300607488-7-1-2024-22-AS-SSAS-D78QF8-20240716120732

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 300607488
Report Date: 07/01/2024
Date Signed: 07/01/2024 04:43:10 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 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
03/27/2024 and conducted by Evaluator Kevin Saborit-Guasch

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20240327152419

FACILITY NAME:	HERITAGE POINTE		FACILITY NUMBER:	300607488
ADMINISTRATOR:	JONATHAN PERLES		FACILITY TYPE:	740
ADDRESS:	27356 BELLOGENTE		TELEPHONE:	(949) 364-9685
CITY:	MISSION VIEJO	STATE: CA	ZIP CODE:	92691
CAPACITY:	225	CENSUS: 116	DATE:	07/01/2024
		UNANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	Erin Palposi, Administrator		TIME COMPLETED:	04:55 PM

ALLEGATION(S):

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Facility is refusing to accept the resident back to the facility.

INVESTIGATION FINDINGS:

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On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility for the purpose of delivering the findings of the investigation into the allegation listed above. LPA was greeted and granted entry by front desk staff after introducing himself and stating the reason for the visit. Administrator Erin Palposi was present and assisted with the visit after being informed of the allegation.

The initial complaint investigation visit took place on March 28, 2024. During the visit, LPA requested and obtained records maintained at the facility for resident R1. An interview with facility staff regarding R1's current hospitalization was also conducted. R1 was stated to be undergoing psychiatric evaluation prior to organizing her readmission at the facility.

An additional witness interview was conducted via telephone.
CONTINUED ON FORM 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: 07/01/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2024

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-20240327152419

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

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

FACILITY NAME: HERITAGE POINTE	FACILITY NUMBER: 300607488
	VISIT DATE: 07/01/2024

NARRATIVE

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CONTINUED FROM FORM LIC9099
During the follow-up investigation visit, two staff interviews were conducted along with an interview of resident R1. Additional resident records were requested and obtained after a new physician report and resident assessments had been conducted.

Regarding the allegation that the Facility is refusing to accept the resident back to the facility, the following has been concluded: Resident R1 was sent out to receive a psychiatric evaluation following an incident involving aggression towards a staff member on March 21, 2024. The resident was still hospitalized during the initial complaint investigation visit. Multiple interviews with facility staff confirmed that no eviction was notified to the resident or their responsible party and that the goal of the hospital stay was to ensure the safety of both staff and resident upon readmission. Treatment adjustments were conducted and the resident was admitted back to the facility's memory care unit in April 2024. No new incidents have been reported by facility staff since the readmission took place. There is no additional evidence that a plan to not readmit the resident was ever in place and the resident has successfully returned to the facility.

As a result, the allegation is found to be Unsubstantiated, meaning that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.

An exit interview was conducted with Executive Director Erin Palposi and a copy of this report was provided to a 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: 07/01/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2024

LIC9099 (FAS) - (06/04)

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