial air sampling report bldg A, menus, resident roster, and resident handbook).

It is alleged staff did not provide adequate food service. LPA toured the facility kitchen, and it was observed that there were sufficient amount of quality and quantity of perishable and nonperishable food

Continued on LIC9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Armando J Lucero	TELEPHONE: (949) 430-1222
LICENSING EVALUATOR NAME: Ruth Martinez	TELEPHONE: (657) 285-1397
LICENSING EVALUATOR SIGNATURE:	DATE: 04/18/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2024

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 4

Control Number 22-AS-20240416112024

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: MERIDIAN AT LAGUNA HILLS	FACILITY NUMBER: 306004520
	VISIT DATE: 04/18/2024

NARRATIVE

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for residents. LPA observed food being prepped and staff preparing the food for the residents who have restrictions. In addition, LPA obtained a copy of the facility weekly menu and always available menu for review and observed the food service to be well balanced with a variety of choices. LPA conducted interviews with the Food Service Director and indicated that food delivery is twice a week and resident have the choice to modify the menu to their liking as well as food being modified based on resident needs. Staff also indicated that when the ice cream machine is broken there is buckets of ice cream in the freezer that is used to serve to the residents. It is alleged that facility is in disrepair. Based on information received by the copy of microbial air sampling report, resident rooms affected is in building B and building A, 6th floor. Interviews conducted with 3 of 3 staff verified that they had received a complaint from a resident that resides in building B regarding mold and that is being addressed. LPA verified that complaint had been addressed on a previous facility complaint received on March 27, 2024. Testing done by a testing vendor indicated that testing was done in building A and the air sampling results show the office is safe for occupancy. Copies of documentation obtained of the microbial air sampling report page 1 indicates: Lead Tech Environmental (LTE) performed air sampling at the RSD Office located at 24552 Paseo Valencia, Laguna Hills, CA (“Office”). LTE performed the evaluation on March 20, 2024. As part of this evaluation, he took air samples for determination of non-viable fungi. The scope of sampling was limited to the collection of one interior sample and one exterior, control sample. He did not observe visible signs of mold. Based on the results of the air sampling, the microbial evaluation, and visual observations, the Office was safe for occupancy. The exterior/control sample contained a higher mold spore count than the interior air sample. Furthermore page 4 indicates: The air sample results show the Office is safe for occupancy. At the time of this writing, no Threshold Limit Values (TLVs) or Permissible Exposure Levels (PELs) for mold have been established. It should be noted that surfaces of construction and finishing materials, as well as indoor air, are not sterile, and that no structure is ever completely free of microbial contaminants. Under normal circumstances, under current industry guidelines, we would expect the levels of fungi in the indoor environment to be qualitatively and quantitatively lower or at most similar to the air outside of the residence. Based on the information on file for the facility CCLD licensure covers building A, floors 1-5. Building B and Building A floors 6-7 are independent living and is not covered under CCLD licensure for this facility.
Based on the information mentioned above, the Department is unable to ascertain if the allegation 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, this allegation is deemed Unsubstantiated. An exit interview was conducted with the facility representative and a copy of this LIC9099 report was left at facility.

SUPERVISOR'S NAME: Armando J Lucero	TELEPHONE: (949) 430-1222
LICENSING EVALUATOR NAME: Ruth Martinez	TELEPHONE: (657) 285-1397
LICENSING EVALUATOR SIGNATURE:	DATE: 04/18/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2024

LIC9099 (FAS) - (06/04)

Page: 2 of 4

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
04/16/2024 and conducted by Evaluator Ruth Martinez

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20240416112024

FACILITY NAME:	MERIDIAN AT LAGUNA HILLS		FACILITY NUMBER:	306004520
ADMINISTRATOR:	TIERRE THORNTON		FACILITY TYPE:	740
ADDRESS:	24552 PASEO DE VALENCIA BLDG A		TELEPHONE:	(949) 581-6111
CITY:	LAGUNA HILLS	STATE: CA	ZIP CODE:	92653
CAPACITY:	150	CENSUS: 77	DATE:	04/18/2024
		UNANNOUNCED	TIME BEGAN:	08:40 AM
MET WITH:	Karen Enciso, Continuous Improvement Specialist		TIME COMPLETED:	01:00 PM

ALLEGATION(S):

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Staff did not accommodate resident
Staff did not provide a safe and comfortable environment for residents
Staff spoke inappropriately to resident
Facility doesn't have a first aid kit

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Ruth Martinez made an unannounced visit to conduct the required 10-day visit to begin the investigation into the allegation listed above. LPA arrived at the facility was greeted by receptionist and granted entry. LPA met with Karen Enciso, Continuous Improvement Specialist and explained the nature of today’s visit.
Findings are based upon this investigation which included a tour of the physical plant of the facility, interviews, and copy of pertinent documents (microbial air sampling report bldg A, menus, resident roster, and resident handbook).
It is alleged that staff did not accommodate resident by not allowing residents to park motorize scooters in lobby or common spaces and staff did not provide a safe and comfortable environment for residents. LPA toured the facility and observed postings for scooter walker of motorized wheelchair parking/usage in the front lobby entrance, elevator hallways, facility hallways and common spaces. LPA observed a

Continued on LIC9099-C

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Armando J Lucero	TELEPHONE: (949) 430-1222
LICENSING EVALUATOR NAME: Ruth Martinez	TELEPHONE: (657) 285-1397
LICENSING EVALUATOR SIGNATURE:	DATE: 04/18/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2024

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

LIC9099 (FAS) - (06/04)

Page: 3 of 4

Control Number 22-AS-20240416112024

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: MERIDIAN AT LAGUNA HILLS	FACILITY NUMBER: 306004520
	VISIT DATE: 04/18/2024

NARRATIVE

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designated space in the dinning for scooters, walkers and motorized wheelchairs in order to not obstruct passageways in the dining room. LPA toured the facility club house and observed a ramp leading up to the club house. Continuous Improvement Specialist indicated that when there are events in the club house there is a staff member in the bottom of the ramp as well as on the top of the ramp to assist resident as needed to accommodate to them. Continuous Improvement Specialist indicated that residents get upset because They are not allowed to park their devices on the ramp or in common spaces that can obstruct the passageways. Per title 22 regulation 87307(d)(6) Personal Accommodations and Services (d) The following space and safety provisions shall apply to all facilities: (6) All outdoor and indoor passageways and stairways shall be kept free of obstruction.Continuous Improvement Specialist states all residents receive a copy of the handbook for their records and reference. Copy of resident handbook page 21-23 section X. rules for the safe operation of motorized vehicles outlines the rules regarding the safe operation of motorized vehicles, which include motorized scooters, carts, wheelchairs, or similar motorized devices that residents use to assist with mobility.

It alleged that staff spoke inappropriately to resident. Based on the information on file for the facility CCLD licensure covers building A, floors 1-5. Building A floors 6-7 is independent living and not covered under CCLD licensure for this facility. Resident R1 resides in building A 7th floor on the independent side of the facility, which is not covered by CCLD licensure.

It is alleged that facility doesn’t have a first aid kit. LPA toured the facility and observed a mounted first aid kit in the kitchen and a first aid kit in the medication room. Medication room also has a drawer with supplies that are used to give resident first aid supplies as needed and also to replenish the first aid kits. 2 of 2 staff interviewed indicated that since building B and building A floors 6-7 are independent and not covered by the licensure by the Department there is no medication room in those buildings/floors. Resident R1 resides in building A 7th floor on the independent side of the facility, which is not covered by CCLD licensure.

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.

A copy of this report is being reviewed with facility representative and a copy of this LIC9099 furnished to the facility.

SUPERVISOR'S NAME: Armando J Lucero	TELEPHONE: (949) 430-1222
LICENSING EVALUATOR NAME: Ruth Martinez	TELEPHONE: (657) 285-1397
LICENSING EVALUATOR SIGNATURE:	DATE: 04/18/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2024

LIC9099 (FAS) - (06/04)

Page: 4 of 4