306005798-2-24-2025-22-AS-AORZ-DEYM7L-20250321092141

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306005798
Report Date: 02/24/2025
Date Signed: 02/24/2025 04:40:55 PM

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
12/28/2021 and conducted by Evaluator RoseMarie Ruppert

COMPLAINT CONTROL NUMBER: 22-AS-20211228151621

FACILITY NAME:	PARK VIEW ESTATES		FACILITY NUMBER:	306005798
ADMINISTRATOR:	HEATHER MYERS		FACILITY TYPE:	740
ADDRESS:	11360 WARNER AVE.		TELEPHONE:	(949) 333-3486
CITY:	FOUNTAIN VALLEY	STATE: CA	ZIP CODE:	92708
CAPACITY:	150	CENSUS: 137	DATE:	02/24/2025
		UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Peggy Ulland, Executive Director		TIME COMPLETED:	03:30 PM

ALLEGATION(S):

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Facility staff violated resident's rights
Facility staff are restraining residents
Facility is lacking PPE

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Rose Ruppert conducted a follow-up visit to deliver findings for a complaint received in our Regional Office on December 28, 2021. LPA was greeted and granted entry by the Concierge and explained the purpose of the visit with Peggy Ulland, Executive Director (ED).

On January 4, 2022 the Department conducted a ten-day initial visit which needed further investigation. On February 11 and 13, 2025 LPA Ruppert visited the facility and requested to speak with residents who resided in the facility at the time of the incident. LPA interviewed two of two Memory Care Residents and two of two Assisted Living residents and asked if facility staff cursed or spoke inappropriately to them. Four of four residents denied the allegation. The four residents were asked if they were forced or restrained to take the COVID-19 vaccine. Four of four residents denied this allegation. Residents were asked if Personal Protective Equipment (PPE) was readily available to them. Four of four residents stated PPE was always available for their use.
(Continued on LIC 9099-C)

Unfounded

Estimated Days of Completion:

SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: RoseMarie Ruppert
LICENSING EVALUATOR SIGNATURE:	DATE: 02/24/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/24/2025

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 22-AS-20211228151621

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: PARK VIEW ESTATES	FACILITY NUMBER: 306005798
	VISIT DATE: 02/24/2025

NARRATIVE

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(Continued from LIC 9099)

LPA interviewed seven of seven staff members regarding the Maintenance Director (MD) in December 2021. Six of the seven staff members worked alongside the MD and denied the allegations that the MD cursed or spoke inappropriately to staff. One of the seven staff members interviewed was hired by MD and had no issues and denied the allegation that the MD cursed or spoke inappropriately to staff.

Seven of seven staff members were asked if residents were coerced to take the COVID-19 vaccination and all staff denied this allegation. Seven of seven staff stated the COVID-19 shot was always a choice for residents and staff members.

LPA inquired if there was plenty of PPE on-site. Seven of seven staff members stated they never had a shortage of PPE. LPA also observed the storage supply room had plenty of PPE for both residents and staff members.

The Department has investigated the complaints alleging: that residents' rights were being violated by staff, that staff members restrained residents to take the COVID-19 vaccine and that the facility lacked PPE. The agency has found that the complaint was unfounded, meaning that the allegations were false, could not have happened and/or is without a reasonable basis. An exit interview was conducted with Peggy Ulland, Executive Director and a copy of this report was provided to the facility.

SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: RoseMarie Ruppert
LICENSING EVALUATOR SIGNATURE:	DATE: 02/24/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/24/2025

LIC9099 (FAS) - (06/04)

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