Ivy Park At Laguna Woods

Report on file with the state — no findings text was published for this visit. The complete document is on the state’s site.

Allegation investigated: Facility is without power

Licensing Program Analyst (LPA) Jenifer Tirre made an unannounced visit to deliver findings into complaint investigation. During investigation, Department conducted tour, gathered & reviewed documents as well as conducted interviews with Staff and residents. The following was based on information gathered from investigation. Based on record review, Incident Report dated 2/28/2025, stated that Fire Department arrived at facility to check on smoke that was coming from main breaker panel near garage area. Report stated that power went out in facility approximately at 3:30AM. Report stated that Southern California Edison also came out and shut off main power to entire building for purposes of electrician to work on panel. At 6:45AM, same day 2/28/2025, Business Office Director had sent out email blast to residents informing of power outage, stating that facility was working on restoring issue as soon as possible, asking residents to remain in apartments for delivery of meals. CONTINUED ONthe state’s words, verbatim · CDSS document, May 22, 2026 · control 22-AS-20250228160500

Report on file with the state — no findings text was published for this visit. The complete document is on the state’s site.

Report on file with the state — no findings text was published for this visit. The complete document is on the state’s site.

Allegation investigated: Residents Room is not cleaned Silverware not sanitized Food is being served cold Facility is short staffed caregivers and housekeepers

Licensing Program Analyst (LPA) Joseph Alejandre made an unannounced visit to deliver the findings into the complaint investigation into the allegations listed above. LPA met with Business Office Manager Jessica Hernandez and explained the reason for the visit. The investigation into the allegation, resident's room is not cleaned, revealed the following. It was reported that Resident 1’s (R1) room was not cleaned for over a week and the floor in the bathroom was not cleaned under the bath mats. No other details were provided regarding R1’s room not being cleaned. It was alleged a housekeeper (no name provided) reported that rooms were not cleaned thoroughly because of a lack of staff and due to time constraints. This report could not be verified. 3 out of 3 housekeeping staff reported that they clean anywhere from 8 to 10 rooms a day and have not missed any of the residents’ rooms. R1 reported that their room was not cleaned properly, especially the floors. Unsubstantiatedthe state’s words, verbatim · CDSS document, Apr 29, 2026 · control 22-AS-20241217161129

Allegation investigated: Resident sustained neck bruising.

Licensing Program Analyst (LPA) Ruth Martinez conducted an unannounced visit to the facility to investigation the above identified complaint allegation. LPA met with Zehra Syed, Executive Director and explained the nature of the visit. During the course of the investigation, interviews were conducted, a tour of the physical plant of the facility was conducted, a review of resident records was completed and copy of pertinent documents obtained. It is alleged that resident sustained neck bruising. LPA obtained resident roster at the facility and observed resident (R1) was not listed. Interview with 2 of 2 staff stated that R1 moved into the facility on January 3, 2026, and on January 8, 2026, R1 was sent to the hospital via 911 due to finding R1 in distress in their Continued on LIC9099-C Unsubstantiatedthe state’s words, verbatim · CDSS document, Jan 13, 2026 · control 22-AS-20260112093724

Allegation investigated: -Facility threatened to evict resident -Facility did not allow resident to reject medical care or other services -Facility is not providing Basic Services to resident -Facility coerced resident into accepting medication management

Licensing Program Analyst (LPA) Ruth Martinez visited the facility to deliver findings for the investigation into the above identified complaint allegations. LPA arrive at facility was greeted and granted entry. LPA spoke with Zehra Syed, Executive Director and explained the purpose of the visit. Findings are based upon this investigation which included resident file review, facility file review, tour of the physical plant of the facility and interviews conducted. It is alleged facility threatened to evict resident, specifically to receiving a letter signed and dated letter declaring that resident will either face eviction or agree to the services and charges. LPA Martinez requested a copy of the letter however such letter was never made available. LPA is unsure if the letter exist. Interview Continued on LIC9099-C Unsubstantiatedthe state’s words, verbatim · CDSS document, Oct 22, 2025 · control 22-AS-20240506152040

Allegation investigated: Staff stole a resident's personal property Staff did not respond to residents calls for assistance timely

On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility for the purpose of following up on the investigation of the five allegations listed above and delivering findings to the licensee. LPA was greeted and granted entry by facility staff after stating the purpose of the visit. Business Office Manager Jessica Hernandez was present on the premises and presented with the allegations as well as the findings. The initial investigation visit was conducted on April 21, 2025, by Licensing Program Analyst (LPA), Kevin Saborit-Guasch. During the visit, LPA accompanied by facility staff conducted a tour of the facility's three levels and common areas. No immediate risk to residents' health and safety was assessed. LPA requested and reviewed records for multiple residents. Resident 1 (R1) was admitted to Ivy Park at Laguna Woods on December 2, 2023. Per the physician report established upon admission, R1 had a primary diagnosis of a history of lthe state’s words, verbatim · CDSS document, Oct 3, 2025 · control 22-AS-20250418135127

Report on file with the state — no findings text was published for this visit. The complete document is on the state’s site.

Allegation investigated: - Staff are not following residents dietary plan

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 accomthe state’s words, verbatim · CDSS document, Jul 17, 2025 · control 22-AS-20250206120944

Report on file with the state — no findings text was published for this visit. The complete document is on the state’s site.

Report on file with the state — no findings text was published for this visit. The complete document is on the state’s site.

Report on file with the state — no findings text was published for this visit. The complete document is on the state’s site.

Allegation investigated: -Staff left resident in soiled diapers/linin for an extra period of time -Staff will not provide resident with water -Staff are not taking universal precautions to prevent spread of illness

Licensing Program Analyst (LPA) Ruth Martinez visited the facility to deliver findings for the investigation into the above identified complaint allegation. LPA arrive at facility was greeted and granted entry. LPA spoke with Jessica Hernandez, Business Office Manager and explained the purpose of the visit. Findings are based upon this investigation which included resident file review, facility file review, tour of the physical plant of the facility and interviews conducted. It is alleged staff left resident in soiled diapers/linin for an extended period of time. Record review for resident (R1) individualized service plan and assessment do not reflect R1 has any bladder and/or bladder impairment that would require R1 to use diapers. Charting notes reflect that R1 has private caregivers and on February 3, 2025, when doing resident check in R1 was found being assisted by R1’s private caregiver in Continued on LIC9099-C Unsubstantiatedthe state’s words, verbatim · CDSS document, Mar 19, 2025 · control 22-AS-20250203141522

Allegation investigated: Facility did not issue refund

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 Substantiatedthe state’s words, verbatim · CDSS document, Dec 16, 2024 · control 22-AS-20241029144756

Allegation investigated: Facility staff did not seek timely medical attention for resident

On December 6, 2024, Licensing program Analyst (LPA) Jenifer Tirre met with Executive Director (ED) Jennifer Turgeon to deliver findings for the above allegation. The investigation consisted of observations, interviews, and record review. The investigation revealed the following: Regarding allegation Facility Staff did not seek timely medical attention for resident: On September 18, 2024, the Department received an allegation that facility staff did not seek timely medical attention for resident. During the course of this investigation, LPA Tirre conducted an unannounced initial visit on September 23, 2024, and subsequent visits on November 8, 2024, November 26, 2024, and November 27, 2024 related to complaint investigation. On September 12, 2024, per Call Device Activity Report, resident 1 (R1) pressed their medical alert pendant at 1:09 PM. Caregiver responded at 1:21 PM, twelve (12) minutes after the call. R1 asked for their blood pressure to be checked after they did their own bloothe state’s words, verbatim · CDSS document, Dec 6, 2024 · control 22-AS-20240918134343

Report on file with the state — no findings text was published for this visit. The complete document is on the state’s site.

Allegation investigated: Facility did not accept resident back after hospitalization

Licensing Program Analyst (LPA) Joseph Alejandre made an unannounced visit to begin the investigation into the allegations listed above. LPA met with Executive Director Elena Madsen and explained the reason for the visit. The investigation into to the allegation revealed the following. It was alleged that Resident 1 (R1) was not allowed back to the facility after the Skilled Nursing Facility (SNF) cleared R1 to return to their home. R1’s responsible party (RP) reported that they spoke to the Executive Director who informed them R1 would need medication management if they were to return to the facility based on the nurse’s assessment. RP reported that they disagreed with the assessment and provided an LIC 602A dated June 7, 2024, which stated R1 could manage their own meds with the following comments in the comments section, “PT can take own medication in the pillbox sorted by son”. The LIC 602A section 16 concerning resident medication is a yes or no question, the resident is either cathe state’s words, verbatim · CDSS document, Jun 20, 2024 · control 22-AS-20240617153724