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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306004520
Report Date: 12/23/2021
Date Signed: 12/23/2021 11:35:47 AM



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
12/21/2021 and conducted by Evaluator Ruth Martinez
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20211221134228
FACILITY NAME:MERIDIAN AT LAGUNA HILLSFACILITY NUMBER:
306004520
ADMINISTRATOR:FERLINDA MCBRIDEFACILITY TYPE:
740
ADDRESS:24552 PASEO DE VALENCIA BLDG ATELEPHONE:
(949) 581-6111
CITY:LAGUNA HILLSSTATE: CAZIP CODE:
92653
CAPACITY:150CENSUS: 73DATE:
12/23/2021
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Ferlinda McBride, Business Office ManagerTIME COMPLETED:
11:50 AM
ALLEGATION(S):
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Staff do not prevent a resident from causing self harm while in care
INVESTIGATION FINDINGS:
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This unannounced visit conducted by Licensing Program Analyst (LPA) Ruth Martinez is being conducted to initiate the 10 day visit to investigate the above mentioned complaint allegation. LPA arrived at facility was greeted at the front desk by receptionist and granted entry. LPA met with Ferlinda McBride, Business Office Manager and explained the nature of today’s visit.

During the course of the investigation, interview was conducted with staff, a tour of the physical plant of the facility completed, a review of resident records was completed and copy of pertinent documents obtained.

Based on the information obtained during this visit the department has concluded the investigation into the above mentioned allegation. Findings are based upon this investigation which include resident file review and

Continued LIC9099-C
Unfounded
Estimated Days of Completion:
SUPERVISOR'S NAME: Sheila SantosTELEPHONE: (714) 334-2062
LICENSING EVALUATOR NAME: Ruth MartinezTELEPHONE: (657) 285-1397
LICENSING EVALUATOR SIGNATURE:

DATE: 12/23/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/23/2021
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 2
Control Number 22-AS-20211221134228
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: 12/23/2021
NARRATIVE
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interview with staff. It is alleged that the staff do not prevent a resident from causing self harm while in care. Based on the information on file for the facility CCLD licensure covers building A, floor 1-5 only. R1 resides in building A in the 6th floor of the facility which is independent living and is not covered under CCLD licensure for this facility.

Therefore, the Department has determined the complaint to be unfounded, meaning that the allegation 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 was furnished to the facility.
SUPERVISOR'S NAME: Sheila SantosTELEPHONE: (714) 334-2062
LICENSING EVALUATOR NAME: Ruth MartinezTELEPHONE: (657) 285-1397
LICENSING EVALUATOR SIGNATURE:

DATE: 12/23/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/23/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 2