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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306006233
Report Date: 04/02/2025
Date Signed: 04/02/2025 11:58:32 AM

Unfounded


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
03/27/2025 and conducted by Evaluator Alvaro Ramirez Jr.
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20250327143704
FACILITY NAME:IVY PARK OF WELLINGTONFACILITY NUMBER:
306006233
ADMINISTRATOR:DAVID ARMOURFACILITY TYPE:
740
ADDRESS:24962 CALLE ARAGONTELEPHONE:
(562) 865-9500
CITY:LAGUNA WOODSSTATE: CAZIP CODE:
92637
CAPACITY:220CENSUS: 171DATE:
04/02/2025
UNANNOUNCEDTIME BEGAN:
08:40 AM
MET WITH:David Armour-AdministratorTIME COMPLETED:
12:13 PM
ALLEGATION(S):
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Staff discarded residents’ meals
Staff is giving medication to residents without a prescription order
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Alvaro Ramirez, Jr. conducted an unannounced initial 10-Day complaint visit to initiate the investigation into the above allegations and to deliver the findings of the investigation. LPA was greeted and granted entry into the facility and met with Administrator (AD) David Armour. LPA explained the reason for the visit.

This agency has investigated the complaint alleging that staff discarded residents' meals. Regarding the allegation, the following was revealed: During the course of the interviews one of eight individuals interviewed confirm the allegations. During the course of the interviews with residents, Resident 1 (R1) reported that staff have never discarded their food. Per R1 she can get seconds and/or can substitute an item. During the course of the interviews with staff, Staff 1 (S1) reported that staff will only discard the food that is left over and once the residents have done eating. Per S1 if the residents do not like the food they have other options to choose from.
CONTINUED ON LIC9099-C...
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Alvaro Ramirez Jr.
LICENSING EVALUATOR SIGNATURE:

DATE: 04/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/02/2025
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 2
Control Number 22-AS-20250327143704
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 OF WELLINGTON
FACILITY NUMBER: 306006233
VISIT DATE: 04/02/2025
NARRATIVE
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Regarding the allegation that staff is giving medication to residents without a prescription order, the following was revealed: During the course of the interviews with staff, S1 reported that the residents that take Ativan all have a prescription order. Per S1 she has never noticed medication missing and/or any discrepancies. S1 reported that she has never worked with S2 or S3. During the initial visit on April 02, 2025, LPA reviewed random Medication Administration Records (MARs). Per MARs, the residents that take Ativan have a prescription order.

Therefore, the allegations are deemed UNFOUNDED, meaning the allegations are false, could not have happened and/or are without a reasonable basis.

For today’s visit, there were no citations issued per Title 22, Division 6 of the California Code of Regulations.
LPA Ramirez conducted an exit interview with AD Armour, and a copy of this report was provided to the facility.
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Alvaro Ramirez Jr.
LICENSING EVALUATOR SIGNATURE:

DATE: 04/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/02/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2