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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306006233
Report Date: 09/22/2025
Date Signed: 09/22/2025 01:02:09 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
08/28/2025 and conducted by Evaluator Ruth Martinez
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20250828135635
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: 163DATE:
09/22/2025
UNANNOUNCEDTIME BEGAN:
12:50 PM
MET WITH:Brenda Myers, Interim Executive DirectorTIME COMPLETED:
01:30 PM
ALLEGATION(S):
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Staff left resident unattended on toilet with no clothes on for an extended amount of time.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Ruth Martinez conducted an unannounced visit to the facility to conclude investigation to the above identified complaint allegation. LPA arrived at the facility and was greeted at the door and granted entry. LPA spoke with Brenda Myers, Interim Executive Director and explained the purpose of the visit.

Findings are based upon this investigation which included tour of the facility, facility file review, resident file review and interviews conducted.
It is alleged that staff left resident unattended on the toilet with no clothes on for an extended amount of time. The interview with staff stated that on August 27, 2025, resident (R1) was being assisted with toileting needs, physical therapist arrived to R1’s apartment and did not knock and proceeded to walk in.

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

DATE: 09/22/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2025
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-20250828135635
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: 09/22/2025
NARRATIVE
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R1 was undressed when physical therapist walked in and staff covered R1 with body and asked for them to wait. Staff stated that R1 was not left unattended. The interview with R1 stated that staff assist them with their needs, but there was an incident that happened where they were assisted with changing clothes and toileting needs when therapist walked in without knocking and was uncomfortable. Staff told therapists to please wait while they finished assisting me. Resident stated that they were not left unattended and staff finished helping them get dressed so they can do therapy.

Based on the information mentioned above, the Department is unable to ascertain if the allegation occurred as reported. Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove or refute the alleged violation occurred; therefore, this allegation is deemed Unsubstantiated.

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

DATE: 09/22/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2