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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198600459
Report Date: 04/17/2025
Date Signed: 04/17/2025 03:53:09 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
04/04/2025 and conducted by Evaluator Lizeth Villegas
COMPLAINT CONTROL NUMBER: 11-AS-20250404151516
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:
04:00 PM
ALLEGATION(S):
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Staff did not ensure resident’s mattress is clean and in good repair.
Staff threatened to evict resident.
Staff do not keep the facility free from pests.
Staff do not ensure that drinking cups are sanitary.
INVESTIGATION FINDINGS:
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On 04/17/25 at 9 am 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 client roster, mattress factory invoice, menu for April 2025, and Dewey pest control report dated: January 2025-April 2025. On 04/09/25 LPA obtain copies of the following documents for staff #1 (S1), employement application dated: 8/8/23,personnel record, independent contractor agreement dated 8/18/23, and reporting elder and dependent adult abuse dated 8/8/23. LPA obtained the following for client #1 (C1), facesheet, admission agreement dated 6/21/24, personal rights dated 6/21/24, Physicians report dated 6/20/24, needs and service plan dated 3/11/25, and public guardian business card. On 04/09/25 from 10am-11:22 am LPA conducted interviews with clients 2-5 (C2-C5) and on 04/09/25 from 11:25am-12 pm LPA conducted interview with Licensee (L1).
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 5
Control Number 11-AS-20250404151516
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
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On 4/9/25 at 1pm LPA conducted a tour of the facility, which included inspection of 5 bedrooms, 8 mattresses, 4 bathrooms, kitchen, and pantry. On 4/17/25 from 11:35am-11:45 LPA conducted interview with Client #1 C1. On 04/17/25 LPA conducted medication review for C1, and on 4/17/25 from 1pm-1:45 pm am LPA conducted interview with staff #2-4 (S2-S4). On 4/9/25 and 4/17/25 LPA was unable to interview S1, as S1 was not on site during visit.

The allegation revealed the following:
Allegation: Staff did not ensure resident’s mattress is clean and in good repair.
It is being alleged that client in care has been sleeping on a mattress that has urine and feces stains.
On 04/09/25 from 10am-11:22 am LPA conducted interviews with C2-C5, 4 of 4 clients interviewed denied the allegation above. On 04/09/25 from 11:25am-12 pm LPA conducted interview with L1 regarding the allegation above, L1 denied the allegation above. Per L1, all mattresses have a mattress cover that are replaced when a new client is admitted, L1 continued to report that L1 keeps a supply of new mattresses in a different location, and if a new mattress is needed it can take 3 days to be transported to the facility. On 4/9/25 at 1pm LPA conducted a tour of the facility, which included inspection of 5 bedrooms, 8 mattresses, LPA observed mattresses to be clean, mattress covers appear to be in good repair. On 04/17/25 from 11:35am-11:45 am LPA conducted interview with C1 regarding the allegation above, C1 confirmed the allegation above and reported the mattress client was sleeping on was dirty and stained but has since been replaced. On 04/17/25 from 1pm-1:45 pm LPA conducted interview with S2-S4, 3 of 3 staff interviewed denied the allegation above and reported that mattresses are replaced as needed. On 4/9/25 and 4/17/25 LPA was unable to interview S1, as S1 was not on site during visit. On 04/17/25 LPA conducted a review of mattress factory invoices dated 1/22/25 which indicates 4 full size size mattresses, and 5 metal bed frames where purchased.

Allegation: Staff threatened to evict resident.
It is being alleged that facility staff told client in care that eviction paperwork was going to be prepared. On 04/09/25 from 10am-11:22 am LPA conducted interviews with C2-C5, 4 of 4 clients interviewed denied the allegation above. On 04/09/25 from 11:25am-12 pm LPA conducted interview with L1 regarding the allegation above, L1 denied the allegation above and reported that clients are not threatened with eviction. Per L1, if a client reports being unhappy at the facility L1 reminds clients that they have the option to move out but they need to provide L1 with a 30 day notice. On 04/17/25 from 11:35am-11:45 am LPA conducted interview with C1 regarding the allegation above, C1 confirmed the allegation above and reported being threatened with eviction after asking for a new mattress. On 04/17/25 from 1pm-1:45 pm LPA conducted interview with S2-S4, 3 of 3 staff interviewed denied the allegation above. On 07/17/25 LPA conducted a file
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: 4 of 5
Control Number 11-AS-20250404151516
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
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On client #1's file, LPA did not observe an eviction notice on file.

Allegation: Staff do not keep the facility free from pests.
It is being alleged that the facility has cockroaches all over. On 04/09/25 from 10am-11:22 am LPA conducted interviews with C2-C5, 1 of 4 clients interviewed denied the allegation above, 3 of 4 clients interviewed reported seeing roaches in the past. On 04/09/25 from 11:25 am-12 pm LPA conducted interview with L1 regarding the allegation above, L1 denied the allegation above and reported the facility is taking all the steps needed to keep it under control. On 04/17/25 from 11:35 am-11:45 am LPA conducted interview with C1 regarding the allegation above, C1 confirmed the allegation above and reported there are roaches in the bathroom and has reported it. On 04/17/25 from 1pm-1:45 pm LPA conducted interview with S2-S4, 1 of 3 staff interviewed denied the allegation above, 2 of 3 staff interviewed reported seeing roaches in the past and that pest control came to the facility to spray. On 4/9/25 and 4/17/25 LPA was unable to interview S1, as S1 was not on site during visit. On 4/17/25 LPA did not observe any pest at the time of visit, LPA reviewed pest service report dated: January 2025-April 2025 per report Dewey pest control facility is inspected and installed 3 exterior rodent stations, treatment in exterior crack and crevices as well. On 4/17/25 at 3pm LPA observed Dewey pest control spraying the exterior and common areas of the facility., LPA also observed common areas being mopped twice during LPAs visit.

Allegation: Staff do not ensure that drinking cups are sanitary.
It is being alleged that that some of the facility cups look like they need to be replaced due to having cigarette butts in them, and appear to be unsanitary. On 04/09/25 from 10am-11:22 am LPA conducted interviews with C2-C5, 4 of 4 clients interviewed denied the allegation above. On 04/09/25 from 11:25 am-12 pm LPA conducted interview with L1 regarding the allegation above, L1 denied the allegation above and reported plates and cups are thrown out and misplaced when in disrepair. On 04/17/25 from 11:35 am-11:45 LPA conducted interview with C1 regarding the allegation above, C1 confirmed the allegation above and reported there are cigarette burns on the dishes and it is unsanitary. On 04/17/25 from 1pm-1:45 am LPA conducted interview with S2-S4, 3 of 3 staff interviewed denied the allegation above and 2 of the 3 staff interviewed reported that clients will put out cigarettes on the dishes even after being asked not too, per 2 of 3 staff the dishes in disrepair will be thrown out per licensees order. On 4/9/25 and 4/17/25 LPA was unable to interview S1, as S1 was not on site during visit. On 04/09/25 and 04/17/25 LPA Villegas conducted a tour of the facility including kitchen and pantry, plates, and cups appear to be in good repair.

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.
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: 5 of 5