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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306005798
Report Date: 09/22/2026
Date Signed: 09/24/2026 04:56:54 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 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
12/12/2025 and conducted by Evaluator Eboni Bentley
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20251212164740
FACILITY NAME:PARK VIEW ESTATESFACILITY NUMBER:
306005798
ADMINISTRATOR:MARIA ARRIAGAFACILITY TYPE:
740
ADDRESS:11360 WARNER AVE.TELEPHONE:
(949) 333-3486
CITY:FOUNTAIN VALLEYSTATE: CAZIP CODE:
92708
CAPACITY:170CENSUS: 128DATE:
09/22/2026
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Peggy Ulland - Executive Directorn and and Ronesha Hamilton, Health Services DirectorTIME COMPLETED:
04:30 PM
ALLEGATION(S):
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Staff did not keep resident’s room free from pests.
Staff did not maintain resident's hygiene.
Staff did not rotate resident resulting in a bedsore.
Staff did not provide resident with nutritious meals.
INVESTIGATION FINDINGS:
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On September 22, 2026, Licensing Program Analyst (LPA) Eboni Bentley arrived at the facility unannounced to conduct a follow up complaint investigation visit into the above allegations. LPA was greeted and granted entry after stating the purpose of the visit to staff and met with Executive Director Peggy Ulland and Ronesha Hamilton, Health Services Director.

During the visit, the following documentation were reviewed: Resident Roster, Staff Roster, Employee Contact Information, Staff Schedule, Menus, Resident Face Sheets, Physician’s Reports, Progress notes, Call System logs, Maintenance requests/work order, Dietary orders, Hospice/Home Health records, and Service Plans.

CONTINUE TO LIC9099-C PAGE....
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kevin Saborit-Guasch
LICENSING EVALUATOR NAME: Eboni Bentley
LICENSING EVALUATOR SIGNATURE:

DATE: 09/22/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2026
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
Control Number 22-AS-20251212164740
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME: PARK VIEW ESTATES
FACILITY NUMBER: 306005798
VISIT DATE: 09/22/2026
NARRATIVE
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The following was determined during the course of the investigation:

Regarding the allegation, Staff did not keep resident’s room free from pests, LPA toured the facility during the initial visit conducted on December 17, 2025, and no immediate health and safety threats were identified at the time of inspection. LPA did not observe any pests in R1’s former apartment. Based on the interviews conducted, three out of fourteen residents stated they have observed pests in the facility. Residents stated that when pests were observed, they notified the staff, the area was sprayed, and pests did not return. Six out of six staff denied the allegation. Per Maintenance Director, when residents report an incident to staff, a work order is created and the issue is documented. Based on records reviewed from September 8, 2025 – November 1, 2025, no work orders were created to service pests in R1’s former apartment. Although pictures were provided by a witness, LPA was unable to identify the location where the picture was taken and no time/stamp was present. Based on the information gathered, the allegation, Staff did not keep resident’s room free from pests is deemed Unsubstantiated.

Regarding the allegation, Staff did not maintain resident’s hygiene, it was alleged that staff did not assist Resident #1 (R1) with hygiene and showers for 10 days. During the investigation, interviews were conducted with staff. Three out of three caregiving staff denied the allegation, stating caregivers would try to initiate shower assistance, R1 would often refuse, staff would return at a later time to make second and third attempt but R1 would continue to refuse assistance. Nine out of fourteen residents interviewed denied the allegation. One resident stated staff assists them with showers weekly and as needed. LPA was unable to qualify three residents due to their diagnosis. A review of R1’s service plan dated September 8, 2025, states R1 “requires stand-by assistance with shampooing/rinsing/drying hair” and “stand-by assistance with personal hygiene.” LPA was unable to locate any documentation stating resident did not shower for 10 days. Additionally, there is no record of bruising. Although pictures were provided, LPA was unable to identify the person in the picture, determine the date, time, and source of bruising on the arms of the person in the pictures as the person’s face was not visible and time/date stamp not present. Based on the information gathered, the allegation, Staff did not maintain resident's hygiene is deemed Unsubstantiated.

CONTINUE TO LIC9099-C PAGE....
SUPERVISORS NAME: Kevin Saborit-Guasch
LICENSING EVALUATOR NAME: Eboni Bentley
LICENSING EVALUATOR SIGNATURE:

DATE: 09/22/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 22-AS-20251212164740
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME: PARK VIEW ESTATES
FACILITY NUMBER: 306005798
VISIT DATE: 09/22/2026
NARRATIVE
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Regarding the allegation, Staff did not rotate resident resulting in a bedsore, it is alleged that R1 sustained a bed sore on her tailbone between September 8, 2025 and November 1, 2025. During an interview, Witness #1 (W1) stated they believe the bedsore is from staff not rotating the resident. A record review of R1’s Home Health records from September 9, 2025 through January 6, 2026, revealed R1 received wound care for a stage 1 wound, located on the buttocks. During the time period reviewed, the wound did not change from stage 1. Based on records reviewed, the allegation Staff did not rotate resident resulting in a bedsore is deemed Unsubstantiated.

Regarding the allegation, Staff did not provide resident with nutritious meals, it was alleged that staff is “providing food that is unhealthy, everything is fried, and there is no fresh food” according to W1. During the investigation, LPA observed two meal services in the common dining room located in the Assisted Living. At breakfast meal service, residents were observed eating the items listed on the main dining menu which included breakfast pancakes, eggs made to order, choice of sausage, bacon, ham and breakfast potatoes, fresh fruits, hot or cold cereal, and toast. For lunch, residents were served oven roasted pot roast with steamed potatoes and carrots. LPA conducted a tour of the kitchen with staff and observed an ample amount of perishables and non-perishable food items. A variety of fruits and vegetables were also observed. LPA reviewed the weekly and daily menus describing a variety of nutritious meals being served to residents in addition to alternative options available upon request. Per the Lunch and Dinner menus for the current week, meals included cheese tortellini, pot roast, beef chili, teriyaki chicken, with sides of steamed or sauteed vegetables, baked beans, and daily entree alternatives available for each meal. Three out of fourteen meals included fried foods such as cheeseburger and/or fries. Based on the information gathered, the allegation, Staff did not provide resident with nutritious meals is deemed Unsubstantiated.

Based on the observations made, interviews that were conducted, and the records that were reviewed, although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the following allegations: Staff did not keep resident’s room free from pests, Staff did not maintain resident's hygiene, Staff did not rotate resident resulting in a bedsore, and Staff did not provide resident with nutritious meals are deemed UNSUBSTANTIATED.

An exit interview was conducted with Health Services Director Ronesha Hamilton, and a copy of this report and LIC811 were provided at the end of the visit.
SUPERVISORS NAME: Kevin Saborit-Guasch
LICENSING EVALUATOR NAME: Eboni Bentley
LICENSING EVALUATOR SIGNATURE:

DATE: 09/22/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3