300607488-10-25-2023-22-AS-AORZ-CXZQB4-20231128110051

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 300607488
Report Date: 10/25/2023
Date Signed: 10/25/2023 04:05:08 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
06/30/2021 and conducted by Evaluator Rosie Quiroz

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20210630143904

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:	10:01 AM
MET WITH:	Georgianna Mendez, Executive Director and Tami Olsen, Executive Director Assistant		TIME COMPLETED:	01:57 PM

ALLEGATION(S):

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-Facility is over charging a resident while in care

INVESTIGATION FINDINGS:

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On today's date, Licensing Program Analyst (LPA) Rosie Quiroz conducted an unannounced visit for the purpose to conduct additional interviews and file review of pertinent documents for complaint allegation listed above. LPA Quiroz was greeted 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 10 day visit was conducted by LPA Ruth Martinez on 7/07/2021 and a complaint follow up visit was conducted by LPA Quiroz on 5/12/2022.
During the course of the investigation, LPA Quiroz conducted interviews with interviewees consisting of staff and residents. LPA Quiroz also conducted documentation review but not limited to resident roster, staff roster, Financial Aid policy and the following for four of four residents: Admission agreement, Individual Service Plan, Identification form, Fee Schedule and Invoice.
Regarding the allegation "Facility is over charging a resident while in care," the investigation revealed the following: The identification form for Resident 1 (R1) indicates move in date effective 9/10/2012.
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: 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

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-20210630143904

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...(R1)s admission agreement dated 9/9/2012 indicates monthly fee of $3,770.00 plus an assisted living service fee of $240.00, no fees for activity of daily living care/assistance with a total amount of $4,010.00.
During the course of the investigation, two of two interviewees reported that (R1) had a change of condition and required higher level of care during the start of the COVID-19 Pandemic indicating that due to the COVID-19 pandemic and not wanting to overwhelm the residents and their families that the facility decided to hold off on increasing fees related to change of level of care/condition. Former (ED) Mike Silverman indicated "(R1)s family was informed that they were welcome to purchase (R1)s supplies and utilize the facility laundry area free of cost to do (R1)s laundry; indicating that (R1)s familiy preferred for the facility to purchase the supplies and do (R1)s laundry. Former Director of Health Care Tracii Brown indicated commencing reassessing the residents and the level of care needs on or about 5/1/2021, indicating "Some resident's fees increased due to higher level of care needs. The charges were based on the resident's needs. We've had to increase salaries to retain employees and cover agency staff as well to be able to provided the best care possible to the residents."
Documentation review of Individual Service Plan for (R1) printed on 2/9/2022 indicated a total of 4,400 care points totaling an amount of $4,400.00 concluding a total monthly amount of $8,450.00 which includes the basic monthly and assisted living service fee of $4,010.00.
Documentation review of Heritage Pointe Financial Aid Policy page 1 indicates the following: "When a Family has the capability of paying the full rental and service fee in combination with the resident's own funds, it is expected that they do so. As Jews, we are committed to care for those who cannot are for themselves and to that extent, we may approve Financial Aid within these specific guidelines: A. A resident shall only be considered for Financial Aid after four years of residence at Heritage Pointe and dependent on documented need. B. The resident must have an approval from the State of California that deems the Resident is eligible for Medi-Cal. Pending approvals for Medi-Cal will not be considered until such time as the application is approved by the state. C. The resident account must be current prior to commencing any financial support. Heritage Pointe will not write off outstanding balances connected to the Financial Aid application. Financial Aid support will not commence until such tie as the account balance is current."
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 allegation that the "Facility is over charging a resident while in care" is deemed UNFOUNDED, meaning that the allegations were false, could not have happened and/or are without a reasonable basis. This agency has investigated this complaint. CONTINUED ON NEXT LIC 9099-C PAGE...

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)

Page: 2 of 3

Control Number 22-AS-20210630143904

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
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	CONTINUED...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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