<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198600459
Report Date: 04/17/2025
Date Signed: 04/17/2025 07:02:20 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, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245
This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/08/2025 and conducted by Evaluator Lizeth Villegas
COMPLAINT CONTROL NUMBER: 11-AS-20250408122850
FACILITY NAME:HERITAGE BOARD & CARE #1FACILITY NUMBER:
198600459
ADMINISTRATOR:MARILEE CRUZFACILITY TYPE:
735
ADDRESS:2330 & 2340 EAST 15TH STREETTELEPHONE:
(562) 900-5577
CITY:LONG BEACHSTATE: CAZIP CODE:
90804
CAPACITY:42CENSUS: 36DATE:
04/17/2025
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Licensee Marilee Cruz TIME COMPLETED:
12:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility staff are not providing adequate food service to residents in care.
Facility staff did not provide resident medication as prescribed.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 04/17/25 at 9am Licensing Program Analyst (LPA) Villegas conducted a subsequent complaint visit regarding the allegation(s) above. LPA met with Licensee Marilee Cruz as the purpose of today’s visit was explained.

The investigation consisted of the following: On 04/09/25 LPA Villegas obtained copies of the staff and resident roster, and requested the following documents for client #1 (C1) facesheet, admission agreement dated: 12/9/24, personal rights dated 12/9/24, physicians report dated: 9/19/24, needs and service plan dated: 3/11/25, medication administration records for March-April 2025, public guardian business card, and a copy of invoice dated 4/1/24. On 04/09/25 from 10am-11:22 am LPA conducted interviews with clients 2-5 (C2-C5). On 04/09/25 from 11:22am-11:55am LPA conducted interview with C1. On 04/09/25 from 12pm-12:40 pm LPA conducted interview with Licensee (L1), and at 12:40pm LPA conducted a tour of the facility including facility kitchen and pantry. On 04/17/25 LPA conducted medication review, and from 1pm-2:00pm LPA conducted interview with staff #1-3 (S1-S3).
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Lizeth Villegas
LICENSING EVALUATOR SIGNATURE:

DATE: 04/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2025
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 11-AS-20250408122850
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245
FACILITY NAME: HERITAGE BOARD & CARE #1
FACILITY NUMBER: 198600459
VISIT DATE: 04/17/2025
NARRATIVE
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
The investigation revealed the following:
Allegation: Facility staff are not providing adequate food service to clients in care.
It is being alleged that clients in care receive the same meals every day. On 04/09/25 from 10 am-11:22 am LPA conducted interviews with clients C2-C5, 1 of 4 clients interviewed confirmed the allegation above reported they receive rice with every meal every day, 1 client interviewed reported going out for meals daily, 2 of 4 clients interviewed denied the allegation and reported having no issue with the meals being served. On 04/09/25 from 11:22 am-11:55 am LPA conducted interview with C1, C1 did not not provide an answer when asked about the allegation above; however C1 spoke about the variety of food provided at the facility that is not to C1's liking. On 04/17/25 LPA conducted a tour of the facility kitchen and pantry, LPA observed the pantry to have a variety of food selection, the kitchen refrigerator was stocked with a variety of fruits, proteins, and vegetables. On 04/17/25 LPA conducted a review of menus for the months of March 2025-April 2025, LPA observed breakfast, lunch, and dinner meals to be different every day. On 04/09/25 from 12 pm-12:40 pm LPA conducted interview with L1 regarding the allegation above, L1 denied the allegation above and stated that the kitchen staff have actually gotten compliments about the food from the newer clients coming in. On 04/17/25 from 1 pm-2 pm LPA conducted interview with S1-S3, 3 of 3 staff interviewed denied the allegation above about reported clients have different meals every day.

Allegation: Facility staff did not provide resident medication as prescribed.
It is being alleged that client in care did not receive blood pressure medication.
On 04/09/25 from 10 am-11:22 am LPA conducted interviews with clients C2-C5, 4 of 4 clients interviewed denied the allegation above and reported receiving their medications everyday. On 04/09/25 from 11:22 am-11:55 am LPA conducted interview with C1, C1 confirmed the allegation above and reported that staff have not given C2 a blood pressure machine. On 04/09/25 from 12 pm-12:40 pm LPA conducted interview with L1 regarding the allegation above, L1 denied the allegation above and reported medications are administered as prescribed. On 04/17/25 from 1pm-2 pm LPA conducted interview with S1-S3, 2 of 3 staff interviewed denied the allegation above and reported staff do not refuse to to administer medications to clients in care. 1 of 3 staff interviewed reported they do not have any knowledge regarding the allegation above as they do not assist with medication administration. On 04/17/25 LPA conducted medication review for C1, LPA observed the MAR and physical medications to match. Per MAR C1 is receiving all medications as prescribed. On 04/17/25 LPA conducted a review of physicians report dated 9/19/24, there is no indication that C1 requires to have to blood pressure taken before medication is administered.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated.
Exit interview conducted, and a copy of this report was provided to Licensee.
SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Lizeth Villegas
LICENSING EVALUATOR SIGNATURE:

DATE: 04/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2