Laguna Palms

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Joseph Alejandre made an unannounced visit to conduct the required annual inspection. LPA met with Co-Administrator (CA) Julieta Santiago and explained the reason for the visit. Michael Milo's Administrator's Certificate expires on September 6, 2025. Facility is licensed for 6 non-ambulatory residents with a hospice waiver for 2 residents. No residents are currently on hospice. LPA and the Co-Administrator toured the facility. Facility is a single story home with 6 bedrooms, 1 staff room, 4 bathrooms, living room with a screened fireplace, family room with a screened fireplace, dining room, kitchen and a 2 car garage. LPA observed the See Something, Say Something poster (PUB 475) posted next to the front door in the living room. The living room has a couch and two chairs. LPA observed games and books stored in the living room. There is a large fish tank in the living room. The CA reported that the fireplaces are never used. LPA observed all six resident rooms had the required linens and furnishings. LPA observed a two day perishable and a seven day non-perishable food supply on hand in the kitchen. Knives are kept locked in a tool box in the kitchen. LPA observed the fire extinguisher in the kitchen is fully charged. LPA observed all bathrooms are clean and operational. Hot water measured 114.6 degrees Fahrenheit in all bathrooms. LPA observed clean linens stored in the hall pantry. LPA and CA toured the garage. The garage is kept locked and used for storage. LPA observed a day emergency supply of food and water in the garage. Smoke detectors/carbon monoxide detectors tested operational. The last emergency drill was conducted on July 15, 2026. LPA and CA toured the backyard. There is a fountain in the backyard. The backyard has a covered patio with chairs to sit outside. The exit gate is operational. No obstacles or hazards observed in the backyard. LPA reviewed 5 resident files and medication. No discrepancies observed. LPA reviewed two staff files, both staff members are background cleared and associated to the facility. Staff 1 (S1) and Staff 2 (S2) did not have 4 hours of training specific to postural supports, hospice and restricted health conditions but did have 20 hours of total training. S1 and S2 both have current CPR/First Aid Training. No other discrepancies observed. Facility has a dedicated internet device (tablet) for resident use. LPA inspected the first aid kit. The first aid kit has all the required elements. Deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. Co-Administrator Julieta Santiago refused to sign the report (LIC 809 & LIC 809D) including the deficiency page (LIC 809D) per advise from her attorney. An exit interview was conducted and a copy of the report provided along with appeal rights.the state’s words, verbatim · CDSS document, Aug 26, 2026

Allegation investigated: Staff member yells at residents Staff member failed to treat residents with dignity and respect Insufficient staffing

Licensing Program Manager (LPM) Mota spoke with Michael Milo, Administrator via telephone visit to discuss and deliver the findings for the above allegations. During the course of the investigation, the Department conducted interviews, reviewed records, and toured the facility. It is alleged that Staff (S1) is verbally abusive, yells, and speaks inappropriately to the residents and facility has insufficient staffing. Based on interviews conducted by Licensing Program Analyst (LPA) Alejandre with 5 of 5 residents there were no complaints by residents of staff speaking to them inappropriately or being verbally abusive. All residents stated that staff are nice and provide appropriate care when needed. In addition, 2 of 2 staff stated that they do not speak to residents inappropriately nor have they observed staff to do the same. Based on all statements being consistent about no witnessed or observation of any staff yelling, speaking inappropriately or being verbally abusive to residents and all residents stating that their care needs are being met, the department has determined that although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the allegations did or did not occur. Therefore, the above allegations are UNSUBSTANTIATED. Unsubstantiatedthe state’s words, verbatim · CDSS document, Jul 23, 2026 · control 22-AS-20220422160701

Allegation investigated: Staff did not seek immediate medical assistance for resident. Lack of care and supervision resulted in resident sustaining pressure injuries.

Licensing Program Analyst (LPA) Ruth Martinez conducted an unannounced visit to the facility to conclude investigation into the above identified complaint allegations. LPA spoke with Michael Milo, Administrator and explained the purpose of the visit. Findings are based upon this investigation which included tour of the facility, facility file review, resident file review, interviews conducted, and copies of pertinent records. It is alleged staff did not seek immediate medical assistance for resident. Record review for LIC624 incident report submitted to the department states resident (R1) was significantly sleepy while family was visiting. This behavior is not unusual for her diagnosis. Family decided to call 911 and when paramedics arrived insisted on R1 to being transferred to the hospital for further evaluation. Interview with 4 of 4 staff continued on LIC9099-C Unsubstantiated stated that R1’s baseline was not concerning as this was usual for R1. Vitals for R1 were good and did not have any indications medical services needed to be called. It is alleged that lack of care and supervision resulted in resident sustaining pressure injuries. Records review revealed that discharge paperwork for visit July 8, 2025, reason for visit was back pain. Shift notes state Monday August 4, 2025, 10:00am gave R1 a shower because they had bowel movement while eating breakfast. Caregivers helped residents with incontinence care. Skin checked were assessed and there were no redness, wounds or sores on R1’s buttocks. Interview with 4 of 4 staff no redness noted or injuries from staff. Staff do a skin assessment every time they changed or give R1 a bath. Based on the information mentioned above, the Department is unable to ascertain if the allegations 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, the allegations are deemed Unsubstantiated. An exit interview was conducted with the Administrator and a copy of this LIC9099 report was left at facility.the state’s words, verbatim · CDSS document, Jun 2, 2026 · control 22-AS-20250821110613

Allegation investigated: Staff did not adequately supervise resident resulting in a medical condition Staff did not assist resident with toileting needs Staff left resident in wet briefs for extended periods of time Staff refused to allow resident to return to facility after hospital stay Staff withheld resident’s personal belongings

Licensing Program Analyst (LPA) Alvaro Ramirez, Jr. conducted an unannounced visit to deliver findings on the above allegations received on September 27, 2024. LPA was greeted and granted entry into the facility and met with Administrator (AD) Julieta Milo. LPA explained the reason for the visit. This Department has investigated the complaint alleging that staff did not adequately supervise resident resulting in a medical condition. Regarding the allegation the following was revealed: During the course of the interviews with individuals three of five individuals interviewed denied the allegations. LPA reviewed documents including the Preplacement Appraisal Information dated May 6, 2024, for Resident 1 (R1). Per Preplacement Appraisal R1 had Pneumonia in January 2024 and states that R1 is prone to Urinary Tract Infections (UTIs). During the investigation LPA reviewed the San Juan Hills Healthcare Center summary report dated May 6, 2024, for R1. Per San Juan Hills Healthcare Center summary report it states diagnosis, Encephalopathy. Per healthdirect.gov.au, encephalopathy refers to the group of symptoms that you CONTINUED ON LIC9099-C... Unsubstantiated experience when your whole brain is not functioning normally. During the interviews with residents, R2 reported that staff check on her often and stated that staff adequately supervise her. During the interviews with staff, Staff 1 (S1) reported that staff adequately supervise the residents in order to prevent wounds and UTIs. Regarding the allegation that staff did not assist resident with toileting needs, the following was revealed: During the investigation LPA reviewed the Care Plan for R1. Per Care Plan, it states R1 is bowel incontinent and states ask R1 if he wants to use the urinal during a diaper change. During the interviews with residents, R3 reported that she does need assistance with incontinence care. During the interviews with staff, S1 reported that staff always assist the residents with their toileting needs. Per AD, staff always assist the residents with their toileting needs. Regarding the allegation that staff left resident in wet briefs for extended periods of time, the following was revealed: During the investigation LPA reviewed the Physician Report dated May 1, 2024, for R1. Per Physician Report under Care or Service Plan it states incontinence of bowel and/or bladder. During the interviews with residents, R3 reported that she is not aware if some residents wear a diaper. Per R3, staff are helpful. During the interviews with staff, S1 reported that the diapers get changed three times per day or as needed. Per S1, the residents are not left in wet diapers for extended periods of time. Regarding the allegation that staff refused to allow resident to return to facility after hospital stay, the following was revealed: During the investigation LPA reviewed the San Juan Hills Healthcare Center summary for R1. Per San Juan Hills Healthcare Center summary report, R1 was discharged on May 6, 2024. Per San Juan Hills Healthcare Center summary report, it states R1 will be discharging to Laguna Palms located at 24571 Kings Road Laguna Niguel, CA 92677. During the interviews with staff, S1 reported that the R1 returned to the facility and was here for another two weeks before leaving. Per AD, staff did not refused to allow the resident to return to the facility after a Hospital stay. Regarding the allegation that staff withheld resident's personal belongings, the following was revealed: During the initial visit on October 3, 2024, LPA tour the facility and did not observe personal belongings for R1. CONTINUED ON LIC9099-C... During the interviews with staff, S1 reported that staff have never withheld the resident's personal belongings and stated that staff do no touch the resident's personal belongings. Per AD, R1's personal belongings were given to R1's wife the same day she requested them. During the interviews with residents, R3 reported that she has no issues with her personal belongings and stated that staff are respectful. Based on the information gathered during the investigation and review of documents obtained, LPA is unable to ascertain if the allegations occurred as reported due to conflicting information. Although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove or refute the alleged violations occurred; therefore, these allegations are deemed UNSUBSTANTIATED. For today’s visit, there were no citations issued per Title 22, Division 6 of the California Code of Regulations. LPA conducted an exit interview with facility representative, and a copy of this report was provided to the facility.the state’s words, verbatim · CDSS document, Feb 11, 2026 · control 22-AS-20240927170807

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Joseph Alejandre made an unannounced visit to conduct the required annual inspection. LPA met with Co-Administrator (CA) Julieta Santiago and explained the reason for the visit. Michael Milo's Administrator's Certificate expires on September 6, 2025. Facility is licensed for 6 non-ambulatory residents with a hospice waiver for 2 residents. No residents are currently on hospice. LPA and the Co-Administrator toured the facility. Facility is a single story home with 6 bedrooms, 1 staff room, 4 bathrooms, living room with a screened fireplace, family room with a screened fireplace, dining room, kitchen and a 2 car garage. LPA observed the See Something, Say Something poster (PUB 475) posted next to the front door in the living room. The living room has a couch and two chairs. LPA observed games and books stored in the living room. There is a large fish tank in the living room. The CA reported that the fireplaces are never used. LPA observed all six resident rooms had the required linens and furnishings. LPA observed a two day perishable and a seven day non-perishable food supply on hand in the kitchen. Knives are kept locked in a tool box in the kitchen. LPA observed the fire extinguisher in the kitchen is fully charged. LPA observed all bathrooms are clean and operational. Hot water measured 108.1 degrees Fahrenheit in all bathrooms. LPA observed clean linens stored in the hall pantry LPA and CA toured the garage. The garage is kept locked and used for storage. Smoke detectors/carbon monoxide detectors tested operational. The last fire drill was conducted on July 31, 2025. LPA and CA toured the backyard. There is a fountain in the backyard. The backyard has a covered patio with chairs to sit outside. The exit gate is operational. No obstacles or hazards observed in the backyard. LPA reviewed 4 resident files and medication. Resident 4 (R4) had no current reappraisal/needs and care plan. No other discrepancies observed. LPA reviewed two staff files, both staff members are background cleared and associated to the facility. Staff 2 (S2) did not have 4 hours of training specific to postural supports, hospice and restricted health conditions. S2 did have current CPR/First Aid Training. No other discrepancies observed. Facility did not have a dedicated internet device for resident use. Deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. Co-Administrator Julieta Santiago refused to sign the report (LIC 809 & LIC 809D) including the deficiency page (LIC 809D) per advise from her attorney. An exit interview was conducted and a copy of the report provided along with appeal rights.the state’s words, verbatim · CDSS document, Aug 4, 2025

The state marks this report as 5 pages; the online copy we transcribed has 4. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Joseph Alejandre made an unannounced visit to conduct the required annual inspection. LPA met with Co-Administrator Julieta Santiago and explained the reason for the visit. Michael Milo's Administrator's Certificate expires on September 6, 2025. Facility is licensed for 6 non-ambulatory residents with a hospice waiver for 2 residents. 2 residents are currently on hospice. LPA and the Co-Administrator toured the facility. Facility is a single story home with 6 bedrooms, 1 staff room, 4 bathrooms, living room, family room with a screened fireplace, dining room, kitchen and a 2 car garage. Smoke detectors/carbon monoxide detectors tested operational. LPA observed the PUB 475, See Something, Say Something was not posted but was leaning on entrance wall. LPA observed all resident rooms have the required furnishings and bed linens. LPA observed the fire extinguisher in the kitchen is fully charged. There is a 2 day perishable and a 7 day non-perishable food supply on hand in the kitchen. Knives are kept locked in a kitchen drawer. Medications are kept locked in a kitchen cabinet. LPA inspected the first aid kit. The first aid kit has all the required elements. All 4 bathrooms are clean and operational. Hot water measured from 108.2 to 109.0 degrees Fahrenheit in all bathrooms. LPA toured the garage. The garage is kept locked and used for storage. LPA observed emergency food and water, tools and supplies in the garage. LPA toured the backyard. LPA observed ladders, dirt and rocks on the side of the North side of house which creates an obstacle leading to the exit gate to the front of the house. The Co-Administrator reported that the side of the house is having the stucco repaired and the process has not been completed. LPA observed a fountain in the backyard. There is a pergola with chairs and a table to sit outside. There is a walkway on the South side of the house leading to the front courtyard. In the front courtyard there is a shaded patio and a fountain. LPA reviewed 5 resident files. 3 out of 5 residents did not have a current Appraisal/Needs and Service Plan. LPA reviewed 5 resident medications, no discrepancies observed. LPA reviewed 2 staff files, no discrepancies observed. Deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. Co-Administrator Julieta Santiago refused to sign the report (LIC 809 & LIC 809D) including the deficiency page (LIC 809D) per advise from her attorney. An exit interview was conducted and a copy of the report along with appeal rights was provided.the state’s words, verbatim · CDSS document, Aug 20, 2024

The state marks this report as 4 pages; the online copy we transcribed has 2. You can request the full file from the county licensing office.