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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 300607488
Report Date: 01/31/2025
Date Signed: 01/31/2025 03:06:13 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
10/08/2021 and conducted by Evaluator Kimberly Lyman
COMPLAINT CONTROL NUMBER: 22-AS-20211008154417
FACILITY NAME:HERITAGE POINTEFACILITY NUMBER:
300607488
ADMINISTRATOR:MIKE SILVERMANFACILITY TYPE:
740
ADDRESS:27356 BELLOGENTETELEPHONE:
(949) 364-9685
CITY:MISSION VIEJOSTATE: CAZIP CODE:
92691
CAPACITY:225CENSUS: 109DATE:
01/31/2025
UNANNOUNCEDTIME BEGAN:
07:50 AM
MET WITH:Erin PalposiTIME COMPLETED:
12:00 PM
ALLEGATION(S):
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9
Staff are not allowing resident to leave the facility
Staff are not allowing resident to take a shower
Staff threaten resident in care
Staff is forcing resident to obtain psychiatric treatment without cause
INVESTIGATION FINDINGS:
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13
Licensing Program Analysts (LPAs) Kimberly Lyman and Andrea Mendivil conducted an unannounced complaint visit to continue the investigation into the above allegations. LPAs were greeted and granted entry into the facility and explained the reason for the visit.
During the course of the investigation, LPA toured the facility and interviewed staff and residents. Regarding the allegations that staff are not allowing resident to leave the facility, staff are not allowing resident to take a shower, staff threaten resident in care and staff is forcing resident to obtain psychiatric treatment without cause, the investigation revealed the following: Per interview conducted with Resident 1 (R1), facility does allow resident to leave the facility. Physician report dated 03/18/2021 indicated resident is able to leave the facility unassisted. Resident denied being refused showers and facility charge form shows resident received stand by assistance 7 days a week for showering. Per interview with resident, resident denied any staff threatening her at the facility. Resident had obtained psychiatric care multiple times while admitted to facility and denied being forced to obtain treatment and confirmed needing said treatment. CONTINUED ON LIC 9099 C DATED 01/31/2025.
Unfounded
Estimated Days of Completion:
SUPERVISOR'S NAME: Alisa OrtizTELEPHONE: (714) 703-2855
LICENSING EVALUATOR NAME: Kimberly LymanTELEPHONE: (714) 795-1497
LICENSING EVALUATOR SIGNATURE:

DATE: 01/31/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2025
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 3
Control Number 22-AS-20211008154417
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: 01/31/2025
NARRATIVE
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Five out of five residents interviewed state satisfaction with facility and indicate staff is good to them. Based on interviews conducted and records reviewed, the allegations are deemed UNFOUNDED, meaning that the allegations were false, could not have happened and/or are without a reasonable basis.

Exit interview conducted and a copy of this report was left at the facility.
SUPERVISOR'S NAME: Alisa OrtizTELEPHONE: (714) 703-2855
LICENSING EVALUATOR NAME: Kimberly LymanTELEPHONE: (714) 795-1497
LICENSING EVALUATOR SIGNATURE:

DATE: 01/31/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
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
10/08/2021 and conducted by Evaluator Kimberly Lyman
COMPLAINT CONTROL NUMBER: 22-AS-20211008154417

FACILITY NAME:HERITAGE POINTEFACILITY NUMBER:
300607488
ADMINISTRATOR:MIKE SILVERMANFACILITY TYPE:
740
ADDRESS:27356 BELLOGENTETELEPHONE:
(949) 364-9685
CITY:MISSION VIEJOSTATE: CAZIP CODE:
92691
CAPACITY:225CENSUS: 109DATE:
01/31/2025
UNANNOUNCEDTIME BEGAN:
07:50 AM
MET WITH:Erin PalposiTIME COMPLETED:
12:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff are not administering medications to resident as instructed by their physician
Resident is not accorded privacy while in care
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analysts (LPAs) Kimberly Lyman and Andrea Mendivil conducted an unannounced complaint visit to continue the investigation into the above allegations. LPAs were greeted and granted entry into the facility and explained the reason for the visit.
During the course of the investigation, LPA toured the facility and interviewed staff and residents. Regarding the allegations that staff are not administering medications to resident as instructed by their physician and resident is not accorded privacy while in care, the investigation revealed the following: R1 indicates missing medication due to physician error and not facility error. However, resident indicates not being administered a medication for Keflex. Due to the age of the complaint, LPA is unable to locate an order for Keflex. Facility staff indicate privacy for residents while having a key card to enter for care and/ or supervision and deny removing items. Based on interviews conducted, LPA is unable to corroborate the allegations. Therefore the allegations are deemed UNSUBSTANTIATED, meaning although the allegations may have happened or are valid, there is no preponderance of evidence to prove the alleged violations did or did not occur. Exit interview conducted and a copy of this report was left at the facility.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Alisa OrtizTELEPHONE: (714) 703-2855
LICENSING EVALUATOR NAME: Kimberly LymanTELEPHONE: (714) 795-1497
LICENSING EVALUATOR SIGNATURE:

DATE: 01/31/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2025
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 3