The Meridian at Lake San Marcos.

On 3/27/26, Licensing Program Analyst (LPA) Kyle Wellington made an unannounced visit to the facility to conduct an annual inspection. LPA met with the Administrator (Admin), Shaun McGuirk, who was informed of the purpose of the visit. Admin informed LPA there are 121 residents and 132 staff members at the facility. The facility has a fire clearance to serve 170 non-ambulatory residents of which 10 may be bedridden on the first floor only. The facility has an approved hospice waiver for 10 residents with 7 residents currently receiving hospice services. LPA received a resident and staff roster from the Admin. LPA did an observation of the inside and outside of the facility with the Admin and conducted record reviews for the inspection. The facility contains two (2) three story buildings for memory care and assisted living residents and one (1) two story commons building that contains a kitchen, dining room, activities rooms and common areas available for resident use. There are multiple outdoor shaded areas with seating. Indoor and outdoor passageways along with entrances and exits were free of obstructions. There is a swimming pool and spa on the property that is surrounded by a fence with locked gates. There are fire alarm systems, carbon monoxide detectors, and charged fire extinguishers throughout the facility. The fire extinguisher service tags noted the fire extinguishers were last serviced on 9/30/25. LPA reviewed the fire safety certificate performed by the San Marcos Fire Dept conducted on 6/18/25 noting the facility passed its fire safety inspection. LPA reviewed the facility's Fire/Disaster Drill noting the facility's last fire drill was conducted on 8/28/25. LPA observed the laundry and supply rooms to be locked and inaccessible to residents, LPA toured the kitchen and observed food prepared and stored in a safe and clean manner. The facility has a two day supply of perishable foods and a seven day supply of non perishable foods. LPA observed a white board with on the kitchen wall noting residents' food allergies and dietary needs. LPA observed medications secured in medication carts, only 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 accessible to authorized personnel such as nurses and medication technicians. LPA reviewed five staff and ten resident files. The files contained all the required documentation and paperwork. No deficiencies were cited during this visit. Exit interview was conducted with the Administrator and a copy of this report was given to the Administrator.

(Continuation from LIC9099) Interview conducted with R1 further detailed encounters with Resident #2 (R2) where R2 wanders the common areas and has attempted to open R1’s unit door but has not gained access to the unit as it required a key to open. R1 reports having a key to access their unit. R1 reports that all staff and residents are aware of R2’s actions as R2 is highly confused. R1 further reports that R2 nor any other resident have ever entered into R1’s room. Therefore, the complaint allegation of staff do not ensure adequate supervision is provided to residents in care is unfounded. A finding that the complaint is unfounded means that the allegation is false, could not have happened, and/or is without a reasonable basis. Exit interview conducted and copy of report provided Executive Director, Shaun McGuirk.

Licensing Program Analyst (LPA) Kathleen Banrasavong arrived unannounced to conduct an annual inspection. Upon arrival LPA was greeted by facility staff and granted entry. LPA began inspection with introduction and visit purpose. Upon arrival LPA learned that one- hundred and twenty-eight (128) residents live at this facility. The Executive Director, Amy Banaga was advised of the annual and conducted and completed the facility tour. Client Records/Incident Reports/Clients Rights Information: LPA reviewed client records. Ten (10) records were reviewed. LPA reviewed for identification and emergency information, admission agreement, medical assessment, and TB test results, needs and service plans, placement, functional assessment, centrally stored medication/destruction records, safeguard for personal property/valuables, and personal rights notification. Personnel Records/Training/ Staffing/ Administration : LPA reviewed employee records. Ten (10) records were reviewed. LPA reviewed employee records for first aid certification, criminal record clearance or an exemption, health screening and TB test results, employee rights, training verification, and current administrative organization. The Exceuctive Director, Amy Banaga, Administrator’s certificate expiration date was 09/25/2026 Food Service: Food prep areas are clean and organized. Food supply meets the requirement of one (1) week supply of nonperishable and two (2) day supply of perishables. Emergency food and water supply is present. There is a location for sharps in the kitchen. 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 Physical Plant and Safety of Environment/Operational Requirements: LPA toured the facility inside and outside. LPA observed the facility to be clean and in good repair. The facility is maintained at 75 degrees for the client’s comfort. Lighting is sufficient for safety. Water temperature measured 108.0 degrees F. Laundry is done in the designated laundry room. There is a location for storing laundry soap, cleaning supplies and chemicals in the closet in the Housekeeper’s closet. All outdoor and indoor passageways are free of obstruction. Emergency lighting is available. There is a telephone working at this location. LPA dialed the facility’s landline number, which rang and was operable. The LIC 610, emergency disaster plan is maintained. There are no firearms at this facility. There is one (1) secured fireplace at this facility. There is one (1) pool at the facility. It is secured with a gate surrounding the pool. LPA observed emergency supplies and several first aid kits throughout the facility. The last emergency fire drill was conducted on 02/26/2025. Infection Control: The LPA observed the hand washing stations in the facility restrooms and kitchen had hand hygiene supplies and hand washing signs. LPA observed PPE equipment and cleaning supplies to do regular cleaning of the facility. LPA reviewed the facility's infection control plan which met department requirements. LPA reviewed staff records and found that staff had infection control training. Medications/Health Related Services/Incidental Medical Services: The medications are centrally stored. There is a locked cabinet allocated for medication storage. Centrally stored medication and destruction logs are maintained separately. LPA reviewed medication logs and observed that they were dispensed accurately. LPA made observation throughout the inspection process to assess if the facility remains in conformity with the State Fire Marshall regulations. LPA observed several smoke detectors and carbon monoxide detectors that are hard wired throughout the facility. The system is monitored by Simplified Technologies, INC. The most current fire inspection was conducted on 07/10/2024. 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 Pursuant to Title 22 of The California Code of Regulations Division 6, there are zero (0) deficiencies observed. An exit interview was conducted, this LIC 809 was reviewed with, and a copy of this report was provided to Executive Director, Amy Banaga.

FC reported the facility also serves cold food that is traditionally consumed raw/undercooked such as sandwiches, wraps, salads, or vegetables. FC reported some residents have expressed differences in opinions regarding doneness of steaks/vegetables, but kitchen staff will remake the food in question and accommodate food preferences. FC was unable to recall complaints of food served cold/undercooked during the specific alleged timeframe. FC reported they have completed food safety training and ensure hot foods are cooked to safe minimum internal temperatures using food thermometers. Four (4) of six (6) resident interviews conducted refuted the allegations. One (1) of six (6) resident interviews conducted reported the food was never served undercooked, however, sometimes it was served on a cold plate which would make the food cool down faster. One (1) of six (6) resident interviews conducted explained if their food was cold or not prepared as ordered they would send it back to the kitchen and receive a replacement in a timely manner. Two (2) staff interviews conducted confirmed hot food is transported in food warmers and placed onto steamtables before being served to the residents. Administrator, Amy Banaga reported due to the lapse in time, the facility was unable to locate the California Food Handlers Cards or food safety training records for the kitchen or dining room staff who worked during the alleged incident timeframe. It was further alleged from approximately April 2022 to April 2023, dining tables shared by residents residing in Independent Living (IL), AL, and MCU were often sticky and not cleaned. The CDR was identified as the only dining room shared and accessible by residents residing in IL, AL, and MCU. LPA conducted an interview with Dining Room Supervisor (DRS) Victoria Taverna who reported being present during most of the alleged incident timeframe. DRS reported facility servers were responsible for bussing tables, wiping them with sanitizing spray, and resetting silverware and napkins for new residents. DRS recalled during breakfast or rush hours some residents would choose to sit at dirty tables where plates from the previous resident(s) had not been cleared, and tables had not been wiped despite clean tables being available. DRS reported facility servers bussed and disinfected tables in a timely manner. DRS was unable to recall any reports of dining room tables being sticky and not cleaned during the alleged timeframe. Six (6) residents were interviewed and refuted the allegations. One (1) of six (6) resident interviews conducted explained the CDR tables have placemats with slight rubberized backing which caused the placemats to adhere to the dining tables after wiping. One (1) of six (6) resident interviews conducted reported the dining tables and placemats did not feel greasy or appeared dirty and the placemats did not stick to the tables once the table tops air dried. 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 It was also alleged from approximately February 2023 to March 2023, the elevator shared by residents residing in IL, AL, and MCU made a loud banging noise. LPA conducted an interview with Maintenance Director (MD), Oliver Davila who identified the elevator in question as the club house elevator, also known as “car number 8”. MD was unable to recall the club house elevator being in disrepair specifically during the alleged incident timeframe. MD reported any issues with any of the elevators would have been addressed and repaired immediately. MD has not received complaints of the elevators making loud/unusual noises. MD reported the facility has an ongoing contract with Schindler Elevator Corporation (SEC) who has provided monthly preventative maintenance inspections and as needed repairs since 2012. LPA reviewed copies of SEC invoices confirming the preventative maintenance inspections during the alleged incident timeframe. MD reported the facility has always maintained a conveyance permit to operate all the elevators including the club house elevator. Administrator Banaga reported due to the lapse in time, the facility was unable to locate a copy of the club house elevator’s Conveyance Permit issued by the San Diego District Office for the alleged incident timeframe. Six (6) resident interviews conducted reported the club house elevator has never made unusual noises or been in disrepair for an extended period of time. One (1) of six (6) resident interviews reported the club house elevator may be the facility's most used elevator since it transports residents to the second floor to access the various activity rooms. One (1) of six (6) resident interviews conducted estimated the club house elevator to be in working order ninety percent of the time with maintenance working on it the remaining ten percent. During the investigation, LPA attempted to make contact with the reporting party to inquire about all the allegations but was unsuccessful. Although the allegations may have happened or are valid, there is no preponderance of evidence to prove the alleged violations did or did not occur; therefore, the allegations are unsubstantiated. An exit interview was conducted and a copy of this report was reviewed and provided to Administrator Banaga.

On March 08, 2024, Licensing Program Analyst (LPA), Venus Mixson conducted an unannounced annual required visit and met with Jessica Lane, Resident Services Director, who was informed of the purpose of the visit. The Facility File review was conducted in the Regional Office and additional forms were requested and reviewed on site. LPA Mixson toured the facility, along with the Resident Services Director, and inspected the inside and outside of the facility. The facility is comprised of five buildings two of which are licensed for memory care and assisted living. Each building is three stories with total capacity of 170 residents, 170 of which may be non-ambulatory, and ten of which may be bedridden on the first floor only. The residents served are elderly ages 60 and above. The Facility is located at 1177 San Marino Dr San Marcos, CA. 92078, and the facility phone number is (760) 510-7500, and is operable. Infection Control: The LPA observed the hand washing stations in the facility restrooms and kitchen. LPA Mixson observed gloves and cleaning supplies to do regular cleaning of the facility. The LPA reviewed the facility's infection control plan and found all required infection control measures. LPA Mixson observed PPE supplies at the facility. The LPA reviewed infection control training conducted with facility staff which met the department requirements. Physical Plant/Planned activities: LPA Mixson observed the resident living units. Physical plant, floors, windows, and doors were observed to be clean. Fixtures and furniture were in good repair and were present. The outdoor area was observed to be free of hazards. There is a pool that is locked with resident in assisted living having a key to access. The laundry room was observed to be locked. The hot water temperature was recorded and logged within regulations. Food Service: LPA Mixson observed facility kitchen had the ability to prepare food in clean environment and possessed equipment in good working condition. The LPA observed the facility met the required two day supply of perishable and seven day supply of non-perishable foods. Care & Supervision : adequate per facility type and within the regulations. Records Review: The LPA reviewed staff and resident files, conducted staff and residents interviews, and reviewed Previous Community Care Licensing forms. There were no Title 22, Division 6 Regulation violations observed or cited during today’s visit. An exit interview was conducted, and a copy of this report was provided to Resident Service Director, Jessica Lane.

On September 29, 2023, Licensing Program Analyst (LPA), Venus Mixson arrived unannounced to the facility to conduct a follow up, Health and Safety case management visit. LPA Mixson met with Jessica Lane. LPA Mixson toured the facility along with the Resident Services Director, Jessica and requested and received pertinent documentation. LPA Mixson observed facility clean, neat, and well organized. The utilities were observed to be on and operating without issue. There was a sufficient amount of staff present at the facility to provide assistance to the residents as needed. LPA Mixson assessed the available food supply and observed the supply exceeds the requirement of a two day supply of perishable foods and a seven day supply of non-perishable foods. Medications were found to be in sufficient supply and locked on med carts and in the med room. There were no Health and/or Safety concerns observed while conducting the tour of the facility at this time. The facility had the required Regulation postings. The LPA observed an activities schedule, the resident council minutes and schedule of the next meetings. LPA Mixson observed the environment was positive and the residents were welcoming and greeting staff and visitor who arrived. Based on the information obtained during today's visit, there are no immediate threats to the health, safety, and/or the welfare of the residents in care. No deficiencies were cited during today's visit. An exit interview was conducted and a copy of this report, along with the LIC 811, and a Site Visit Appeals Right, was provided to Jessica Lane.