300607488-4-26-2023-22-AS-SSAS-CRAPZ3-20230427114451

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 300607488
Report Date: 04/26/2023
Date Signed: 04/26/2023 03:57:00 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE & INLAND A/SC, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/18/2022 and conducted by Evaluator Kevin Saborit-Guasch

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20220218155229

FACILITY NAME:	HERITAGE POINTE		FACILITY NUMBER:	300607488
ADMINISTRATOR:	MIKE SILVERMAN		FACILITY TYPE:	740
ADDRESS:	27356 BELLOGENTE		TELEPHONE:	(949) 364-9685
CITY:	MISSION VIEJO	STATE: CA	ZIP CODE:	92691
CAPACITY:	225	CENSUS: 128	DATE:	04/26/2023
		UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Georgianna Mendez, Executive Director		TIME COMPLETED:	04:15 PM

ALLEGATION(S):

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1. Facility did not allow resident visitors.

3. Resident did not receive their mail.

4. Resident was not allowed to receive phone calls.

INVESTIGATION FINDINGS:

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On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch conducted an unannounced visit to the facility for the purpose of delivering findings into the allegations listed above. LPA was greeted and granted entry by Georgianna Mendez, Executive Director after explaining the purpose of the visit and listing the allegations.

On February 18, 2022, LPA conducted the initial investigation visit. Executive Director Michael Silverman and Health Care Director Tracii Brown were interviewed. Resident records for resident R1 were also reviewed.

A follow-up visit was conducted on April 12, 2022. The Director of Hospitality along with one resident were interviewed.

CONTINUED ON LIC9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Sheila Santos	TELEPHONE: (714) 334-2062
LICENSING EVALUATOR NAME: Kevin Saborit-Guasch	TELEPHONE: (714) 497-8754
LICENSING EVALUATOR SIGNATURE:	DATE: 03/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2023

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

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE & INLAND A/SC, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/18/2022 and conducted by Evaluator Kevin Saborit-Guasch

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20220218155229

FACILITY NAME:	HERITAGE POINTE		FACILITY NUMBER:	300607488
ADMINISTRATOR:	MIKE SILVERMAN		FACILITY TYPE:	740
ADDRESS:	27356 BELLOGENTE		TELEPHONE:	(949) 364-9685
CITY:	MISSION VIEJO	STATE: CA	ZIP CODE:	92691
CAPACITY:	225	CENSUS:	DATE:	04/26/2023
		UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Georgianna Mendez, Executive Director		TIME COMPLETED:	04:15 PM

ALLEGATION(S):

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2. Facility phone system is not working.

INVESTIGATION FINDINGS:

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Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Sheila Santos	TELEPHONE: (714) 334-2062
LICENSING EVALUATOR NAME: Kevin Saborit-Guasch	TELEPHONE: (714) 497-8754
LICENSING EVALUATOR SIGNATURE:	DATE: 03/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2023

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

LIC9099 (FAS) - (06/04)

Page: 3 of 5

Control Number 22-AS-20220218155229

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE & INLAND A/SC, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

FACILITY NAME: HERITAGE POINTE	FACILITY NUMBER: 300607488
	VISIT DATE: 04/26/2023

NARRATIVE

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CONTINUED FROM FORM LIC9099-A

An additional follow-up facility visit was conducted on November 15, 2022. LPA attempted or conducted interviews with a total of thirteen (13) individuals receiving care and supervision at the facility.

Regarding the allegation that Facility phone system is not working, the following has been concluded: Based on staff interviews and resident interviews conducted during multiple visits to the facility conducted between the months of February and November 2022, the majority of accounts gathered confirmed that on multiple instances they had been unable to use the facility's telephone system due to technical issues happening at the time, or to difficulties in navigating a telephone system too complicated in regards to their technical abilities. Therefore, the allegation is found to be Substantiated, meaning that during the course of the investigation, the preponderance of evidence standard has been met.

An attached form LIC9099D was generated to one cited deficiency per Title 22 of the California Code of Regulations.

At the time of the present visit, the phone systems for the facility were demonstrated to be operational. As a result, the issued citation was cleared and a Plan of Corrections clearance letter was provided to the facility.

An exit interview was conducted and a copy of this report along with appeal rights was provided and left with facility representative.

SUPERVISOR'S NAME: Sheila Santos	TELEPHONE: (714) 334-2062
LICENSING EVALUATOR NAME: Kevin Saborit-Guasch	TELEPHONE: (714) 497-8754
LICENSING EVALUATOR SIGNATURE:	DATE: 04/26/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/26/2023

LIC9099 (FAS) - (06/04)

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Control Number 22-AS-20220218155229

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE & INLAND A/SC, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

FACILITY NAME: HERITAGE POINTE	FACILITY NUMBER: 300607488
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 04/26/2023

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 04/27/2023 Section Cited CCR 87311	1 2 3 4 5 6 7	The California Code of Regulations 87311 Telephones states that: "All facilities shall have telephone service on the premises." This requirement was not met as evidenced by: Based on a majority of interviews conducted, telephone outages have been a common occurrence throughout the first semester of (...)	1 2 3 4 5 6 7	While occasional maintenance request services are still occasionally submitted to the facility administrator, systems are now operational and most if not all issues are due to user errors rather than systemic outages. The deficiency is therefore cleared during the visit.
	8 9 10 11 12 13 14	the calendar year 2022 after a new phone system was installed by the facility. This posed a potential risk to the health, safety and personal rights of the residents in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	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: Sheila Santos	TELEPHONE: (714) 334-2062
LICENSING EVALUATOR NAME: Kevin Saborit-Guasch	TELEPHONE: (714) 497-8754
LICENSING EVALUATOR SIGNATURE:	DATE: 04/26/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/26/2023

LIC9099 (FAS) - (06/04)

Page: 5 of 5

Control Number 22-AS-20220218155229

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE & INLAND A/SC, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

FACILITY NAME: HERITAGE POINTE	FACILITY NUMBER: 300607488
	VISIT DATE: 04/26/2023

NARRATIVE

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CONTINUED FROM LIC9099

An additional follow-up facility visit was conducted on November 15, 2022. LPA attempted or conducted interviews with a total of thirteen (13) individuals receiving care and supervision at the facility.

Regarding the allegation that Facility did not allow resident visitors, the following has been concluded: Based on observation, records reviewed and interviews conducted with staff members and residents at the facility, LPA was able to confirm that the facility did not voluntarily bar individuals from accessing the facility and visiting residents but occasionally referred to current guidelines issued by the Department in relation to COVID-19-related precautions to require visitors' current vaccination documentation before authorizing visits. The facility declined to provide residents' relatives with a blanket authorization to visit their loved ones, but was not found responsible of interfering with personal rights. As a result, the allegation is deemed to be Unsubstantiated, meaning that 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.

Regarding the allegation that Resident did not receive their mail, the following has been concluded: Facility staff does not access residents' mailboxes on their behalf and does not have the keys to any individual mailbox, unless specifically authorized. Facility staff is therefore unable to tamper with any individual mail. The only reason for mail not to be delivered was identified to be a discrepancy in the postal information used to send mail to a resident. As a result, the allegation is deemed to be Unsubstantiated, meaning that 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.

Regarding the allegation that Resident was not allowed to receive phone calls, the following has been concluded: Residents are issued individual phone numbers that route call directly into their individual units. In the event a caller chooses to call the front desk to ask for a specific unit instead, there were no evidence of instructions to screen calls provided to front desk staff for any reason whatsoever. As a result, the allegation is deemed to be Unsubstantiated, meaning that 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.

An exit interview was conducted and a copy of this report was provided to facility representative.

SUPERVISOR'S NAME: Sheila Santos	TELEPHONE: (714) 334-2062
LICENSING EVALUATOR NAME: Kevin Saborit-Guasch	TELEPHONE: (714) 497-8754
LICENSING EVALUATOR SIGNATURE:	DATE: 03/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2023

LIC9099 (FAS) - (06/04)

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