306005351-8-1-2024-22-AS-AORZ-D7RTRK-20240802145740

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306005351
Report Date: 08/01/2024
Date Signed: 08/01/2024 12:18:32 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
07/29/2024 and conducted by Evaluator Kimberly Lyman

COMPLAINT CONTROL NUMBER: 22-AS-20240729154235

FACILITY NAME:	IVY PARK AT MISSION VIEJO		FACILITY NUMBER:	306005351
ADMINISTRATOR:	FOUDIL MANADI		FACILITY TYPE:	740
ADDRESS:	27783 CENTER DRIVE		TELEPHONE:	(949) 364-6210
CITY:	MISSION VIEJO	STATE: CA	ZIP CODE:	92692
CAPACITY:	150	CENSUS: 106	DATE:	08/01/2024
		UNANNOUNCED	TIME BEGAN:	10:45 AM
MET WITH:	Foudil Manadi		TIME COMPLETED:	12:50 PM

ALLEGATION(S):

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Facility did not provide records to authorized representative

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Kimberly Lyman conducted an unannounced complaint visit to initiate an investigation into the above allegation. LPA was greeted and granted entry into the facility and explained the reason for the visit.
During the course of the investigation, LPA interviewed Administrator as well as reviewed email string. Regarding the allegation that facility did not provide records to authorized representative, the investigation revealed the following: Facility received request for records for Resident 1 (R1) on Friday, July 5, 2024. Records were sent to authorized representative in the afternoon on Monday, July 8, 2024. Law firm confirms receipt of records on July 8, 2024. Health and Safety Code requires records to be "provided promptly and not to exceed 2 business days". Facility adhered to the regulatory turn around time. Therefore the allegation is deemed unfounded, meaning the allegation is false could not have happened and/or is without a reasonable basis.

Exit interview conducted with Administrator and a copy of this report was left at the facility.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Alisa Ortiz	TELEPHONE: (714) 703-2855
LICENSING EVALUATOR NAME: Kimberly Lyman	TELEPHONE: (714) 795-1497
LICENSING EVALUATOR SIGNATURE:	DATE: 08/01/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/01/2024

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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