306006222-7-24-2025-22-AS-SSAS-DKCLX6-20250808090810

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306006222
Report Date: 07/24/2025
Date Signed: 07/24/2025 09:24:36 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
06/03/2025 and conducted by Evaluator Ruth Martinez

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20250603091336

FACILITY NAME:	IVY AT WELLINGTON, THE		FACILITY NUMBER:	306006222
ADMINISTRATOR:	VADNAIS, GERRY		FACILITY TYPE:	740
ADDRESS:	24903 MOULTON PARKWAY		TELEPHONE:	(949) 458-2311
CITY:	LAGUNA HILLS	STATE: CA	ZIP CODE:	92653
CAPACITY:	305	CENSUS: 125	DATE:	07/24/2025
		UNANNOUNCED	TIME BEGAN:	07:20 AM
MET WITH:	Gerry Vadnais		TIME COMPLETED:	10:00 AM

ALLEGATION(S):

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-Staff tamper with resident's personal belongings
-Staff are not following the monthly menu
-Staff are serving a poor quality of food

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Ruth Martinez visited the facility to deliver findings for the investigation into the above identified complaint allegations. LPA arrive at facility was greeted and granted entry by staff. LPA spoke with Gerry Vadnais, Executive Director and explained the purpose of the visit.

Findings are based upon this investigation which included facility file review, menus, room service menus, tour of the physical plant of the facility and interviews conducted.

It is alleged that staff tamper with resident’s personal belongings. The interview with 2 of 2 staff stated that resident (R1) complained about an artificial plant in the exterior of their apartment in which the leaves were cut and/or removed. R1 never complained about a safe or missing batteries from it. Staff stated they weren’t

Continued on LIC9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Ruth Martinez
LICENSING EVALUATOR SIGNATURE:	DATE: 07/24/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/24/2025

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-20250603091336

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: IVY AT WELLINGTON, THE	FACILITY NUMBER: 306006222
	VISIT DATE: 07/24/2025

NARRATIVE

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aware that R1 had a safe in their room and that residents are free to have their own property in their apartment. As to which residents don’t always inform the staff of purchases made to place in the inventory form LIC621 Resident personal property and valuables. LPA toured the physical plant of the facility and observed the artificial plant in question. LPA on the following dates: June 4, 2025, June 18, 2025, and on July 17, 2025, conducted a tour and observed that the artificial plant remained the same as it was observed on June 4, 2025.
It is alleged that staff are not following the monthly menu, specifically to the room service to go menu. Interviews with 2 of 2 staff stated that the facility has several menus they use: the dining room menu, the to go menu for room service, and the alternative options menu. Facility recently improved the room service system to improve consistency and quality. As of May 21, 2025, room service orders are not done by telephone call but rather an ordering system for the specific meal period, the forms are slot units on the wall adjacent to the kitchen/in front of the facility elevators. There will be daily order forms on the table outside the kitchen and will be available in a weekly package as well that can be taken and completed in the residents leisure time. Staff stated the R1 orders a mainly from the room service option and crossed out the meal options and writes in a meal that is not offered on the menu, regardless of staff accommodating to R1 as best as they can based on what they are requesting. Interviews with 10 of 10 residents stated that they have never had an issue with the room service and have always received what they have ordered. If they want something not offered on the menu, they let staff know and staff always try to accommodate residents as best as they can.

It is alleged that staff are serving a poor quality of food. LPA toured the facility kitchen, and it was observed that there was sufficient amount of quality and quantity of perishable and nonperishable food for residents. LPA observed food being prepped and staff preparing the food for the residents. In addition, LPA obtained a copy of the facility weekly menu for review with meal options and the room service menus for one week and observed the food service to be well balanced with a variety of choices. LPA conducted interviews with the Executive Chef and indicated that food service for residents have the choice to modify the menu to their liking as well as food being modified based on resident needs. Residents have the ability to choose from the variety of options offered out of the weekly menu. Interviews with 10 of 10 residents stated that they didn’t have an issue with the food served and they have always been able to modify the food to their liking or request for

Continued on LIC9099-C

SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Ruth Martinez
LICENSING EVALUATOR SIGNATURE:	DATE: 07/24/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/24/2025

LIC9099 (FAS) - (06/04)

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Control Number 22-AS-20250603091336

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: IVY AT WELLINGTON, THE	FACILITY NUMBER: 306006222
	VISIT DATE: 07/24/2025

NARRATIVE

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something out of the menu. LPA toured the dining room and bistro and observed food being served, menu posted, and alternative menu posted.

Based on the information gathered during the investigation, interviews and review of all documents obtained, the Department is unable to ascertain if the allegation 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 violation occurred; therefore, this allegation is deemed Unsubstantiated.

This report was reviewed with the Executive Director and a copy was furnished to the facility.

SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Ruth Martinez
LICENSING EVALUATOR SIGNATURE:	DATE: 07/24/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/24/2025

LIC9099 (FAS) - (06/04)

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