306005530-9-17-2025-22-AS-APAO-DLSTBY-20250923143554

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306005530
Report Date: 09/17/2025
Date Signed: 09/17/2025 09:08:50 AM

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
01/05/2022 and conducted by Evaluator Ruth Martinez

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20220105111506

FACILITY NAME:	VIVIDUS SENIOR LIVING		FACILITY NUMBER:	306005530
ADMINISTRATOR:	SHARIFAN, BAABAK		FACILITY TYPE:	740
ADDRESS:	25572 MAXIMUS ST		TELEPHONE:	(949) 584-0920
CITY:	MISSION VIEJO	STATE: CA	ZIP CODE:	92691
CAPACITY:	6	CENSUS:	DATE:	09/17/2025
		UNANNOUNCED	TIME BEGAN:	07:40 AM
MET WITH:	Baabak Sharifan		TIME COMPLETED:	09:30 AM

ALLEGATION(S):

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-Staff are mismanaging residents's medication.
-Staff did not respond to resident in a timely manner.
-Staff handled resident in a rough manner
-Staff are threatening resident
-Staff are not providing adequate food service to resident's.
-Staff did not feed resident.
-Staff di not safeguard resident's personal belongings.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Ruth Martinez conducted an unannounced visit to the facility to conclude the investigation to the above identified complaint allegations. LPA arrived at the facility and was greeted at the door and granted entry. LPA spoke with Baabak Sharifan, 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 and interviews conducted.

It is alleged that staff are mismanaging residents’ medication, specifically to seroquel. LPA Martinez visited the facility on January 13, 2022, and residents (R1) had already moved out and medication was not available for review. Record review revealed that on January 4, 2022, the medication release form signed by R1’s POA to have received 7 medications upon move out. Medication list does not list Seroquel as one of the

Continued on LIC9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Ruth Martinez
LICENSING EVALUATOR SIGNATURE:	DATE: 09/17/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2025

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-20220105111506

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: VIVIDUS SENIOR LIVING	FACILITY NUMBER: 306005530
	VISIT DATE: 09/17/2025

NARRATIVE

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medications that was released. Interview with staff stated that medication was given as ordered by the doctor and only medication that was prescribed to residents was given.

It is alleged that staff did not respond to residents in a timely manner. The interview with 4 of 4 residents stated that they always got responses from staff when needing help and that they waited about 5-10 minutes the most. Residents stated that they got help and assistance from all staff at the facility when they needed it and never had an issue with not getting help. Resident in question was not available for interview due to the resident had moved out of the facility on January 4, 2022.

It is alleged that staff handled resident in a rough manner. The interview with 4 of 4 residents stated that they had never witnessed staff being rough with another resident. They had never seen any yelling, treating or being rough with any resident. Residents stated there was a previous resident who would scream and yell and be loud all the time and disrupt residents’ peace. Staff were very good to them and never rough. Interview with 2 of 2 staff stated that R1 had behavior issues and yell and scream all the time. Staff would transfer R1 from wheelchair to bed and R1 gave staff a hard time, but regardless staff did the best they could to transfer R1.

It is alleged that staff are threatening resident, specifically by giving 30-day notice. Interview with staff (S1) stated that they had brought to the attention of R1’s POA that R1 was having behavioral issues and that S1 was concerned about it on multiple occasions. S1 stated that after several conversations with the POA about the concerns of the wellbeing and quality of life of R1, R1’s POA gave S1 a 30 day notice. S1 on December 30, 2021, received a 30 day notice of move out for R1, however POA informed S1 that on January 4, 2022, R1 would be moving out.

It is alleged that staff are not providing adequate food service to residents. LPA conducted a facility visit on January 13, 2022, and observed there to be a minimum of one week of non-perishables foods and two days of perishables foods available, and fresh fruit available. An interview with 4 of 4 residents stated that they get 3 meals and snacks every day. They are happy with the food service, which is of good and of quality.
It is alleged that staff did not feed residents. LPA conducted a facility visit on January 14, 2022, observed

Continued on LIC9099-C

SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Ruth Martinez
LICENSING EVALUATOR SIGNATURE:	DATE: 09/17/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2025

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 22-AS-20220105111506

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: VIVIDUS SENIOR LIVING	FACILITY NUMBER: 306005530
	VISIT DATE: 09/17/2025

NARRATIVE

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lunch being prepared, served and given to residents. The interview with 4 of 4 residents stated that they get all the meals they should at the facility. Records review for R1 revealed that per LIC602 physicians report page 4 section 15 resident is able to feed self. The interview with 2 of 2 staff stated that R1 did struggle at time with feeding and POA expressed that they wanted the food to be puree, but staff informed POA that a doctors order was needed. State stated that regardless of the situation when R1 would struggle with feeding they accommodated R1 as best as they could in order for R1 to eat their meals.

It is alleged that staff did not safeguard resident’s personal belongings. Record review revealed that LIC621 resident personal property and valuable was blank. The interview with 2 of 2 staff revealed that when residents moved in with personal property LIC621 would be completed and there were times when family brought items to residents and didn’t let staff know in order to update the form or take inventory. It wasn’t uncommon for families to bring items and place them with the residents belonging in their bedroom. R1 moved out and their POA came and removed all of R1’s personal belongings and based on observations they may have taken items of clothing from R1’s roommate since R1 was in a shared room.

Based on the information mentioned above, the Department is unable to ascertain if the allegation 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, this allegation is deemed Unsubstantiated.

An exit interview was conducted with the Administrator and a copy of this LIC9099 report was left at facility.

SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Ruth Martinez
LICENSING EVALUATOR SIGNATURE:	DATE: 09/17/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2025

LIC9099 (FAS) - (06/04)

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