306004520-2-25-2025-22-AS-AJLO-DERSPF-20250314140303

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306004520
Report Date: 02/25/2025
Date Signed: 02/25/2025 01:13:35 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
12/02/2022 and conducted by Evaluator Ruth Martinez

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20221202143122

FACILITY NAME:	MERIDIAN AT LAGUNA HILLS		FACILITY NUMBER:	306004520
ADMINISTRATOR:	FREDERICK M PAOLI		FACILITY TYPE:	740
ADDRESS:	24552 PASEO DE VALENCIA BLDG A		TELEPHONE:	(949) 581-6111
CITY:	LAGUNA HILLS	STATE: CA	ZIP CODE:	92653
CAPACITY:	0	CENSUS: 0	DATE:	02/25/2025
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Eric Jensen, Executive Director		TIME COMPLETED:	10:30 AM

ALLEGATION(S):

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-Facility staff does not provide adequate food service for residents.
-Facility staff unable to communicate with resident(s) due to language barrier.
-Facility staff provides dirty utensils and cups to resident.

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 arrived at the facility was greeted by receptionist and granted entry. LPA met with Eric Jensen, Executive Director 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 conducted, and copy of pertinent documents (staff schedule, resident roster, menus, diet physician order).

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

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: 02/25/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/25/2025

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-20221202143122

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: 02/25/2025

NARRATIVE

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who have restrictions. In addition, LPA obtained a copy of the facility weekly menu for review and observed the food service to be well balanced with a variety of choices. LPA conducted interviews with the Dining 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 prep food based on restrictions and resident 1 (R1) has a physician order for a low sodium, no salt diet which staff follow. Interview with facility residents 8 of 8 indicated that they didn’t have an issue with the food served and they have always been able to modify the food to their liking or request for something out of the menu. Tour of the dining rooms of the facility LPA observed food being served, menu posted, and alternative menu posted.

It is alleged that facility staff unable to communicate with resident’s due to language barrier. Interview with Executive Director indicated that there is a server where their English is a bit broken, but their main job duty is to be a runner and that staff only does the job duty of server when there is staff missing, but that is on occasion not very often. Their primary job duty is runner and bus tables where he doesn’t have much interaction with residents. Interview with 8 of 8 residents indicated that they have never encountered a problem in the dining room or with staff not being able to communicate with them. They also indicated that there is a staff that has limited English bit that staff doesn’t assist much with taking orders for food.

It is alleged facility staff provides dirty utensils and cups to residents. Tour of the main dining on the first floor and dining room in second floor LPA observed the utensils, cups, dishes in the dining rooms tables. LPA observed a glass to have water marks but not dirty, utensils looked scratched from wear and tear but not dirty, and dishes looked clean. Interview with Executive Director stated that he has seen glassware to have water marks here and there but does not recall every seeing dirty utensils, dishes, cups, or glasses. Interview with 8 of 8 residents indicated that they have never had dirty utensils, dishes, cups, or glasses and indicated that they have seen on occasion water marks on the glasses, but not dirty. Residents indicated that if they request a replacement, they get it and not have an issue with the cleanliness of them.

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 Executive Director 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: 02/25/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/25/2025

LIC9099 (FAS) - (06/04)

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