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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306005350
Report Date: 04/13/2023
Date Signed: 04/13/2023 02:38:35 PM

Unfounded


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
04/04/2023 and conducted by Evaluator Kimberly Lyman
COMPLAINT CONTROL NUMBER: 22-AS-20230404154546
FACILITY NAME:REGENCY, THEFACILITY NUMBER:
306005350
ADMINISTRATOR:JENNIFER TURGEONFACILITY TYPE:
740
ADDRESS:24441 CALLE SONORATELEPHONE:
(949) 830-8057
CITY:LAGUNA WOODSSTATE: CAZIP CODE:
92637
CAPACITY:220CENSUS: 118DATE:
04/13/2023
UNANNOUNCEDTIME BEGAN:
12:38 PM
MET WITH:Elena MadsenTIME COMPLETED:
03:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility is not providing meals to residents
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Kimberly Lyman conducted an unannounced complaint visit to deliver findings on the above allegations. LPA was greeted and granted entry into the facility by Executive Director Elena Madsen and explained the reason for the visit. Business Office Manager Danielle Hauseman was present as well.
During the course of the investigation, LPA toured the facility, interviewed staff and residents as well as reviewed and obtained pertinent documentation such as facility staff schedule. Regarding the allegation that facility is not providing meals to residents, the investigation revealed the following: LPA observed residents dining in the dining room as well as a schedule for room service. Resident 1 (R1) indicates no issue receiving meals and indicates room service delivery times within 15-45 minutes of ordering. Four out of four dining staff indicate wait times around 15-20 minutes depending on the time of day. Four out of four clients who receive room service indicate food is delivered timely. Facility schedule shows 3-4 servers per meal. Facility does not document delivery times. Therefore the allegation is deemed UNFOUNDED, meaning the allegation was false, could not have happened and/or is without a reasonable basis. Exit interview conducted and a copy of this report was emailed to facility representative.
Unfounded
Estimated Days of Completion:
SUPERVISOR'S NAME: Alisa OrtizTELEPHONE: (714) 703-2855
LICENSING EVALUATOR NAME: Kimberly LymanTELEPHONE: (714) 795-1497
LICENSING EVALUATOR SIGNATURE:

DATE: 04/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/13/2023
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 3
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
04/04/2023 and conducted by Evaluator Kimberly Lyman
COMPLAINT CONTROL NUMBER: 22-AS-20230404154546

FACILITY NAME:REGENCY, THEFACILITY NUMBER:
306005350
ADMINISTRATOR:JENNIFER TURGEONFACILITY TYPE:
740
ADDRESS:24441 CALLE SONORATELEPHONE:
(949) 830-8057
CITY:LAGUNA WOODSSTATE: CAZIP CODE:
92637
CAPACITY:220CENSUS: DATE:
04/13/2023
UNANNOUNCEDTIME BEGAN:
12:38 PM
MET WITH:Elena MadsenTIME COMPLETED:
03:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Insufficent staffing to meet resident needs
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Kimberly Lyman conducted an unannounced complaint visit to deliver findings on the above allegations. LPA was greeted and granted entry into the facility by Executive Director Elena Madsen and explained the reason for the visit. Business Office Manager Danielle Hauseman was present as well.
During the course of the investigation, LPA toured the facility, interviewed staff and residents as well as reviewed and obtained pertinent documentation such as staff schedule. Regarding the allegation that insufficent staffing to meet resident needs, the investigation revealed the following: Facility schedule indicates 6 caregivers on 1st shift, 5 caregivers on 2nd shift and 3 caregivers on NOC shift. Interviews conducted with staff and residents indicated facility struggles at times meeting those caregiving levels due to call outs and hiring shortages. Facility states actively engaging in the hiring process to fill any staffing shortages. Residents confirm needs are being met at the facility. During the visit on 04/13/2023, Health Services Director and Wellness Director were pitching in to help cover call outs that occurred that day. LPA observed 3 caregivers working with a med tech assisting as caregiver. Due to conflicting information, CONTINUED ON LIC 9099C DATED 04/13/2023.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Alisa OrtizTELEPHONE: (714) 703-2855
LICENSING EVALUATOR NAME: Kimberly LymanTELEPHONE: (714) 795-1497
LICENSING EVALUATOR SIGNATURE:

DATE: 04/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/13/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 22-AS-20230404154546
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: REGENCY, THE
FACILITY NUMBER: 306005350
VISIT DATE: 04/13/2023
NARRATIVE
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32
LPA is unable to corroborate the allegation. Therefore, the allegation is deemed unsubstantiated, meaning that although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the violation occurred. Exit interview conducted and a copy of this report will be emailed to facility representative.
SUPERVISOR'S NAME: Alisa OrtizTELEPHONE: (714) 703-2855
LICENSING EVALUATOR NAME: Kimberly LymanTELEPHONE: (714) 795-1497
LICENSING EVALUATOR SIGNATURE:

DATE: 04/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/13/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 3