306005880-2-3-2026-22-AS-SSAS-DRET9D-20260218133146

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306005880
Report Date: 02/03/2026
Date Signed: 02/03/2026 02:23:45 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
04/02/2021 and conducted by Evaluator Jerome Haley

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20210402133244

FACILITY NAME:	SHORELINE SENIOR LIVING		FACILITY NUMBER:	306005880
ADMINISTRATOR:	EDGINGTON, HEATHER		FACILITY TYPE:	740
ADDRESS:	7101 NIMROD DR		TELEPHONE:	(714) 916-0029
CITY:	HUNTINGTON BEACH	STATE: CA	ZIP CODE:	92647
CAPACITY:	6	CENSUS: 6	DATE:	02/03/2026
		UNANNOUNCED	TIME BEGAN:	12:00 PM
MET WITH:	Heather Edgington		TIME COMPLETED:	02:40 PM

ALLEGATION(S):

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Resident had an unexplained injury.
Staff have not obtained timely medical treatment for resident.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Jerome Haley made unannounced visit to begin the investigation into the complaint allegations above. LPA Haley was greeted by staff and explained the reason for the visit before entering.

Regarding the allegation: Resident had an unexplained injury

It was discovered Resident 1 (R1) suffered from an ingrown toenail, and document review revealed that Staff 1 (S1) informed R1’s responsible party of the ingrown toenail on more than one occasion. Additional document review revealed a letter from a family member of R1 that stated, “I have not observed any evidence of improper care of or injury to my [family member] while in the care of Shoreline Senior Living.”
The letter also stated, “I am very happy with the care my [family member] is receiving at Shoreline.”

Regarding the allegation: Staff have not obtained timely medical treatment for residents.
Continued on LIC9099C

Unfounded

Estimated Days of Completion:

SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Jerome Haley
LICENSING EVALUATOR SIGNATURE:	DATE: 02/03/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2026

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-20210402133244

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: SHORELINE SENIOR LIVING	FACILITY NUMBER: 306005880
	VISIT DATE: 02/03/2026

NARRATIVE

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During the investigation it was discovered R1 suffered from an ingrown toenail and facility staff passed the information to R1’s family. According to S1, R1’s family was advised to call a podiatrist because the facility is not allowed to provide podiatry care. Document review confirmed S1 did inform R1’s responsible party on more than one occasion to schedule an appointment so R1 can receive treatment for the ingrown toenail.

Based on the information gathered during interviews and document review, the allegations are deemed unfounded, meaning the allegations are false and could not have happened.

An exit interview was conducted, and a copy of this report was provided.

SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Jerome Haley
LICENSING EVALUATOR SIGNATURE:	DATE: 02/03/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2026

LIC9099 (FAS) - (06/04)

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