<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306006223
Report Date: 12/16/2024
Date Signed: 12/16/2024 04:41:30 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
10/29/2024 and conducted by Evaluator Kevin Saborit-Guasch
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20241029144756
FACILITY NAME:IVY PARK AT LAGUNA WOODSFACILITY NUMBER:
306006223
ADMINISTRATOR:TURGEON, JENNIFERFACILITY TYPE:
740
ADDRESS:24441 CALLE SONORATELEPHONE:
(949) 830-8057
CITY:LAGUNA WOODSSTATE: CAZIP CODE:
92637
CAPACITY:233CENSUS: DATE:
12/16/2024
UNANNOUNCEDTIME BEGAN:
03:30 PM
MET WITH:Jennifer Turgeon, Executive DirectorTIME COMPLETED:
04:55 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility did not issue refund
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On this day, Licensing Program Analysts (LPAs) Kevin Saborit-Guasch and Brandon Lopez made an unannounced visit to the facility for the purpose of following up on the investigation of the allegation listed above as well as to deliver findings to the licensee. LPAs were greeted and granted entry by the facility’s front desk staff after introducing themselves and stating the purpose of the visit. Executive Director Jennifer Turgeon was present on the premises and assisted with the visit.

The initial complaint investigation visit was conducted on November 4, 2024. During the visit, LPA requested and obtained the current facility census in addition to admission paperwork for residents R1 and R2, as well as a final account statement dated October 12, 2024. Additional witness interviews conducted via telephone following the visit.

CONTINUED ON FORM LIC9099-C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Kevin Saborit-Guasch
LICENSING EVALUATOR SIGNATURE:

DATE: 12/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2024
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-20241029144756
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 PARK AT LAGUNA WOODS
FACILITY NUMBER: 306006223
VISIT DATE: 12/16/2024
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
CONTINUED ON FORM LIC9099

Regarding the allegation that Facility failed to issue a refund, the following has been concluded: Residents R1 and R2 signed up as prospective residents of the facility on August 31, 2024 and assumed tenant status of a unit at the facility on that day. They received their move-in binder on September 9, 2024. On September 12, 2024, R1 and R2 gave notice to facility staff of their intent to not move forward with their admission at the facility. Following the terms of the notice, R1 and R2 were charged for one full month and 12 days of residency fees which were deducted from the 80% refund of their community fee which they were owed after terminated their admission after admission and conducting of their respective needs assessments.

However, upon review of the residents records maintained at the facility, LPA Kevin Saborit-Guasch observed that the admission agreement signed by both residents on August 31, 2024 did not bear a signature made by a facility representative within seven days of the admission. The facility therefore was not in possession of a binding agreement to establish residence in exchange for payment of a monthly residency fee. Residents R1 and R2 additionally never physically moved into their unit at the facility.

As a result, the allegation is found to be Substantiated, meaning that the preponderance of evidence standard has been met. One violations is being cited per California Code of Regulations Title 22.

An exit interview was conducted and a copy of this report along with appeal rights was provided to a facility representative.
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Kevin Saborit-Guasch
LICENSING EVALUATOR SIGNATURE:

DATE: 12/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 22-AS-20241029144756
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 PARK AT LAGUNA WOODS
FACILITY NUMBER: 306006223
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/16/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
12/17/2024
Section Cited
CCR
87507(c)
1
2
3
4
5
6
7
Per CCR 87507(c) :" Admission agreements shall be signed and dated, (...), by the resident (...) and the licensee (...) no later than seven days following admission." This requirement is not met as evidenced by:
Based on records review and staff interviews,
1
2
3
4
5
6
7
Licensee to issue all residency and community fees paid by residents R1 and R2.
8
9
10
11
12
13
14
the admission agreement for residents R1 and R2 was not signed by the licensee or its representative within seven days of admission. This constitutes an immediate risk to the health, safety and personal rights of residents in care.
8
9
10
11
12
13
14
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Kevin Saborit-Guasch
LICENSING EVALUATOR SIGNATURE:

DATE: 12/16/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3