306005798-3-26-2026-22-AS-AORZ-DSNT4N-20260330142410

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306005798
Report Date: 03/20/2026
Date Signed: 03/26/2026 02:06:56 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
04/21/2022 and conducted by Evaluator Samer Haddadin

COMPLAINT CONTROL NUMBER: 22-AS-20220421153926

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:	170	CENSUS: 153	DATE:	03/20/2026
		UNANNOUNCED	TIME BEGAN:	08:33 AM
MET WITH:	Executive Director (ED) Peggy Ulland		TIME COMPLETED:	11:45 AM

ALLEGATION(S):

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Staff did not prevent inappropriate behaviors between residents
Staff are not providing adequate food service for residents
Staff are not meeting resident's toileting needs
Facility walls are dirty
Facility floors are dirty

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Samer Haddadin conducted an unannounced visit to the facility to investigate the above-mentioned allegations. Upon arrival, LPA Haddadin was greeted and granted entry by Executive Director (ED) Peggy Ulland. The purpose of the visit was explained. The investigation included staff and resident interviews, record reviews, and direct observations of the physical plant.
The allegations investigated were: “Staff did not prevent inappropriate behaviors between residents,” “Staff are not providing adequate food service for residents,” “Staff are not meeting residents’ toileting needs,” “Facility walls are dirty,” and “Facility floors are dirty.” Regarding the allegation that staff are not providing adequate food service to residents, LPA interviewed five staff members who reported residents receive three meals a day with additional meals available upon request. {***CONTINUE9099C***} {***THIS IS AN AMENDED REPORT***}1

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Samer Haddadin
LICENSING EVALUATOR SIGNATURE:	DATE: 03/20/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2026

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-20220421153926

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: 03/20/2026

NARRATIVE

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LPA interviewed five residents who confirmed they get three meals a day and they have access to additional food in fridges located in lounge & memory care unit. LPA toured the facility and observed two refrigerators: one on the first floor near the lounge area containing food items such as sandwiches, pudding, apple juice, and orange juice, and another refrigerator in memory care unit offering the same. The facility menu was observed and found to reflect residents’ dietary plans. A review of the facility’s quarterly dietitian report, completed by the Dining Manager, showed that the facility received a passing score of 47.5 out of a possible 52 point
Regarding the allegation that staff are not meeting residents’ toileting needs, the investigation determined as follows: LPA interviewed five staff members who reported they conduct resident checks approximately every two hours and more if required. Staff members further reported residents have the ability to call for assistance if needed. Two of the five staff interviewed reported direct knowledge of R1. Progress notes dated July 2, 2021, documented that staff attempted to assist R1 with hygiene and a shower, but R1 refused care and repeatedly asked staff to leave the room.
LPA interviewed five residents who reported if they required help, they would receive it from facility staff. Residents reported staff check on residents throughout the day. Facility records confirmed that staff maintain a log for memory care resident two-hour checks. Facility does not maintain a log for facility Assisted Living resident checks. LPA tested facility pull cords in residents rooms and observed staff responding timely during visits.
Regarding the allegation that staff failed to prevent inappropriate behaviors between residents, interviews were conducted with five staff members of which two reported knowledge of a verbal altercation between R1 and resident 2 (R2). Staff reported when the incident occurred residents were separated and no further incidents occurred. Staff denied that any physical interaction occurred between the two residents. LPA also interviewed five residents, all of whom stated they had no knowledge of any physical or verbal altercations between residents. A review of the facility’s Progress Notes revealed no evidence to support the allegation. Additionally, Progress Notes for Resident 1 (R1) showed no further incidents of aggression toward peers or staff. {***CONTINUE 9099C***}
{***THIS IS AN AMENDED REPORT***}

SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Samer Haddadin
LICENSING EVALUATOR SIGNATURE:	DATE: 03/20/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2026

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 22-AS-20220421153926

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: 03/20/2026

NARRATIVE

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Regarding the allegations that facility walls and floors are dirty, LPA interviewed five staff members who reported the facility has housekeeping and maintenance. Housekeeping cleans resident rooms, common areas and bathrooms daily and clean additionally as needed. LPA interviewed five residents, who reported their rooms are cleaned regularly and have no observed dirty walls or floors. Resident rooms are cleaned on a schedule. LPA toured the facility and observed that the walls and floors were clean meaning free of graffiti and no chipped paints. LPA observed the facility to be free of odors. Review of housekeeping and maintenance logs indicated the facility follows a scheduled cleaning routine performed by designated maintenance staff.
Based on the investigation, there was insufficient evidence to prove that the alleged violations occurred. Therefore, the allegations: Staff did not prevent inappropriate behaviors between residents,” “Staff are not providing adequate food service for residents,” “Staff are not meeting residents’ toileting needs,” “Facility walls are dirty,” and “Facility floors are dirty” are deemed Unsubstantiated.
An exit interview was conducted with Executive Director (ED) Peggy Ulland and a copy of this report was provided to the facility representative.
{***THIS IS AN AMENDED REPORT***}

SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Samer Haddadin
LICENSING EVALUATOR SIGNATURE:	DATE: 03/20/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2026

LIC9099 (FAS) - (06/04)

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