306006222-10-21-2025-22-AS-SSAS-DMRLHH-20251024084623

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306006222
Report Date: 10/21/2025
Date Signed: 10/21/2025 11:36:21 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
10/06/2025 and conducted by Evaluator Ruth Martinez

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20251006154342

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: 120	DATE:	10/21/2025
		UNANNOUNCED	TIME BEGAN:	10:20 AM
MET WITH:	Gerry Vadnais		TIME COMPLETED:	12:20 PM

ALLEGATION(S):

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Faciltiy did not safeguard resident's personal items.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Ruth Martinez conducted an unannounced visit to the facility to conclude investigation into the above identified complaint allegation. LPA arrived at the facility and was greeted at the and granted entry. LPA spoke with Gerry Vadnais, Executive Director and explained the purpose of the visit.

Findings are based upon this investigation which included tour of the facility, facility file review, and interviews conducted.

It is alleged that facility did not safeguard resident’s personal items, specifically to items in an assigned residents (R1) locker. Interview with staff stated that when the license and the building were under the

Continued on LIC9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Ruth Martinez
LICENSING EVALUATOR SIGNATURE:	DATE: 10/21/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2025

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-20251006154342

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: 10/21/2025

NARRATIVE

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previous license, they had issued lockers. Staff found a list of assigned lockers and to what residents it was assigned to. There was not an inventory list along with it and it is unsure if there was any since the previous licensee had control of the lockers. Each locker has a locker number and the corresponding residents name on it. In order to go into the locker area a resident need to make an appointment to gain access to their locker. Staff accompany residents to their locker; residents provide their own lock and therefore are the only ones who have a key to the lock. Staff do not obtain a copy of the key. Staff were made aware by the resident and accompanied R1 to their assigned locker. Locker was observed to not have a lock but had items in it that did not belong to R1. Interview with R1 stated that they originally had the locker 4 years ago and place items in the locker that they did not inform the management/staff about and did not give them an inventory list. R1 stated that they had not accessed or checked on locker since they placed items in there 4 years ago. R1 does not have anything to show what was in the locker and was the only one to have a key to the lock. LPA conducted a facility visit and toured the locker area and locker assigned to R1. It was observed to have paperwork, storage boxes and two paintings. LPA was informed that R1 indicated those paintings were not the ones they were missing. The locker was observed to have a number but without a lock or resident’s name.

Based on the information mentioned above, the Department is unable to ascertain if the allegation occurred as reported. Although the allegation 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.

An exit interview was conducted with the 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: 10/21/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2025

LIC9099 (FAS) - (06/04)

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