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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306004520
Report Date: 11/29/2022
Date Signed: 11/29/2022 12:13:29 PM


Document Has Been Signed on 11/29/2022 12:13 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		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 HILLSFACILITY NUMBER:
306004520
ADMINISTRATOR:FREDERICK M PAOLIFACILITY TYPE:
740
ADDRESS:24552 PASEO DE VALENCIA BLDG ATELEPHONE:
(949) 581-6111
CITY:LAGUNA HILLSSTATE: CAZIP CODE:
92653
CAPACITY:150CENSUS: 91DATE:
11/29/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:18 AM
MET WITH:Frederick Paoli TIME COMPLETED:
12:30 PM
NARRATIVE
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Licensing Program Analyst (LPA) Jessica Cho made an unannounced case management visit for the purpose of following up on the Technical Violation (TV) issued during the required annual visit conducted on 11/03/2022. Upon arrival, LPA met with Executive Director (ED) Frederick Paoli. At 11:35am, LPA conducted a tour of Levels 2-5. LPA observed two carbon monoxide detectors and observed hand washing signs in the public bathrooms on each levels. The facility met the requirements and is in compliance for the carbon monoxide and hand washing signs. With regards to the fire panel, the ED confirmed on today's date that the fire panel is pending approval by the Orange County Fire Authority (OCFA). The fire panel is inoperative resulting in 22 malfunctioning smoke detectors in the facility. During the interview, ED confirmed that the estimated date of repair and completion of repair is still unknown, therefore the facility is not in compliance. ED also confirmed that the firewatch is on patrol 24 hours and checking the residents’ apartments every hour. LPA met and interviewed the firewatch on duty.

Based on observations, interviews, and record review, a deficiency is being cited under Title 22 Division 6 of the California Code of Regulations. An immediate CIVIL PENALTY (LIC421M) is assessed.

An exit interview was conducted with Executive Director Fred Paoli, and a copy of this report (along with LIC809D, LIC421M, and the appeal rights) were provided at the time of this visit.
SUPERVISOR'S NAME: Sheila SantosTELEPHONE: (714) 334-2064
LICENSING EVALUATOR NAME: Jessica ChoTELEPHONE: 714-703-2840
LICENSING EVALUATOR SIGNATURE:
DATE: 11/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/29/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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Document Has Been Signed on 11/29/2022 12:13 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION 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

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/29/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/30/2022
Section Cited

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87203 Fire Safety All facilities shall be maintained in conformity with the regulations adopted by the State Fire Marshal for the protection of life and property against fire and panic. CIVIL PENALTY ASSESSED.

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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Sheila SantosTELEPHONE: (714) 334-2064
LICENSING EVALUATOR NAME: Jessica ChoTELEPHONE: 714-703-2840
LICENSING EVALUATOR SIGNATURE:
DATE: 11/29/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/29/2022
LIC809 (FAS) - (06/04)
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