198600456-7-16-2026-11-AS-PMAA-DWFUXC-20260729155806

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198600456
Report Date: 07/16/2026
Date Signed: 07/16/2026 03:37:12 PM

Substantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

This is an official report of an unannounced visit/investigation of a complaint received in our office on
07/06/2026 and conducted by Evaluator Socorro Leandro

COMPLAINT CONTROL NUMBER: 11-AS-20260706132253

FACILITY NAME:	HERITAGE BOARD & CARE #2		FACILITY NUMBER:	198600456
ADMINISTRATOR:	MARILEE CRUZ		FACILITY TYPE:	735
ADDRESS:	2445 PACIFIC AVENUE		TELEPHONE:	(562) 900-6334
CITY:	LONG BEACH	STATE: CA	ZIP CODE:	90806
CAPACITY:	18	CENSUS: 18	DATE:	07/16/2026
		UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Licensee/Administrator - MARILEE CRUZ		TIME COMPLETED:	03:40 PM

ALLEGATION(S):

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Staff did not ensure clients received necessary medical attention.

INVESTIGATION FINDINGS:

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On 07/16/2026, Licensing Program Analyst (LPA) Socorro Leandro conducted an unannounced continuation complaint investigation visit regarding the allegation listed above. LPA met with the House Manager, Rodney J. Kelley, and the purpose of the visit was explained. LPA was granted entry to the facility.

Investigation consisted of the following:

On 07/06/2026, Witness 1 (W1) was interviewed. On 07/14/2026, interviews were conducted, records were gathered and reviewed. Interviews conducted consisted of Witness 2 (W2), Staff 1 (S1) to Staff 5 (S5), and Resident 1 (R1) to Resident 4 (R4). Records gathered consisted of employee roster, resident roster, Resident 1’s (R1) records, and other pertinent records were provided/reviewed. On 07/16/2026, Staff 6 (S6) was interviewed.

Substantiated

Estimated Days of Completion:

SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Socorro Leandro
LICENSING EVALUATOR SIGNATURE:	DATE: 07/16/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2026

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 11-AS-20260706132253

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: HERITAGE BOARD & CARE #2	FACILITY NUMBER: 198600456
	VISIT DATE: 07/16/2026

NARRATIVE

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The investigation revealed the following:

Allegation: “Staff did not ensure clients received necessary medical attention”, it is being alleged that R1 sustained visible injuries on 06/30/2026 and staff did not ensure R1 received timely medical attention.

Interviews conducted with R1 to R4 revealed the following: 2 out of 4 residents agreed with the allegation, furthermore, R1 indicated that on 06/30/2026 they informed S2 that they had an accident, and on 07/01/2026, W1 took them to the doctor, additionally, a resident indicated that they observed S2 working and staff did nothing to assist R1 on 06/30/2026. 2 out of 4 residents did not know if said allegation occurred or did not occur. 3 out of 4 residents indicated that they observed R1 with visible injuries on their face.

Interviews conducted with S1 to S6 revealed the following: 6 out of 6 staff denied the allegation, moreover, staff indicated that they had not observed visible injuries on R1 on 06/30/2026 and in the morning of 07/01/2026, furthermore, staff indicated that R1 did not inform them of an accident nor request any medical attention. Additionally, a staff indicated that when they spoke with staff, staff acknowledged that on the morning of 07/01/2026, they observed a bruise on R1’s face. The Licensee/Administrator indicated that their staff did not inform the main office nor them that R1 had visible injuries on their face, they went on to explain, that they found out about the incident through R1’s caseworker.

Interviews conducted with W1 to W2 revealed the following: 2 out of 2 witnesses agreed with the allegation. W1 indicated that they came to the facility on 07/01/2026 at around 9:00 AM because R1 had a medical appointment at around 10:00 AM. W1 goes on to explain that they observed R1 with bruising on their face, hands, and foot, moreover, W1 indicated that they informed the facility Licensee/Administrator of the situation, furthermore, W1 went with R1 to their medical appointment. W2 a medical professional explains that on 07/01/2026 at 10:15 AM, R1 had an appointment and they saw R1 and W1 at the appointment; W2 explained that the bruising on R1’s face looked really bad – the whole face looked bad; medical staff took pictures of the face; medical staff checked bones toward his mouth; there was no notification prior to the appointment; medical staff informed R1 and W1 that they needed to follow up with urgent care for x-rays on the face and foot; the foot was pretty bad; the facility has not contacted us for follow up visits.

SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Socorro Leandro
LICENSING EVALUATOR SIGNATURE:	DATE: 07/16/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2026

LIC9099 (FAS) - (06/04)

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Control Number 11-AS-20260706132253

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: HERITAGE BOARD & CARE #2	FACILITY NUMBER: 198600456
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/16/2026

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 08/03/2026 Section Cited CCR 80075(a)	1 2 3 4 5 6 7	Health Related Services (a) The licensee shall ensure that each client receives necessary first aid and other needed medical or dental services, including arrangement for and/or provision of transportation to the nearest available services. This requirement is not met as evidenced by:	1 2 3 4 5 6 7	The Licensee has agreed to create a plan to ensure that persons in care receive necessary medical attention in a timely manner. The Licensee has agreed to train staff on said plan.
	8 9 10 11 12 13 14	Based on observations, interviews, and record review the licensee did not comply with the section cited above by not providing R1 with timely medical attention which poses an immediate health, safety or personal rights risk to persons in care.	8 9 10 11 12 13 14	Email plan and trainings to Socorro.Leandro@dss.ca.gov
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	1 2 3 4 5 6 7		1 2 3 4 5 6 7

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Socorro Leandro
LICENSING EVALUATOR SIGNATURE:	DATE: 07/16/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2026

LIC9099 (FAS) - (06/04)

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Control Number 11-AS-20260706132253

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: HERITAGE BOARD & CARE #2	FACILITY NUMBER: 198600456
	VISIT DATE: 07/16/2026

NARRATIVE

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Observations of facility video recordings revealed the following: On 06/30/2026 at around 8:00 PM to around 9:00 PM, R1 is observed with a large red mark on the half of their face, and a staff member is providing R1 with medication; R1 receives medication and walks away (according to staff observing the video footage the staff is S6). On 07/01/2026 at around 7:00 AM to around 8:00 AM, R1 is standing in line to receive their medication; R1 is observed with a large red mark on the half of their face and a black eye.

Pictures of R1 taken on 07/01/2026 revealed the following: R1 has a black eye with a large red mark underneath their eye on their cheek; R1’s large toe’s nail looks like it’s lifting and black.

Records reviewed revealed the following: Medication Administration Records (MARs) revealed that R1 received their bedtime medications on 06/30/2026 and their morning medications on 07/01/2026. Unusual Incident/Injury Report dated 07/03/2026, stated that on 07/01/2026 caseworker reported to office manager and Administrator that R1 had a black eye when they came to visit R1 in the facility. On 07/01/2026, R1 received a referral to go to urgent care for a Computed Tomography (CT) scan/x-ray for face, head, and foot; assessment showed head trauma and face hematoma. Urgent Care discharge documentation dated 07/01/2026 at 12:35 PM, described the following: Chief Complaint: R1’s right eye swelling, bruising, left big toe injury after fall yesterday; Problems: Toe fracture…closed non-physeal fracture of distal phalanx of left great toe, facial abrasion…

Substantiated: Based on records, observations, and interviews, the preponderance of evidence standard has been met, therefore the above allegation is found to be substantiated. California Code of Regulations, Title 22, Division 6 and Chapter 1 are being cited on the attached LIC 9099D.

An exit interview was conducted, Plans of Corrections were reviewed and developed. A copy of this report and appeal rights were discussed and left with the Licensee/Administrator - Marilee Cruz.

SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Socorro Leandro
LICENSING EVALUATOR SIGNATURE:	DATE: 07/16/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2026

LIC9099 (FAS) - (06/04)

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