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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197608079
Report Date: 04/20/2022
Date Signed: 04/20/2022 02:46:22 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/14/2022 and conducted by Evaluator Kruz Long
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20220414111210
FACILITY NAME:HEIGHTS SENIOR CARE, THEFACILITY NUMBER:
197608079
ADMINISTRATOR:SAYDA NAZ HAIFACILITY TYPE:
740
ADDRESS:690 PICAACHO DRIVETELEPHONE:
(562) 228-3063
CITY:LA HABRA HEIGHTSSTATE: CAZIP CODE:
90631
CAPACITY:6CENSUS: 5DATE:
04/20/2022
UNANNOUNCEDTIME BEGAN:
12:50 PM
MET WITH:Sayda Naz Hai (Administrator)TIME COMPLETED:
03:00 PM
ALLEGATION(S):
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Residents smoke weed on the premises.
Facility is violating resident’s personal rights.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Kruz Long conducted an unannounced complaint investigation visit at the facility. Upon arrival, LPA met with Sayda Naz Hai (Administrator) and explained the purpose of the visit.

During today's visit, LPA obtained a copy of the Staff/Resident rosters, Resident #1's Physician's Report and Preplacement Appraisal, interviewed Staff #1 and #2 in the living room between 1:10 pm to 1:25 pm, toured the facility with Staff #2 at 1:30 pm, interviewed Residents #1 to #5 in various locations of the facility between 1:35 pm to 2:25 pm.

In regards to the allegation: Residents smoke weed on the premises. During a tour of the facility, LPA did not observed weed or notice the odor of weed. Interviews with Staff #1 and #2 indicate they are not aware or witnessed any Residents smoking or in position of weed. Interviews with Residents #1 to #5 indicate that they are not in position of or smoke weed in the facility.
Continue to LIC9099C.......
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Fernando FierrosTELEPHONE: (323) 981- 3981
LICENSING EVALUATOR NAME: Kruz LongTELEPHONE: (323) 383-8117
LICENSING EVALUATOR SIGNATURE:

DATE: 04/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/20/2022
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 28-AS-20220414111210
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: HEIGHTS SENIOR CARE, THE
FACILITY NUMBER: 197608079
VISIT DATE: 04/20/2022
NARRATIVE
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In regards to the allegation: Facility is violating resident’s personal rights. Interviews with 2 of 2 Staff indicate that Residents are allow to leave the facility. There is no curfew but Residents are encouraged to tell Staff where they are going and when they will be back to facility. Interviews with 5 of 5 Residents indicate that they are free to leave the facility as they please and Staff encourages them to be back to the facility at a certain due to safety concerns.

Based on LPA's observations and interviews, investigation revealed: Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are unsubstantiated.

Exit interview conducted with Sayda Naz Hai (Administrator) and a copy of this report provided.
SUPERVISOR'S NAME: Fernando FierrosTELEPHONE: (323) 981- 3981
LICENSING EVALUATOR NAME: Kruz LongTELEPHONE: (323) 383-8117
LICENSING EVALUATOR SIGNATURE:

DATE: 04/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/20/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2