300607488-5-22-2025-22-AS-MSTC-DH75HM-20250530195835

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 300607488
Report Date: 05/22/2025
Date Signed: 05/22/2025 01:59:27 PM

Substantiated

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
01/08/2025 and conducted by Evaluator Kevin Saborit-Guasch

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20250108143658

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: 118	DATE:	05/22/2025
		UNANNOUNCED	TIME BEGAN:	11:55 AM
MET WITH:	Erin Palposi, Executive Director		TIME COMPLETED:	01:00 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff does not ensure residents are spoken to in an appropriate manner

Staff does not respond to call signal system for residents in a timely manner

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility for the purpose of following up on the investigation of the allegations listed above. LPA was greeted and granted entry by front desk staff after stating the purpose of the visit. Executive Director Erin Palposi was present on the premises and assisted with the visit.

An initial investigation visit took place on January 17, 2025. During the visit, licensing staff requested and obtained the facility's resident census, staff roster as well as care assignments for staff for Friday January 17, 2025. Five (5) staff interviews and four (4) resident interviews were conducted during the present visit. Resident records requested for a total of seven (7) residents.

Follow-up interviews conducted on March 18, 2025 during the investigation of a different complaint. Additional staff and resident interviews conducted during the annual visit on May 14, 2025.
CONTINUED ON FORM LIC9099-C

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: 05/22/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2025

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 5

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
01/08/2025 and conducted by Evaluator Kevin Saborit-Guasch

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20250108143658

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:	DATE:	05/22/2025
		UNANNOUNCED	TIME BEGAN:	11:55 AM
MET WITH:	Erin Palposi, Executive Director		TIME COMPLETED:	01:00 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff handle residents in a rough manner

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

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: 05/22/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2025

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

LIC9099 (FAS) - (06/04)

Page: 2 of 5

Control Number 22-AS-20250108143658

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: 05/22/2025

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 FROM FORM LIC9099-A
During the follow-up to the investigation, LPA was provided with a recording of all activity related to pendant pushes for the period of December 23, 2024 until January 22, 2025. Staff records for staff member S1 were also provided during the March 18, 2025 visit and added to the investigation file.

Regarding the allegation that Staff handle residents in a rough manner, the following has been concluded: Complaints of inappropriate staff interactions made during staff and resident interviews mostly described verbal interactions on behalf of staff member S1 rather than inappropriate or rough direct physical handling. No specific instances of rough handling were evidenced during the investigation. No specific acts were described by interviewees either during the present investigation.

As a result, the allegation is found to be Unsubstantiated, meaning that although the allegation may have happened or is valid, there is no preponderance of evidence to prove the alleged violation did or did not occur. An exit interview was conducted and a copy of the report provided.

SUPERVISOR'S NAME: Sheila Santos	TELEPHONE: (714) 334-2062
LICENSING EVALUATOR NAME: Kevin Saborit-Guasch	TELEPHONE: (714) 497-8754
LICENSING EVALUATOR SIGNATURE:	DATE: 05/22/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2025

LIC9099 (FAS) - (06/04)

Page: 3 of 5

Control Number 22-AS-20250108143658

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: 05/22/2025

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 FROM FORM LIC9099
During the follow-up to the investigation, LPA was provided with a recording of all activity related to pendant pushes for the period of December 23, 2024 until January 22, 2025. Staff records for staff member S1 were also provided during the March 18, 2025 visit and added to the investigation file.

Regarding the allegation that Staff does not ensure residents are spoken to in an appropriate manner, the following has been concluded: Multiple staff members interviewed during the investigation related incidents they witnessed and/or reported to their supervisor involving inappropriate behavior from facility staff S1. Incidents described included ignoring calls for assistance, being short with residents requesting assistance, throwing medication across a table. Per a review of S1 staff files and interviews conducted, S1 was hired at the facility in 2011 and was terminated prior to the March 18 visit taking place due to inappropriate behavior.

Regarding the allegation that Staff does not respond to call signal system for residents in a timely manner, the following has been concluded: Based on resident interviews and a review of pendant pushes over a period of 30-days, it was established that approximately three daily occurrences of pendant pushes requiring upwards of forty-five minutes to be addressed were recorded. While a wide majority of pendant pushes are addressed timely, these occurrences demonstrate that timely response is not guaranteed.

As a result, both allegations are found to be Substantiated, meaning that the preponderance of evidence standard has been met. Two type B deficiencies are being cited per California Code of Regulations Title 22.

An exit interview was conducted and a copy of this report and appeal rights were provided.

SUPERVISOR'S NAME: Sheila Santos	TELEPHONE: (714) 334-2062
LICENSING EVALUATOR NAME: Kevin Saborit-Guasch	TELEPHONE: (714) 497-8754
LICENSING EVALUATOR SIGNATURE:	DATE: 05/22/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2025

LIC9099 (FAS) - (06/04)

Page: 4 of 5

Control Number 22-AS-20250108143658

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
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/22/2025

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 06/20/2025 Section Cited CCR 87468.1(a)(1)	1 2 3 4 5 6 7	Per CCR (a) 87468.1(a)(1) defining Personal Rights: "Residents in all RCFE shall have all of the following personal rights: (1) To be accorded dignity in their personal relationships with staff, residents, and other persons". This requirement was not met as evidenced by:	1 2 3 4 5 6 7	Staff member S1 was terminated with cause by licensee on March 11, 2025 as confirmed by interviews and a review of staff files. No other staff evidenced to have interacted inappropriately with residents during the investigation. Deficiency cleared.
	8 9 10 11 12 13 14	Based on staff and resident interviews conducted, staff member S1 was responsible of inappropriate behavior towards multiple residents. This constitutes a potential risk to the health, safety and personal rights of residents in care.	8 9 10 11 12 13 14
Type B 06/20/2025 Section Cited CCR 878464(f)(1)	1 2 3 4 5 6 7	Per CCR 878464(f)(1) on Basic Services: "Basic services shall at a minimum include: (1) Care and supervision as defined in Section 87101(c)(3) and Health and Safety Code section 1569.2(c)". This requirement is not met as evidenced by:	1 2 3 4 5 6 7	Licensee will utilize the newly hired Wellness Director to keep track and audit pendant pushes regularly, conduct bi-monthly in-service training and identify root causes of excessive wait times. Documentation of the corrections to be provided to LPA before the plan of corrections due date.
	8 9 10 11 12 13 14	Based on records reviewed and interviews conducted, multiple instances of excessive response times were recorded.This constitutes a potential risk to the health, safety and personal rights of individuals in care.	8 9 10 11 12 13 14

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: 05/22/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2025

LIC9099 (FAS) - (06/04)

Page: 5 of 5