306005986-3-28-2026-22-AS-AORZ-DT7TEF-20260416143951

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306005986
Report Date: 03/28/2026
Date Signed: 03/28/2026 11:21:23 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
02/24/2025 and conducted by Evaluator Samer Haddadin

COMPLAINT CONTROL NUMBER: 22-AS-20250224143848

FACILITY NAME:	ACTIVCARE LAGUNA HILLS		FACILITY NUMBER:	306005986
ADMINISTRATOR:	MILLER, PATRICIA		FACILITY TYPE:	740
ADDRESS:	25200 PASEO DE ALICIA		TELEPHONE:	(858) 565-4424
CITY:	LAGUNA HILLS	STATE: CA	ZIP CODE:	92653
CAPACITY:	72	CENSUS: 51	DATE:	03/28/2026
		UNANNOUNCED	TIME BEGAN:	08:46 AM
MET WITH:	Patricia Miller		TIME COMPLETED:	03:45 PM

ALLEGATION(S):

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Staff are restraining resident
Staff gave resident the wrong medication
Staff do not serve food of nutricious quality

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 and deliver findings. Upon arrival, LPA was greeted by staff, granted entry, and later met with Executive Director (ED) Patricia Miller, who was informed of the purpose of the visit. During the visit, LPA toured the facility, interviewed staff and residents, and obtained copies of relevant documents.
The allegations investigated were “Staff are restraining resident,” “Staff gave resident the wrong medication,” and “Staff do not serve food of nutritious quality.”
Regarding the allegation, “Staff do not serve food of nutritious quality,” LPA interviewed five staff members and attempted to interview five residents. All five staff members denied the allegation. The residents were unable to provide reliable statements due to their current medical and cognitive condition.
{***CONTINUE9099C***}

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Samer Haddadin
LICENSING EVALUATOR SIGNATURE:	DATE: 03/28/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2026

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-20250224143848

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: ACTIVCARE LAGUNA HILLS	FACILITY NUMBER: 306005986
	VISIT DATE: 03/28/2026

NARRATIVE

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During the health and safety walk-through, LPA did not observe any concerns related to the allegation. LPA observed residents eating lunch, and the menu reflected that lunch included a turkey sandwich or grilled chicken sandwich and mixed fruit.
Regarding the allegation, “Staff gave resident the wrong medication,” LPA interviewed five staff members, all of whom denied the allegation. LPA also conducted a telephone interview with Resident 1’s responsible party (R1’s RP), who advised that R1 had never been given the wrong medication. LPA was unable to obtain reliable resident interviews because the residents were unable to provide consistent statements due to their current medical and cognitive condition. In addition, LPA observed the medication administration process and noted that the Medication Technician verified the resident’s name against the prescription label and the resident’s photograph on the screen before administering medication.
Regarding the allegation, “Staff are restraining resident,” LPA did not observe any physical signs on any resident, such as bruising or other visible marks that would indicate possible restraint or abuse. LPA also interviewed five staff members, all of whom denied the allegation. In addition, LPA conducted a telephone interview with R1’s responsible party, who stated that R1 had never been restrained.
Based on interviews, observations, and record review, the Department was unable to determine that the allegations occurred as reported. Although the allegations may have happened or may be valid, there is not a preponderance of evidence to prove or disprove that the alleged violations occurred. Therefore, the allegations are deemed unsubstantiated. An exit interview was conducted Executive Director (ED) Patricia Miller and a copy of this report was provided.

SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Samer Haddadin
LICENSING EVALUATOR SIGNATURE:	DATE: 03/28/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2026

LIC9099 (FAS) - (06/04)

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