306005804-10-27-2025-22-AS-APAO-DMWQQ6-20251029122149

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306005804
Report Date: 10/27/2025
Date Signed: 10/27/2025 11:01:27 AM

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
10/22/2025 and conducted by Evaluator Ruth Martinez

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20251022124832

FACILITY NAME:	MERIDIAN AT LAGUNA HILLS, THE		FACILITY NUMBER:	306005804
ADMINISTRATOR:	JENSEN, ERIC		FACILITY TYPE:	740
ADDRESS:	24552 PASEO DE VALENCIA BLDG A		TELEPHONE:	(949) 581-6111
CITY:	LAGUNA HILLS	STATE: CA	ZIP CODE:	92653
CAPACITY:	200	CENSUS: 80	DATE:	10/27/2025
		UNANNOUNCED	TIME BEGAN:	07:30 AM
MET WITH:	Eric Jensen		TIME COMPLETED:	11:30 AM

ALLEGATION(S):

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Staff do not prevent a resident from engaging in self harming behaviors.
Staff did not address the resident's change in condition.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Ruth Martinez conducted an unannounced visit to the facility to initiate and deliver findings into the above identified complaint allegations. LPA arrived at facility was greeted and granted entry by receptionist. LPA spoke with Eric Jensen, Executive Director and explained the purpose of the visit.

Findings are based upon this investigation which included resident file review, tour of the physical plant of the facility, interviews conducted, and copies of pertinent documents obtained.

It is alleged that staff do not prevent a resident from engaging in self-harming behavior, specifically to taking medication multiple doses at once. Record review revealed that resident (R1) is not on medication management at the facility. Physicians report indicates that R1 is able to manage and store own

Cotinued on LIC9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Ruth Martinez
LICENSING EVALUATOR SIGNATURE:	DATE: 10/27/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/27/2025

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-20251022124832

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: MERIDIAN AT LAGUNA HILLS, THE	FACILITY NUMBER: 306005804
	VISIT DATE: 10/27/2025

NARRATIVE

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medication, able to administer own medication. Need and services plan indicates that R1 is independent and does not require a level of care with services provided. Interview with staff stated that R1 is very independent and does not have a level of care due to it. Staff stated that R1 has only one medication and is not in the medication management to administer it. Interview with a witness stated that there are no concerns noted for R1 and that they are not concerned that R1 is taking double the dose of medication.

It is alleged that staff did not address the resident’s (R1) change in condition. Interview with staff stated that they have not noticed there to be a change in condition for R1 and that R1 is very independent. R1 is very active in the community and is always observed by staff around the community throughout the day. Staff stated that care staff have not reported any concerns in R1’s condition that require attention. Interview with a witness stated that R1 has not had a change in condition and their primary diagnosis has not changed from what it was when they moved in. They had no changes in condition to report to staff or concerns. Records review revealed that upon admissions to the facility R1 primary diagnosis is MCI (mild cognitive impairment) and that has not changed. Preplacement appraisal reflects resident is ambulatory without assistive device, no sign of confusion, has a service dog, thyroid and no major illness. Admissions assessment scored at 0 and does not require any level of care. Needs and services plan reflects that resident is independent, and medication self-administered, no bathing assistance required.

Based on the information mentioned above, the Department is unable to ascertain if the allegations occurred as reported. Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove or refute the alleged violations occurred; therefore, this allegations are deemed Unsubstantiated.

An exit interview was conducted with Executive Director and a copy of this LIC9099 report was left at facility.

SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Ruth Martinez
LICENSING EVALUATOR SIGNATURE:	DATE: 10/27/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/27/2025

LIC9099 (FAS) - (06/04)

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