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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 04:57:53 PM

Substantiated


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:
04:30 PM
MET WITH:Peggy Ulland - Executive Directorn and and Ronesha Hamilton, Health Services DirectorTIME COMPLETED:
05:00 PM
ALLEGATION(S):
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Staff did not assist resident in a timely manner.
INVESTIGATION FINDINGS:
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Regarding the allegation, Staff did not assist resident in a timely manner, it is alleged that R1 would have to wait 30 minutes or more to be assisted after pressing the call button. A record review of call system logs for R1 from September 8, 2025 – November 1, 2025 indicate R1 called for assistance 310 times during that period. Out of the 310 requests, staff responded more than 31 minutes later, a total of 46 times. During interviews that were conducted, nine out of fourteen residents confirmed the allegation. Residents stated they often have to wait a long time for someone to come because the staff is busy. Based on the information obtained, the allegation Staff did not assist resident in a timely manner is deemed Substantiated.

A deficiencies is being cited as per the Title 22, Division 6, Chapter 8 of the California Code of Regulations on the attached LIC 9099D. An exit interview was conducted with Health Services Director Ronesha Hamilton, and a copy of this report including the LIC9099-D, LIC421IM, LIC811, and the appeal rights were provided at the end of the visit.
Substantiated
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 2
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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/22/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/30/2026
Section Cited
CCR
87464(f)(1)
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87464 Basic Services … (f) Basic services shall at a minimum include: (1) Care and supervision…This requirement was not met as evidenced by:
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The licensee will retrain staff regarding timely call button and pendant responses and submit proof to LPA by POC due date.
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Based on documents and interviews, the licensee did not provide the service of responding to R1's pendant call for assistance in a timely manner, 46 times within a 90 day period, which poses a potential personal rights risk to persons in care. Civil Penalty Assessed.
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This is an amended report.
Amended Civil Penalty Assessed and attached.
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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: Kevin Saborit-Guasch
LICENSING EVALUATOR NAME: Eboni Bentley
LICENSING EVALUATOR SIGNATURE:

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

DATE: 09/22/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2