306005460-6-22-2023-22-AS-AORZ-CT6N8R-20230626101447

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306005460
Report Date: 06/22/2023
Date Signed: 06/22/2023 02:00:25 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE & INLAND A/SC, 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
08/19/2020 and conducted by Evaluator Alvaro Ramirez Jr.

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20200819143438

FACILITY NAME:	MERIDIAN AT ANAHEIM HILLS, THE		FACILITY NUMBER:	306005460
ADMINISTRATOR:	BOTTINELLI, SHELIA		FACILITY TYPE:	740
ADDRESS:	525 S. ANAHEIM HILLS ROAD		TELEPHONE:	(714) 974-2226
CITY:	ANAHEIM	STATE: CA	ZIP CODE:	92807
CAPACITY:	0	CENSUS: 0	DATE:	06/22/2023
		UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:			TIME COMPLETED:	02:00 PM

ALLEGATION(S):

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Residents needs are not being met.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Alvaro Ramirez, Jr. attempted to contact Licensee Representative, Chief Executive Officer: Deepak Israni, via telephone on 05/30/23; 06/01/23; and 06/13/23 due to the facility being closed effective 09/30/2020. LPA Ramirez left three voicemails for Licensee Israni, however, no call was returned to LPA. The purpose of the call was to deliver findings on the above allegation.

This agency has investigated the complaint alleging that residents needs are not being met. Due to the facility being closed effective 09/30/20 LPA was not able to review and obtain copies of facility, resident, and staff records. In an attempt to obtain copies of the records, a collateral visit was conducted on 03/23/23 to Meridian at Anaheim Hills- 306005730. During the visit on 03/23/23 LPA was able to interview staff that have been working at the facility since or prior to 2020; however, per Resident Care Director (RCD) there are no residents present today that were living at the facility in August of 2020. Regarding the allegation, the following was revealed: One of nine staff interviewed corroborated the allegation.
Continued on LIC9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Alisa Ortiz	TELEPHONE: (714) 703-2855
LICENSING EVALUATOR NAME: Alvaro Ramirez Jr.	TELEPHONE: 714-703-2840
LICENSING EVALUATOR SIGNATURE:	DATE: 06/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/22/2023

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-20200819143438

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE & INLAND A/SC, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

FACILITY NAME: MERIDIAN AT ANAHEIM HILLS, THE	FACILITY NUMBER: 306005460
	VISIT DATE: 06/22/2023

NARRATIVE

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Six of nine staff reported that the facility did not neglect to meet the residents needs. The remaining two staff either had a telephone number that has been disconnected and/or did not return the call to LPA. During the course of the interviews it was reported that facility was providing enough Personal Protective Equipment (PPE) and that facility was following Covid-19 guidelines by having staff wear a mask and taking their temperature. Per Executive Director (ED) who has been working at the same location for six years, facility never had an issue regarding residents needs not being met.

Based on the information gathered during the investigation, LPA is unable to ascertain if the allegation occurred as reported due to conflicting information. Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove or refute the alleged violation occurred; therefore, this allegation is deemed UNSUBSTANTIATED.

The facility has been closed effective 09/30/2020. Attempts to reach Licensee Representative Deepak Israni to conduct an exit interview were unsuccessful. A copy of this report will be certify mailed to the Licensee’s last known address.

SUPERVISOR'S NAME: Alisa Ortiz	TELEPHONE: (714) 703-2855
LICENSING EVALUATOR NAME: Alvaro Ramirez Jr.	TELEPHONE: 714-703-2840
LICENSING EVALUATOR SIGNATURE:	DATE: 06/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/22/2023

LIC9099 (FAS) - (06/04)

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