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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306003908
Report Date: 11/09/2021
Date Signed: 11/09/2021 04:03:56 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/05/2021 and conducted by Evaluator Jade Jordan
COMPLAINT CONTROL NUMBER: 11-AS-20211105160701
FACILITY NAME:HERITAGE BOARD & CARE #3FACILITY NUMBER:
306003908
ADMINISTRATOR:WARREN TRINIDADFACILITY TYPE:
735
ADDRESS:2900 E. 7TH STREETTELEPHONE:
(562) 434-1588
CITY:LONG BEACHSTATE: CAZIP CODE:
90804
CAPACITY:18CENSUS: 16DATE:
11/09/2021
UNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Grace TrinidadTIME COMPLETED:
04:00 PM
ALLEGATION(S):
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Lack of supervision resulting in resident wandering away from facility.
Resident was in possession of a weapon.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Jade Jordan conducted an unannounced complaint visit, regarding the allegations above. LPA was met by facility Administrator Mary Grace Trinidad, and the purpose of the visit was explained.
Investigation Consisted of the following: Client Interviews, Staff Interviews, Observation of Physical Plant, Record Review, and copies obtained of Pertinent documents pertaining the to allegations.
(Admissions Agreement, House Rules, Physicians Report, Client Roster, Staff Roster)
Regarding Allegation: Lack of supervision resulting in resident wandering away from facility.
Interview with Reporting Party (RP) revealed a description of a Client believed to have resided at that
Facility. RP was unable to give the name of the client observed to be wandering, but described to LPA a body build, a description of clothing and believed race of the alleged client in care, and see’s this person around the neighborhood.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Michael Cava
LICENSING EVALUATOR NAME: Jade Jordan
LICENSING EVALUATOR SIGNATURE:

DATE: 11/09/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/09/2021
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 2
Control Number 11-AS-20211105160701
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME: HERITAGE BOARD & CARE #3
FACILITY NUMBER: 306003908
VISIT DATE: 11/09/2021
NARRATIVE
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During LPA’S investigation, the LPA interviewed Administrator, and requested Physicians Reports based on RP’s description of client. Based on Record Review, the LPA was able to determine that all clients in care, can leave the facility unassisted. The description given of alleged clients revealed that non have had a change in behavior resulting in a need for reassessment. Additionally, Interview Conducted with the Administrator revealed that on 11-05-21, no clients In care were taken into custody, Escorted home, or 51/50 by local law enforcement on the date of the alleged occurrence. Furthermore, it was revealed that there is also a Sober Living Located on the same block of facility, and LPA verified its address as 2500th E Seventh st, and the facility is located at 2900 E seventh St.

Therefore; Based on Observation, Record Review, and interviews the LPA finds that; Although the allegation may have happened or is valid, there is not preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated.



Regarding Allegation: Resident was in possession of a weapon.

Interview with Reporting Party (RP) revealed that Rp did not see the alleged Client in care to have a gun.

Rp was told by the police that they were called out because they were told that the Alleged client had a gun, and was pointing a gun at traffic. Rp never witnessed the alleged client in care with a gun, and did not see alleged Client get arrested. Interviews with clients in care revealed that they did not see any clients with a gun pointing at traffic on 11/05/21 and stated that they have never seen any residents with guns, or knives. Staff interviews revealed that rooms checks are conducted on a daily basis and staff will confiscate any illegal substances, weapons, guns, or sharp objects to keep clients in care safe. No clients have been seen with a gun on the premises of the facility. No clients in care were arrested, 11/05/21 for brandishing a weapon, and no clients were escorted home by the police, and no clients in care were placed on a 51/50 hold, Friday 11/05/21. LPA did not observe any weapons or Guns on any client in care.

Therefore; Based on Observation, Record Review, and interviews the LPA finds that; Although the allegation may have happened or is valid, there is not preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated

An Exit interview was conducted and a copy of this report was provided. No Citations were issued during this visit.

SUPERVISORS NAME: Michael Cava
LICENSING EVALUATOR NAME: Jade Jordan
LICENSING EVALUATOR SIGNATURE:

DATE: 11/09/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/09/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 2