300607488-10-25-2023-22-AS-AORZ-CXJR7N-20231113114637

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 300607488
Report Date: 10/25/2023
Date Signed: 10/25/2023 03:38:52 PM

Unfounded

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
12/18/2020 and conducted by Evaluator Rosie Quiroz

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20201218083108

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: 120	DATE:	10/25/2023
		UNANNOUNCED	TIME BEGAN:	08:45 AM
MET WITH:	Georgianna Mendez, Executive Director and Tami Olsen, Executive Director Assistant.		TIME COMPLETED:	10:00 AM

ALLEGATION(S):

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-Resident was charged for services not rendered.
-Resident reported personal items missing.
-Facility is not keeping an inventory list for the resident.

INVESTIGATION FINDINGS:

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On today's date, Licensing Program Analyst (LPA) Rosie Quiroz conducted an unannounced Complaint investigation follow up to conduct additional file review of documents to address the allegations listed above. LPA Quiroz was greeted and granted entry by front desk receptionist and met with Executive Director (ED) Georgianna Mendez and Tami Olsen Executive Director Assistant, and discussed purpose of today's visit.
The initial 10-day visit was conducted by LPA Quiroz on 12/28/2020 and an additional complaint follow up inspection visit was conducted on 3/16/2022.
During the course of this investigation, LPA Quiroz conducted interviews with interviewees consisting of staff and residents, reviewed documents for four of four residents including but not limited to Resident Personal Property and Valuables Lists, Physician Reports, Individual Service Plans , Admission Agreements and Identification forms.
Regarding the allegation, "Resident was charged for services not rendered," the investigation revealed the following: Identfication form for Resident 1(R1) indicated (R1) moved into the facility on 5/26/2019.
CONTINUED ON NEXT LIC 9099-C PAGE...

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Alisa Ortiz	TELEPHONE: (714) 703-2855
LICENSING EVALUATOR NAME: Rosie Quiroz	TELEPHONE: (559) 753-4610
LICENSING EVALUATOR SIGNATURE:	DATE: 09/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2023

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 22-AS-20201218083108

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

FACILITY NAME: HERITAGE POINTE	FACILITY NUMBER: 300607488
	VISIT DATE: 10/25/2023

NARRATIVE

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CONTINUED...Six of six interviewees indicated (R1)s level of care/change of condition occurred shortly after move in as evidence by (R1)s increased incontinence care and poor medication medication as evidence by six of six interviewees indicated (R1) has medication all throughot her apartment. Six of six interviewees indicated (R1) was relocated two times in a two year time frame due to (R1)s incontinence and refusing care assistance. Former (ED) Silverman and Former Director of Health Care Tracii Brown indicated "Facility had not been charging (R1) for many of the services being provided and requested by (R1) as evidenced by daily food delivery room services multiple times per day and regular housekeeping/ laundry services requests. Documentation review of Individual Needs and Services Plan for (R1) indicate increased level of care needs in comparison to initial needs and services plan and admission agreement fee dated 5/26/2019.
Regarding the allegation, "Resident reported personal items missing" and "Facility is not keeping an inventory list for the resident," the investigation revealed the following: Six of six interviewees indicated (R1) received amazon packages on a regular basis and when informed about importance of updating personal inventory list that (R1) would become upset indicating "no need to document everything purchased. I have receipts for everything." During the course of the investigation, LPA Quiroz requested list of missing items and proof of receipts for missing items from (R1) to assist with the investigation, (R1) indicated "I don't know where they're at. I should not have to show them to anyone. You should believe me."
The department has investigated this complaint. Therefore based on the preponderance of evidence gathered through interviews, observations conducted by LPA Quiroz and documentation review, the allegations that the "Resident was charged for services not rendered, "Resident reported personal items missing, and "Facility is not keeping an inventory list for the resident" are deemed UNFOUNDED, meaning that the allegations were false, could not have happened and/or are without a reasonable basis.
No deficiencies cited during today's visit.
An exit interview was conducted with Executive Director Assistant Tami Olsen, and a copy of report and LIC 811- Confidential Names were provided at exit.

SUPERVISOR'S NAME: Alisa Ortiz	TELEPHONE: (714) 703-2855
LICENSING EVALUATOR NAME: Rosie Quiroz	TELEPHONE: (559) 753-4610
LICENSING EVALUATOR SIGNATURE:	DATE: 10/25/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2023

LIC9099 (FAS) - (06/04)

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