306005798-2-24-2025-22-AS-AORZ-DEYM7M-20250321092141

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306005798
Report Date: 02/24/2025
Date Signed: 02/24/2025 04:41:51 PM

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
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:	03:30 PM
MET WITH:	Peggy Ulland, Executive Director		TIME COMPLETED:	05:00 PM

ALLEGATION(S):

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Facility lack appropriate staffing

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 office on December 28, 2021. LPA was greeted and granted entry by the Concierge and met with Peggy Ulland, Executive Director (ED) regarding the purpose of the visit.

It was reported that the facility was short-staffed, that staff members were required to work sick and were asked to work seven-days a week so that an outside staffing agency would not be used. On February 11 and 13, 2025, LPA obtained the current resident and staff rosters and requested to interview residents and staff who resided or worked at the facility in December 2021.

During the investigation LPA interviewed four of four residents and seven of seven staff members. Four of four residents denied that there was a staffing issue and stated they did not observe staff working sick. All residents interviewed felt they received the care they needed and had no problems with the staff.
(Coninued on LIC 9099-C)

Unsubstantiated

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)

Seven of seven staff members were asked about the staffing shortage in December 2021 and if they were required to work seven days a week, or were asked to work while sick to avoid using a staffing agency. Seven of seven staff members denied the allegation and stated that, at that time the census was still low and and there were enough hired staff that an agency was not needed. Staff were not asked to work while sick and if a staff member wanted extra hours, they could choose to work, as needed. All seven staff members interviewed denied working seven days per week.

LPA Ruppert requested staffing schedules from November 2021 through January 2022. Facility was unable to provide documentation since home office changed staffing software applications. A technical violation was given to the facility with Control Number 22-AS-20221207111938 since records missing did not pose an immediate or potential health risk to persons in care. Since ED Ulland’s arrival the facility has implemented uploading monthly and daily staff schedules into SharePoint to archive documents.

Although the above allegation may have happened there is not a preponderance of evidence to prove the alleged violation occurred; therefore, the allegation that the facility lacked appropriate staffing is unsubstantiated.

An exit interview was conducted with Peggy Ulland, Executive Director (ED) 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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