306006223-5-22-2026-22-AS-LMOA-DUUPXU-20260608114254

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306006223
Report Date: 05/22/2026
Date Signed: 05/22/2026 02:21:05 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
02/28/2025 and conducted by Evaluator Jenifer Tirre

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20250228160500

FACILITY NAME:	IVY PARK AT LAGUNA WOODS		FACILITY NUMBER:	306006223
ADMINISTRATOR:	TURGEON, JENNIFER		FACILITY TYPE:	740
ADDRESS:	24441 CALLE SONORA		TELEPHONE:	(949) 830-8057
CITY:	LAGUNA WOODS	STATE: CA	ZIP CODE:	92637
CAPACITY:	233	CENSUS: 188	DATE:	05/22/2026
		UNANNOUNCED	TIME BEGAN:	08:32 AM
MET WITH:	Executive Director Zehra Syed		TIME COMPLETED:	02:45 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Facility is without power

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA) Jenifer Tirre made an unannounced visit to deliver findings into complaint investigation. During investigation, Department conducted tour, gathered & reviewed documents as well as conducted interviews with Staff and residents. The following was based on information gathered from investigation.

Based on record review, Incident Report dated 2/28/2025, stated that Fire Department arrived at facility to check on smoke that was coming from main breaker panel near garage area. Report stated that power went out in facility approximately at 3:30AM. Report stated that Southern California Edison also came out and shut off main power to entire building for purposes of electrician to work on panel. At 6:45AM, same day 2/28/2025, Business Office Director had sent out email blast to residents informing of power outage, stating that facility was working on restoring issue as soon as possible, asking residents to remain in apartments for delivery of meals.
CONTINUED ON 9909-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Jenifer Tirre
LICENSING EVALUATOR SIGNATURE:	DATE: 05/22/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2026

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-20250228160500

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 AT LAGUNA WOODS	FACILITY NUMBER: 306006223
	VISIT DATE: 05/22/2026

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

On 5/5/2025, Executive Director sent out letter notifying residents of a scheduled power shut off on 5/7/2025 from 10:00am to 2:00pm to help assist with repairs to power outage that occurred on 2/28/2025, letter mentioned that elevators wont be working during scheduled time and meals were being delivered to resident apartments.

Based on interviews with staff, two of seven staff stated that facility had a unexpected power outage early in the AM on 2/28/2025, both staff members stated that facility power was out the entire day due to electrician working on panel with damaged gear which had over smoked. Staff members stated that residents & responsible parties were informed same day via emails and flyers on door that power was out and facility was working on the issue. Staff interviews stated that facility does not have a backup generator but provided meals to apartments, facility had portable generator power packs available to recharge assistive devices and emergency lighting was available in hallways of each floor. Four of seven staff stated they did not recall power outage on 2/28/2025 but stated that when facility has scheduled power outages, facility protocol is to provide meals to resident apartments, medications to residents, flashlights, and notifications regarding outage. Staff interviews stated that staff are assigned on each floor and check in on residents every hour, especially those who are oxygen dependent and fall risk.

Interviews with residents stated that one of nine residents stated that facility had power outage on 2/28/2025 and staff did not inform residents reason or proper updates on outage. Seven of Nine residents interviewed recalled power outage and stated that Facility communicated with flyers on doors and emails about outage. Seven of nine residents stated that meals were delivered to resident rooms for those who stood in place inside apartments, and staff went door to door providing safety checks & flashlights. Eight of Nine residents stated that facility staff does a good job communicating with residents during incidents whether scheduled or unexpected and has no concerns with the care that is being provided.

Based on information gathered from complaint, the allegation Facility is without power was deemed Unsubstantiated meaning that although the allegation may have happened or is valid, there is no preponderance of evidence to prove or refute the alleged violation did or did not occur as reported.

An exit interview was conducted with Executive Director Zehra Syed and copy of report was provided.

SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Jenifer Tirre
LICENSING EVALUATOR SIGNATURE:	DATE: 05/22/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2026

LIC9099 (FAS) - (06/04)

Page: 2 of 2