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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374603339
Report Date: 10/21/2025
Date Signed: 10/21/2025 12:31:35 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/23/2025 and conducted by Evaluator Valerie Flores
COMPLAINT CONTROL NUMBER: 18-AS-20250923103316
FACILITY NAME:MERIDIAN AT LAKE SAN MARCOS, THEFACILITY NUMBER:
374603339
ADMINISTRATOR:AMY BANAGAFACILITY TYPE:
740
ADDRESS:1177 SAN MARINO DR BLDG 1 & 2TELEPHONE:
(760) 510-7500
CITY:SAN MARCOSSTATE: CAZIP CODE:
92078
CAPACITY:170CENSUS: 131DATE:
10/21/2025
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Executive Director, Shaun McGuirk.TIME COMPLETED:
12:40 PM
ALLEGATION(S):
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Staff did not answer resident's call button in a timely manner
INVESTIGATION FINDINGS:
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On 10/21/2025, Licensing Program Analyst (LPA) Valerie Flores conducted an unannounced visit to the facility for the purpose of delivering investigative findings into the allegation listed above. The investigation consisted of interviews and records review.

Information received alleged facility staff did not answer Resident #2 (R2)’s call button in a timely manner. Information received from R2 alleged Resident #1 (R1) was observed choking in the dining room on 9/21/2025. R2 activated their pendant, and it took Staff #1 (S1) approximately 5 to 10 minutes to arrive for assistance. Interviews conducted with S1 and R1 reported that R1 was not choking and reported that R1 was coughing. Interviews conducted with R1 and S1 further reported that R1’s diagnosis may cause R1 to cough and R1 was not requiring assistance.

(Continue to LIC9099C)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Anthony Perez
LICENSING EVALUATOR NAME: Valerie Flores
LICENSING EVALUATOR SIGNATURE:

DATE: 10/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2025
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 18-AS-20250923103316
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: MERIDIAN AT LAKE SAN MARCOS, THE
FACILITY NUMBER: 374603339
VISIT DATE: 10/21/2025
NARRATIVE
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(Continuation from LIC9099)

Interview conducted with S1 confirmed they observed R1 was coughing and did not clear the R2’s pendant immediately as R2 advised S1 that R1 was the person requiring assistance. A records review conducted of the facility’s signal system recorded a 22-minute response time for an incident occurring on 09/25/2025. The signal system did not have an records of R2’s pendant being activated on 09/21/2025. LPA attempted to conduct an interview with R2 to obtain additional information but R2 declined. Therefore, the allegation is deemed unsubstantiated.

A finding that is determined unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. There were no deficiencies cited during today's visit.

Exit interview conducted and copy of report provided Executive Director, Shaun McGuirk.
SUPERVISORS NAME: Anthony Perez
LICENSING EVALUATOR NAME: Valerie Flores
LICENSING EVALUATOR SIGNATURE:

DATE: 10/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2