198600459-4-26-2024-11-AS-UCOL-D4WUY9-20240503155935

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198600459
Report Date: 04/26/2024
Date Signed: 04/26/2024 03:31:15 PM

Unsubstantiated

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
04/19/2024 and conducted by Evaluator Regina Cloyd

COMPLAINT CONTROL NUMBER: 11-AS-20240419142853

FACILITY NAME:	HERITAGE BOARD & CARE #1		FACILITY NUMBER:	198600459
ADMINISTRATOR:	MARY GRACE TRINIDAD		FACILITY TYPE:	735
ADDRESS:	2330 & 2340 EAST 15TH STREET		TELEPHONE:	(562) 900-5577
CITY:	LONG BEACH	STATE: CA	ZIP CODE:	90804
CAPACITY:	42	CENSUS: 28	DATE:	04/26/2024
		UNANNOUNCED	TIME BEGAN:	09:03 AM
MET WITH:	Administrator Mary Cruz		TIME COMPLETED:	03:45 PM

ALLEGATION(S):

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Staff do not treat resident with respect.
Staff are not giving resident P&I monies.
Residents are smoking in the facility.

INVESTIGATION FINDINGS:

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On 04/26/2024 Licensing Program Analyst (LPA) Regina Cloyd conducted a complaint investigation at the above facility to address the following allegation(s). LPA met with Administrator Mary Cruz and Office Manager Drue Scott and explained the purpose of the visit.

The investigation consisted of the following: During today’s investigation, LPA reviewed register of clients, personnel report, bond insurance, the facility’s admission agreement, (8) Record of Client's/Resident's Safeguarded Cash Resources, Facility House Rules and General Policies, in-service training records, (8) client records, viewed the designated smoking areas and interviewed 8 clients and 4 staff members which includes the Administrator, Office Manager, Cook, and Housekeeper.

Continue to LIC 9099-C.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Regina Cloyd
LICENSING EVALUATOR SIGNATURE:	DATE: 04/26/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/26/2024

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-20240419142853

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 #1	FACILITY NUMBER: 198600459
	VISIT DATE: 04/26/2024

NARRATIVE

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Allegation(s):The investigation revealed the following: Regarding the allegation "Staff do not treat resident with respect,” it is being alleged that Staff #2 (S2) made a disrespectful comment to Client #1 (C1). Interviews conducted indicate the following: 7 out of 8 clients indicated that staff treat clients with dignity and respect and 7 of 8 clients have not witnessed staff making disrespectful comments to clients; 3 out 4 staff members stated that they have not witnessed other staff members speak disrespectfully to clients; 1 staff member was unable to answer due to language barrier. Based on the interviews, the Department found no evidence to support the allegation mentioned above. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, as a result, the allegation is Unsubstantiated.

No deficiencies were cited.

Allegation(s):
The investigation revealed the following: Regarding the allegation "Staff are not giving resident P&I monies,” it is being alleged that Client #1 (C1) did not receive C1’s P&I money. Record review of (8) Client's/Resident's Safeguarded Cash Resources reveal that C1 did receive C1’s P&I money and (3) clients with a remaining balance matched the cash on hands. Interviews conducted indicate the following: 5 out of 5 clients indicated that they receive assistance with money management and do not have issues receiving their P&I money. C1 also confirmed that C1 received P&I money. Interviews with the Administrator and Office Manager indicated that P&I is distributed on Wednesdays. Based on the interviews and record review, the Department found no evidence to support the allegation mentioned above. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, as a result, the allegation is Unsubstantiated.

No deficiencies were cited.

Continue to LIC9099-C

SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Regina Cloyd
LICENSING EVALUATOR SIGNATURE:	DATE: 04/26/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/26/2024

LIC9099 (FAS) - (06/04)

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Control Number 11-AS-20240419142853

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 #1	FACILITY NUMBER: 198600459
	VISIT DATE: 04/26/2024

NARRATIVE

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Allegation(s):
The investigation revealed the following: Regarding the allegation "Residents are smoking in the facility,” it is being alleged residents are smoking in their rooms and staff do not stop them. Record review reveals that the facility has a “No Smoking Agreement,” “"Absolutely No Illegal Drugs or Alcohol on the Premises Agreement,” and “Admission Agreement" with clients that prohibits smoking in the rooms. LPA Cloyd also observed No Smoking Signs on and around the building(s) and a sign indicating that the snack store was closed due to a violation of the agreements. Interviews conducted indicate the following: 8 out of 8 clients were aware of the smoking policy and the designated smoking areas (gazebo, benches, and backyard court area); 4 out of 8 clients indicated that clients do not always follow the no smoking rules but 2 of the 4 clients indicated that the issue is addressed by staff; 3 out of 4 staff interviews indicate that clients are addressed if clients are caught smoking in their rooms. Based on the interviews, record reviews, and observations, the Department found no evidence to support the allegation mentioned above. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, as a result, the allegation is Unsubstantiated.

No deficiencies were cited.

An exit interview was conducted and a copy of this report was discussed and left with the Administrator Mary Cruz.

SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Regina Cloyd
LICENSING EVALUATOR SIGNATURE:	DATE: 04/26/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/26/2024

LIC9099 (FAS) - (06/04)

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