306003908-5-10-2023-11-AS-SCIS-CUHU99-20230808152246

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306003908
Report Date: 05/10/2023
Date Signed: 05/10/2023 06:15:47 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO, 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
05/01/2023 and conducted by Evaluator Pamela Bunker

COMPLAINT CONTROL NUMBER: 11-AS-20230501160628

FACILITY NAME:	HERITAGE BOARD & CARE #3		FACILITY NUMBER:	306003908
ADMINISTRATOR:	WARREN TRINIDAD		FACILITY TYPE:	735
ADDRESS:	2900 E. 7TH STREET		TELEPHONE:	(562) 434-1588
CITY:	LONG BEACH	STATE: CA	ZIP CODE:	90804
CAPACITY:	18	CENSUS: 11	DATE:	05/10/2023
		UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Mary Cruz		TIME COMPLETED:	12:50 PM

ALLEGATION(S):

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Facility staff is not ensuring that residents are adequately fed while in care.
Facility staff is not ensuring that residents receive a variety of food while in care.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Pamela Bunker conducted an unannounced complaint visit on Wednesday, May 10, 2023. Upon arrival at the facility. LPA Bunker called the facility via telephone and conducted a Risk Assessment. Based on the assessment, the facility is cleared of COVID-19 infection. LPA Bunker met with Administrator Mary Cruz. LPA Bunker explained the purpose of today's visit.

The investigation consisted of the following: LPA Bunker interviewed staff 1-2 (S1-S2) and residents 1-6 (R1-R6). S1-S2 and LPA Bunker toured the kitchen. We observed an ample supply of perishable and non-perishable foods. S1-S2 stated residents are served three (3) meals per day plus snacks. S1-S2 stated residents are not just served cold cereal 5-6 times a week. S1-S2 and R1-R6 stated residents get plenty of food to eat. S1-S2 and R1-R-6 stated residents are allowed to eat and food is served seven days a week from Sunday-Saturday.

See continued LIC9099-C page 2

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Pamela Bunker
LICENSING EVALUATOR SIGNATURE:	DATE: 05/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2023

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 11-AS-20230501160628

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: HERITAGE BOARD & CARE #3	FACILITY NUMBER: 306003908
	VISIT DATE: 05/10/2023

NARRATIVE

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Continued LIC812-C page 2

Allegation #1: Facility staff is not ensuring that residents are adequately fed while in care.
Staff 1-2 (S1-S2) and residents 1-6 (R1-R6) interviewed stated residents are adequately fed and are not only served cold cereal. S1-S2 and R1-R6 stated the clients are getting plenty of food to eat, three (3) meals per day plus snacks, breakfast, lunch, dinner, and snacks daily. The facility serves a well-balanced meal. The facility also provides alternative options, if residents don't want what's on the menu. S1-S2 and R1-R6 stated for breakfast residents are served eggs, bacon, sausages, potatoes, hash browns, grits, cream of wheat, oatmeal, pancakes, waffles, toast, cereal & milk, fresh fruits, yogurt, a variety of beverages, coffee, milk, juices, and water. R1-R6 stated for lunch staff serves cold-cut sandwiches, grilled cheese sandwiches, tuna sandwiches, egg salad sandwiches, peanut butter & jelly sandwiches, hot dogs, hamburgers, pizza, tacos, burritos, fish, baked and fried chicken, mashed potatoes, rice, vegetables, stew, spaghetti, pasta, soup, salad, apple sauce, fresh fruits, vegetables, french fries, dessert, and beverages. R1-R6 stated the portions of food served are more than enough and they get plenty of food to eat and the staff will give them seconds. R1-R6 stated that they had no complaints about the food. During today's visit, LPA observed staff cooking and preparing, breakfast and lunch for the residents. S1-S2 and R1-R6 denied the allegation.

Allegation #2: Facility staff is not ensuring that residents receive a variety of food while in care.
Staff 1-2 (S1-S2) and residents 1-6 (R1-R6) interviewed stated residents have a variety of food to eat. S1-S2 and R1-R6 stated the clients are getting plenty of food to eat, three (3) meals per day plus snacks, breakfast, lunch, dinner, and snacks daily. The staff serves a well-balanced meal and a variety of food options to choose from every week. R1-R6 stated that they had no complaints about the food. R1-R6 stated every week the food menu changes and residents can select something different if they prefer. Residents are not served the same food every week. LPA reviewed the food menus for April and May 2023, both months' menu has a variety of food choices. S1 stated that they do not recycle their menus every week. S1 stated they will improve and change the food menu when they get feedback from the residents. S1-S2 and R1-R6 denied the allegation as false.

Investigation revealed the following: Staff 1-2 (S1-S2) interviewed stated the allegations are all false. S2 and LPA Bunker observed the food in the facility refrigerators, freezers, kitchen cabinets, and pantry.

See continued LIC9099-C page 3

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Pamela Bunker
LICENSING EVALUATOR SIGNATURE:	DATE: 05/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 11-AS-20230501160628

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: HERITAGE BOARD & CARE #3	FACILITY NUMBER: 306003908
	VISIT DATE: 05/10/2023

NARRATIVE

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Continued LIC9099-C page 3

The facility had plenty of meat, chicken, chicken patties, beef, steak, ground beef, hamburger patties, pork chops, pork roast, fish, turkey, hot dogs, corn dogs, burritos, pizza, sausages, lunch meat, cold cuts, variety of frozen vegetables, beans, mixed vegetables, stir fry vegetables, peas, corn, French fries, variety of canned vegetables, fruit cups, apple sauce, peanut butter, strawberry preserves, milk, eggs, cheese, yogurt, variety of breads, white & wheat bread, dinner rolls, hot buns, hamburgers bun, flour & corn tortilla, cereals, rice, noodles, pasta, macaroni & cheese, potatoes, cookies, chips, crackers, fresh fruits, apples, oranges, bananas, grapes, melons, cantaloupe, plums, prunes, tomatoes, fresh vegetables, onions, garlic, potatoes, carrots, sweet potatoes, broccoli, celery, lettuce, red peppers, bell peppers, variety of canned fruits, cookies, chips, crackers, desserts, flour, sugar, coffee cream, beverages, coffee, juice, milk, sodas, water, a variety of seasoning and sauces, ketchup, mustard, mayonnaise, ripe olives, mushrooms, and etc. LPA Bunker observed an ample supply of nonperishable foods for a minimum of one week and fresh perishable foods for a minimum of two days. R1-R6 stated they were not only served cold cereal, they are happy with the food portions, they are allowed seconds, and eat a variety of food. R1-R6 stated they had no problem with the food and they get plenty of food to eat. S1-S2 stated residents are getting enough food to eat and residents are not served cold cereal 5-6 days a week for breakfast. S1-S2 and R1-R2 stated if residents don't like what is being served residents have alternative options to choose something else that is not on the menu. S1-S2 and R1-R6 denied the allegation.

Based on interviews, available evidence, observation, information received, and records reviewed there was not enough sufficient evidence to support the allegation. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is deemed unsubstantiated.

There were no deficiencies cited. Exit interview conducted.

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Pamela Bunker
LICENSING EVALUATOR SIGNATURE:	DATE: 05/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2023

LIC9099 (FAS) - (06/04)

Page: 3 of 3