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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306006233
Report Date: 07/14/2025
Date Signed: 07/14/2025 11:11:35 AM

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
07/08/2025 and conducted by Evaluator Ruth Martinez
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20250708122727
FACILITY NAME:IVY PARK OF WELLINGTONFACILITY NUMBER:
306006233
ADMINISTRATOR:DAVID ARMOURFACILITY TYPE:
740
ADDRESS:24962 CALLE ARAGONTELEPHONE:
(562) 865-9500
CITY:LAGUNA WOODSSTATE: CAZIP CODE:
92637
CAPACITY:220CENSUS: 168DATE:
07/14/2025
UNANNOUNCEDTIME BEGAN:
07:20 AM
MET WITH:David ArmourTIME COMPLETED:
11:40 AM
ALLEGATION(S):
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Licensee is violating the fire clearance.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Ruth Martinez conducted an unannounced initial 10-Day complaint visit to initiate the investigation into the above allegation and to deliver the findings of the investigation. LPA was greeted and granted entry into the facility by the receptionist. LPA met with Executive Director/Administrator David Armour. LPA explained the reason for the visit.

Findings are based upon this investigation which included facility file review, tour of the physical plant of the facility and interviews conducted.

It is alleged the license is violating the fire clearance, more specifically to non-ambulatory resident living and/or moving into the third and fourth floor of the facility. LPA obtained copies of the LIC850 Fire Safety

Continued on LIC9099-C
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Ruth Martinez
LICENSING EVALUATOR SIGNATURE:

DATE: 07/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/14/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 2
Control Number 22-AS-20250708122727
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: IVY PARK OF WELLINGTON
FACILITY NUMBER: 306006233
VISIT DATE: 07/14/2025
NARRATIVE
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Inspection approved July 3, 2023, by Orange County Fire Authority approved/granted for 92 ambulatory, 120 nonambulatory and 8 bedridden residents. The Special conditions notated are as follows, bedridden approved for the following rooms: B107, B109, B111, B112, B113, D201, D202, and D203. Delayed egress doors for memory care ward only. Interview with facility Administrator stated that the facility has ambulatory and non-ambulatory residents on all floors of the facility considering that fire clearance has no restrictions on any floors. The only restrictions that the fire clearance has are the specific room for bedridden residents, to which the facility currently has no bedridden residents.

We have found the complaint allegation is unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. We have therefore dismissed the complaint.

An exit interview was conducted with the Executive Director and a copy of this LIC9099 report was left at the facility.
SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Ruth Martinez
LICENSING EVALUATOR SIGNATURE:

DATE: 07/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/14/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2