Ivy Park at Mission Viejo.

Based on the rosters dated January 18, 2024 and April 6, 2026, five of six residents were residing at the facility at the time when the complaint was reported. All five residents denied witnessing named incident. Six of six residents indicated that staff treat them with respect and dignity while one out of the six residents stated that a few caregivers are mean, moody, and less engaged. Three of three staff denied the allegation indicating that the residents are treated like family. Based on LPA's observation on January 18, 2024 and on today's date, staff were observed treating residents respectfully and with a smile. Regarding the allegation, Staff does not assist residents with toileting, it is alleged that the residents are not assisted with wiping after toileting. Based on the six memory care resident interviews, five of six residents stated that they are independent. Based on the review of the ISPs, two of the six residents require full toileting assistance; however, both residents were unable to provide clear answers to the questions asked due to their medical condition. LPA was unable to further determine if residents are being assisted with wiping after toileting. Interviews with staff revealed three of three staff denied the allegation indicating that residents needed to be wiped after toileting if toileting assistance is part of their plan of care. Regarding the allegation, Residents' hygiene needs are not being met, it is alleged that caregivers are lax in making sure that residents wash their hands after going to the bathroom resulting in a couple residents contracting a urinary tract infection. Based on the six memory care resident interviews, one of six residents indicated requiring assistance with grooming and bathing/showering while the remaining residents indicated being independent. LPA was unable to obtain further details of their hygiene care for one resident due to their medical condition. Based on the review of the ISPs, four of six residents either require a full or stand-by assist. Because five of six residents reported being independent, LPA was unable to conclude that their hygiene needs were not being met. Three of three staff interviewed denied the allegation. Regarding the allegation, Facility does not have adequate staffing to meet residents' needs, it is alleged that ratio of caregivers to residents is too low resulting in the lack of providing proper supervision to residents. LPA conducted a walk through of the memory care building on January 18, 2024. LPA observed staff in the common area supervising residents on January 18th and on today's date. The census in the memory care unit is 45 per the roster dated April 6, 2026 and 39 per the roster dated January 18, 2024. LPA observed six staff on duty on both dates. Based on the interviews, six of six residents and three of three staff denied the allegation. Two of three staff reported that when the facility experiences inadequate staffing for the day, the activity aide, medication technician, and/or memory care director would assist as back up. 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 Three of three staff reported that the residents care are/have not been affected. Therefore, based on the observations made, interviews which were conducted, and the records that were reviewed, although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the following allegations: Staff does not treat residents with dignity and respect, Staff does not assist residents with toileting, Residents' hygiene needs are not being met, and Facility does not have adequate staffing to meet residents' needs are deemed UNSUBSTANTIATED. An exit interview was conducted with Business Office Director Joan Shattler, and a copy of this report was provided at exit

Licensing Program Analysts (LPAs) Kimberly Lyman and Andrea Mendivil conducted an unannounced visit to Ivy Park at Mission Viejo. The purpose of today’s visit was to conduct the annual required visit. Facility is licensed for 150 non-ambulatory residents of which 8 may be bedridden in designated rooms. Facility has an approved hospice waiver for 50 residents and the facility has 72 residents in assisted living and 43 in memory care. There are 8 residents on hospice. Administrator Foudil Manadi has an administrator certificate expiring on 01/28/2027 LPAs Lyman and Mendivil along with Administrator Manadi toured the facility at 9:28 AM. LPAs toured the physical plant, checked food service, facility records and the first aid kit. The facility consists of two stories in the main building including a library, bistro, cinema room, game room and hair salon. Memory care is a single story detached building. Resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. Resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure and shower was free of mold/mildew. Water temperature measured between 108 degrees F and 117.8 degrees F in all restrooms. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked. Emergency pull cord response times were immediate. Common areas were clean and clear of hazards, doorways were free of obstructions. Perishable and non-perishable food supply was checked and adequately stocked at time of visit. Facility had posted appliance temperatures and all were in range. Dining room has varied menu choices for residents. Smoke detectors and fire/ sprinkler inspections are conducted by a third party, Quick Response Fire Protection with the last inspection on 04/16/2025. Fire extinguishers were fully charged. LPAs reviewed the emergency disaster plan and plan is thorough and complete. Facility conducts emergency drills with the last drill conducted on 03/04/2026. CONTINUED ON LIC 809C DATED 03/26/2026 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 LPAs observed ample emergency food and water. Outside grounds were toured. LPAs observed outside patio areas for both assisted living and memory care. There is ample outdoor shaded seating for residents. Walkways around the facility were clear of hazards. There are no security bars or weapons on the premises. LPAs observed residents participating in activities and facility offers an array of activities including outings in the community. First aid kit contained all required items including tweezers, scissors and thermometer. LPAs reviewed ten resident files and six staff files. All resident files contained required documentation including admission agreements, physician reports and resident appraisals. Staff files reviewed contained required documentation including required annual training, medical assessment, criminal record clearance and proof of CPR training. LPAs reviewed medication administration and storage. Medications are stored in locked medication carts and facility utilizes an electronic medication administration record. Medications appear to be administered per physician order. Based on the observations made during today's visit, NO deficiencies are being cited. Exit interview conducted and a copy of this report was left at the facility.

CONTINUED FROM FORM LIC9099 Regarding the allegation that Staff is providing an unknown medication causing residents to choke , the following has been concluded: Based on a review of resident records for a random selection of five residents along with a review of medication on hand in the medication central storage, it was verified that all medication administered to residents under medication management by staff had been adequately prescribed and were adequately labelled. No evidence of additional medication not under physician orders was found during the investigation. Regarding the allegation that Staff harasses resident , the following has been concluded: A resident interview conducted with the alleged victim of staff harassment conducted in a confidential manner did not evidence any actual instance of harassment. Resident interviewed made statements to the contrary and told LPA that staff was treating them well. Witness interviews were attempted and did not bring forward any evidence of harassment either. Regarding the allegation that Staff did not inform responsible party of incident , the following has been concluded: Charting notes reviewed for five random residents failed to provide evidence of incidents that had failed to be reported to the appropriate responsible parties. Fall incidents for resident R1 were adequately documented as well as reported to the Department and the resident's responsible party as required. All other instances observed in the charting notes were also reported adequately as confirmed by fax receipts present on file. Based on the evidence gathered during the present investigation, all three allegations are found to be Unsubstantiated, meaning that although the allegations may have happened or are valid, there is not a preponderance of evidence to prove or refute the alleged violations occurred. An exit interview was conducted with the facility and a copy of the report was provided to a facility representative.

Licensing Program Analyst (LPA) Kimberly Lyman conducted an unannounced visit to Ivy Park at Mission Viejo. The purpose of today’s visit was to conduct the annual required inspection. LPA was allowed entry into the facility and explained the reason for the visit. Facility is licensed for 150 non-ambulatory residents. Facility has an approved hospice waiver for 50 residents and the facility has 80 residents in assisted living and 36 in memory care. There are 8 residents on hospice. Administrator Foudil Manadi has an administrator certificate expiring on 01/28/2027 LPA Lyman along with Administrator Manadi toured the facility at 11:02 AM. LPA toured the physical plant, checked food service, facility records and the first aid kit. The facility consists of two stories in the main building including a library, bistro, cinema room, game room and hair salon. Memory care is a single story detached building. Resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. Resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure and shower was free of mold/mildew. Water temperature measured between 106.1 degrees F and 114.8 degrees F in all restrooms. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked. Emergency pull cord response times were under five minutes. Common areas were clean and clear of hazards, doorways were free of obstructions. Perishable and non-perishable food supply was checked and adequately stocked at time of visit. Facility had posted appliance temperatures and all were in range. Dining room has varied menu choices for residents. Smoke detectors and fire/ sprinkler inspections are conducted by a third party, Quick Response Fire Protection with the last inspection on 01/01/2025. Fire extinguishers were fully charged. LPA reviewed the emergency disaster plan and plan is thorough and complete. Facility conducts emergency drills with the last drill conducted on 03/04/2025. LPA observed ample emergency food and water. Outside grounds were toured. LPA observed outside patio areas for both assisted living and memory care. There is ample outdoor shaded seating for residents. Walkways around the facility were clear of hazards. There are no security bars or weapons on the premises. LPA observed residents participating in exercise and movies and facility offers an array of activities including outings in the community. CONTINUED ON LIC 809C DATED 03/19/2025 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 First aid kit contained all required items including tweezers, scissors and thermometer. LPA reviewed ten resident files and six staff files. All resident files contained required documentation including admission agreements, physician reports, resident appraisals, and physician orders for bed rails as indicated. Staff files reviewed contained required documentation including required annual training, medical assessment, criminal record clearance and proof of CPR training. At 3:00 PM, LPA reviewed medication administration and storage. Medications are stored in locked medication carts and facility utilizes an electronic medication administration record. Medications are being administered per physician order. Based on the observations made during today's visit, NO deficiencies are being cited. Exit interview conducted and a copy of this report was left at the facility.

new hires will come on board within this week. The facility staff schedule reflects that there is three shifts per day. Schedule from December 31, 2023 to June 08, 2024 reflect the following on each shift: AM shift has anywhere from 4-7 caregivers, 1 medtech, 1 activity coordinator, and 1 memory care director. PM shift has anywhere from 4-7 caregivers, 1 medtech, and 1 memory care director. NOC shift has anywhere from 2-3 caregivers, and a medtech. All shifts have a nurse on board as well. Interview with Executive Director indicated that all shifts have caregivers, a nurse and a medtech scheduled per shift. Title 22 regulation 87411(a) Personnel Requirements-General states: Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs. In facilities licensed for sixteen or more, sufficient support staff shall be employed to ensure provision of personal assistance and care as required in Section 87608, Postural Supports. Additional staff shall be employed as necessary to perform office work, cooking, house cleaning, laundering, and maintenance of buildings, equipment, and grounds. The licensing agency may require any facility to provide additional staff whenever it determines through documentation that the needs of the particular residents, the extent of services provided, or the physical arrangements of the facility require such additional staff for the provision of adequate services. LPA toured the memory care unit and observed residents in the living room and dinning room. LPA observed 5-6 staff assisting resident with their needs and observed 1 caregiver assisting a resident in their bedroom with hygiene needs. Interview with 2 of 2 staff revealed that they like to staff the memory care unit with a minimum of 4 caregivers on each shift, however the shift has 5-7 caregivers at one time. There are always nurses on board in assisted living and memory care unit that helps as needed when needed. The facility staff are cross trained and everyone at the facility is very hands on and fills in as needed when it is required to do so. The schedule for the memory care unit is always staffed to make sure that each shift is fully staffed. Based on the information gathered during the investigation, 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. This report was reviewed with Executive Director and a copy was furnished to the facility.

Licensing Program Analyst (LPA) Kimberly Lyman conducted an unannounced case management visit to follow up on incident reports dated 04/24/2024 and 04/28/2024. LPA was greeted and granted entry into the facility and explained the reason for the visit. Incident report dated 04/24/2024 indicated Staff 1 (S1) witnessed S2 driving the staff's fist into Resident 1's (R1) stomach. Incident report dated 04/28/2024 indicated R1 had reported to family that S2 had punched the resident three times in the stomach. Resident was assessed to have no injuries. OC Sheriff was called and responded with case numbers #24-014481 and 24-014879. Staff 2 was immediately put on suspension pending investigation. During the visit, LPA interviewed three staff and one out of three confirm the incident. Per physician report dated 08/25/2023, Resident is diagnosed with Dementia. The investigation remains ongoing. Exit interview conducted and a copy of this report was left at the facility.

Based on record review and interviews conducted, the department has determined the facility did seek timely medical treatment for the resident. Therefore the allegation is deemed unfounded meaning the allegation is false could not have happened and/or is without a reasonable basis. Exit interview conducted with Administrator and a copy of this report was left at the facility.

Licensing Program Analysts (LPAs) Kimberly Lyman and Michael Tea made an unannounced visit to conduct the required annual inspection. LPAs met with Executive Director (ED) Foudil Manadi and explained the reason for the visit. Facility consists of two buildings in which one is for Assisted Living (AL) and the other for Memory Care (MC). The capacity is 150 non-ambulatory and a hospice waiver for eight. There are currently a total of 103 residents, thirty three of them are in memory care. Foudil Manadi Administrator's Certificate expires on January 28, 2025. LPAs observed the PUB 475 poster (See Something, Say Something Poster) posted in the front entry way and another one posted by the resident mail box. The PUB 475 poster posted is 20" X 26." Around 9:46 AM, LPAs and ED Manadi toured the facility. LPAs observed the kitchen is clean and organized. There is a two day supply of perishable food and a seven day supply of non-perishable food on-hand in the kitchen. LPAs and ED toured resident rooms on the first and second floors in AL. LPAs and ED toured the resident rooms in the MC building. LPAs inspected ten resident rooms. All resident rooms had the required furnishings. All resident bathrooms were clean and operational. LPAs tested the emergency pendants and observed the staff came promptly when alerted. The hot water in the ten resident rooms inspected measured 102 degrees Fahrenheit to 119 degrees Fahrenheit. LPAs observed residents participating in dancing exercises and memory games. There is fitness room and activities room for all residents. There is an outdoor courtyard in both buildings for residents to sit outside. Memory Care outdoor area had vegetable and fruit garden. There are fire extinguishers on every floor and all fire extinguishers are fully charged. LPAs observed emergency evacuation chairs in each stairwell. The last emergency fire drill was conducted on April 13, 2024. The delayed egress tested operational in the MC Building. The fire safety system is inspected annual every year, the last inspection was 4/19/23. The fire safety system is monitored electronically throughout the year. Around 11:00 AM after the facility tour, LPAs reviewed ten resident files with no discrepancies. All resident files had the required documents. Afterwards LPAs reviewed ten staff files with no discrepancies observed. All staff files reviewed had current CPR/First Aid training. Annual Report cont on LIC-809C 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 All direct care staff files reviewed met training requirements. At around 1:30 PM, LPAs inspected medication and medication administration records (MAR) for ten residents. No discrepancies observed. LPAs observed medications are kept secured in a medication cart that is locked in a medication room. LPAs observed the first aid kits to have all the required components and a first aid book at hand. LPAs interviewed staff and residents. No obstacles or hazards were noted inside or outside of the facility. Based on the observations made during today's visit, no deficiencies are being cited as a result of this visit. An exit interview was conducted and a copy of the report provided.

admits to behavior that may have been misconstrued. Based on record review and interviews conducted, the department has determined the eviction notice was properly given. Therefore the allegation is deemed unfounded meaning the allegation is false could not have happened and/or is without a reasonable basis. Exit interview conducted with Administrator and a copy of this report was left at the facility.