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

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306006223
Report Date: 07/17/2025
Date Signed: 07/17/2025 03:56:43 PM

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
02/06/2025 and conducted by Evaluator Michael Tea
COMPLAINT CONTROL NUMBER: 22-AS-20250206120944
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: 157DATE:
07/17/2025
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Zehra SyedTIME COMPLETED:
04:10 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
- Staff are not following residents dietary plan
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On this day, Licensing Program Analyst (LPA) Michael Tea made an unannounced visit to conclude the investigation and to deliver findings for the allegation mentioned above. LPA Tea was greeted and granted entry by Executive Director (ED) Zehra Syed and explained the reason for the visit.

The department received a complaint on February 6, 2025 and LPA Tea conducted the initial 10-day visit the next day on February 7, 2025. It was alleged that staff are not following residents dietary plan. LPA Tea interviewed facility staff and residents and collected pertinent documents such as staff and resident rosters, copies of Resident 1 (R1)’s file, facility menu schedule, and information sheets of residents that were interviewed. The investigation determined the following:

LPA Tea received a list of residents who had special diets, food allergies and preferences and interviewed those who were present at the facility. Eight out of nine residents interviewed agree that staff are following or accommodating to most of their diet plans and restrictions. A lot of the residents also agree that due to

Report continued on LIC9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Michael Tea
LICENSING EVALUATOR SIGNATURE:

DATE: 07/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2025
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-20250206120944
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: 07/17/2025
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
the numbers of residents living here, they understand that it’s hard to meet all of the residents different food preferences and diets because of the population’s diversity and different upbringing and preferences.
At the time of the initial investigation the facility had a norovirus outbreak and had two menus. The first one had the daily specials, and the second one was an “always available” a la cart menu that had the same items for residents to order throughout the day. Eight out the nine residents felt the second menu gave them a lot of options or alternatives to get around their diet restrictions and they are not limited to choices. Some of the residents said that staff try their best and never denied their choices or requests.

One resident interviewed, R1, said there are no options for their diet restrictions or preferences. R1 said they had a letter from their doctor about their diet restrictions and had given it to the facility. The previous executive director, ED Jennifer Turgeon has said she has never received the resident’s diet restrictions from the doctor. The Health Service Director (HSD) Jazzmyne Jefferies had also never received R1’s diet plan or restrictions and that residents can be on special diets, which they do honor when given to the facility. Based on records review, R1 has no diet restrictions on file. Most of the records, like the physician’s report, reflect no special diet from the doctor. The most recent Diet Clarification Request form indicates no dietary restrictions currently. The current executive director, ED Zehra Syed has never received from R1 any diet restrictions or doctor’s order regarding diet plans as of today since she has been here at the facility.

LPA spoke to the facility dietician and nutritionist. The dietician staff said she did speak to R1 regarding their diet concerns specifically their GERD. It’s her job to provide nutritional information and counseling and it is up to the residents to address their dietary preferences to the executive chef or facility. LPA spoke to the facility nutritionist who conducts mainly kitchen audits and checks food compliance for the facility. She said the facility is very flexible with the resident’s food preferences, whether they are dietary or not. If they wanted lower sodium, sugar free, the facility would accommodate them. She stated that residents can order lots of food based on their food preferences. One staff interviewed said they are not saying no to the residents’ diet and food preferences. She makes sure the facility servers provide options to the residents.

Therefore, based on LPA Tea's observations and interviews conducted and records reviewed the allegation that staff are not following residents dietary plan has been determined to be unsubstantiated meaning that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.

Complaint investigation continued on LIC9099-C
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Michael Tea
LICENSING EVALUATOR SIGNATURE:

DATE: 07/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 22-AS-20250206120944
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: 07/17/2025
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
No deficiencies cited at this time and an exit interview was conducted with Executive Director Zehra Syed. A copy of the report and confidential names list were provided to the facility
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Michael Tea
LICENSING EVALUATOR SIGNATURE:

DATE: 07/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3