306004520-7-12-2022-22-AS-SSAS-CL7SY4-20221115131655

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306004520
Report Date: 07/12/2022
Date Signed: 07/12/2022 01:50:47 PM

Unsubstantiated

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
05/19/2021 and conducted by Evaluator Ruth Martinez

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20210519102519

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: 70	DATE:	07/12/2022
		UNANNOUNCED	TIME BEGAN:	12:07 PM
MET WITH:	Fred Paoli, Administrator		TIME COMPLETED:	01:07 PM

ALLEGATION(S):

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-Facility has an odor

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 allegation. 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 that facility has an odor. Interview with staff (S1) revealed that facility had a pluming issue with the sewer line of the facility. S1 indicated that sever agencies and vendors have been working on the issue. TR Sewer Services has been working on resolving the issue, City of Laguna Hills has come out to the facility for permit purposes, and OC Fire Authority has come out to the facility for permit purposes as well. Since the

Continued on LIC9099

Unsubstantiated

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: 07/12/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/12/2022

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-20210519102519

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: 07/12/2022

NARRATIVE

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issue occurred S1 instructed staff to place signs throughout the facility to keep the residents and visitors informed. S1 has also given information to the residents in the Town Hall meeting at the facility. S1 indicates that due to severity of the issue this has been an ongoing issue. Facility has been proactive on dealing with any odors that have been noticed. Generally, the smell is upon the entrance of the facility, however facility has utilized automatic air fresheners and purifiers to aid with the smell. S1 stated that this issue is not a fecal matter, but it is a sewer pipe that runs underneath that building. S1 indicated the issue is plumbing issue there is no hole in the facility, we do have a tunnel in the facility. However, the tunnels have nothing to do with the odor. The pipes are extremely old and there is obviously work that needs to be done and that’s what’s happening, it is hard for me to explain the structure of the tunnel, but it isn’t in use it’s more used for when work needs to be done. Interview with S2 indicates they have not received any complaints from residents. Interviews with facility residents revealed that odor is faint and generally upon entrance. The smell is not noticed throughout the facility and with wearing a mask due to covid the smell is not very noticeable. Residents states that the facility has been proactive on keeping residents informed as much as possible by emails, signs posted and town hall meeting. They are aware that the issue is being work on and that other agencies are involved to resolve the issue as well. Review of records revealed that TR Sewer Services is the outside vendor working on sewer pipeline issue. The scope of the work is to repair and replace approximately 45 feet of the 8 inch sewer pipe and the 6x8 wye connection for the sewer mainline in the building. Work is located in the hallway on the basement floor level. Vendor continued to work diligently with facility and other agencies involved. LPA Martinez conducted facility visits on 05/27/2021, 07/08/2021 and 08/09/2021 and toured the physical plant of the facility. LPA observed electronic units mounted on the walls of the main entry of the facility. LPA observed there was a very faint odor upon entry of the facility, due to the air purifiers/fresheners the fragrance delivered from the units quickly overpowered the odor or smell making it a quick faint smell. Upon conducting the tour of the physical plant LPA came across several residents who were sitting at the main entry and lounge area of the facility. LPA greeted residents and asked about the smell, residents expressed not having an issue because the smell was very faint and the active activity of facility staff to eliminate issue is appreciated. 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.

Continued on LIC9099-C

SUPERVISOR'S NAME: Sheila Santos	TELEPHONE: (714) 334-2062
LICENSING EVALUATOR NAME: Ruth Martinez	TELEPHONE: (657) 285-1397
LICENSING EVALUATOR SIGNATURE:	DATE: 07/12/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/12/2022

LIC9099 (FAS) - (06/04)

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Control Number 22-AS-20210519102519

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: 07/12/2022

NARRATIVE

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

An exit interview was conducted with 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: 07/12/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/12/2022

LIC9099 (FAS) - (06/04)

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