306004192-4-15-2022-22-AS-MVAO-CG3PN7-20220706112725

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306004192
Report Date: 04/15/2022
Date Signed: 04/15/2022 12:21:38 PM

Substantiated

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
04/08/2022 and conducted by Evaluator Sean Haddad

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20220408162727

FACILITY NAME:	WHITTEN HEIGHTS ASSISTED LIVING AND MEMORY CARE		FACILITY NUMBER:	306004192
ADMINISTRATOR:	CHIN SHUN LEE LIAU		FACILITY TYPE:	740
ADDRESS:	200 WEST WHITTIER BLVD.		TELEPHONE:	(562) 691-1200
CITY:	LA HABRA	STATE: CA	ZIP CODE:	90631
CAPACITY:	196	CENSUS: 89	DATE:	04/15/2022
		UNANNOUNCED	TIME BEGAN:	08:58 AM
MET WITH:	Carol Lee		TIME COMPLETED:	11:30 AM

ALLEGATION(S):

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Staff did not respond to resident's call light in a timely manner.

INVESTIGATION FINDINGS:

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This unannounced inspection is being conducted by Licensing Program Analyst (LPA) Sean Haddad for the purpose of investigating the above-mentioned complaint allegation. LPA met with Administrator (AD) Carol Lee, discussed the purpose of the inspection, and explained the allegation.

The investigation into the allegation that staff did not respond to a resident's call light in a timely manner revealed the following: During the course of the investigation, LPA inspected the facility’s kitchen, common areas, hallways, and 9 resident rooms, interviewed 3 staff and 6 residents, and requested and reviewed the resident roster, staff roster, staff schedule, photographs of insects at the facility, and pest control records.

The investigation into the allegation that staff did not respond to Resident #1’s (R1) call light in a timely manner revealed the following:

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Armando J Lucero	TELEPHONE: (714) 703-2840
LICENSING EVALUATOR NAME: Sean Haddad	TELEPHONE: (714) 335-7094
LICENSING EVALUATOR SIGNATURE:	DATE: 04/15/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2022

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

Control Number 22-AS-20220408162727

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: WHITTEN HEIGHTS ASSISTED LIVING AND MEMORY CARE	FACILITY NUMBER: 306004192
	VISIT DATE: 04/15/2022

NARRATIVE

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Per interviews with facility staff, recently R1 attempted to use the call system in their room, believed the response from staff took too long, and on that basis believed the call system was not working, but facility staff checked the system and confirmed it was working properly. Per interviews with R1, R1 stated that they recently fell in the bathroom and activated the call system for help. After not receiving a response for 15 to 20 minutes, R1 activated the call system for help a second time. Facility staff never responded to either of these first two calls. After not receiving a response, R1 got up, moved to the living room, and activated the call system in the living room. R1 received a response from staff immediately and reported to this staff member that their two calls from the bathroom were not answered. R1 was not able to indicate whether the light on the call system turned on in response to R1’s first two calls due to their viewing angle on the floor. Per interviews with AD, AD had no knowledge of this occurrence or any attempts to identify what had gone wrong and fix it, and stated that the call system is always staffed at the front desk and the calls are responded to as quickly as possible. AD stated they were not notified of this issue by R1 or the staff member who answered R1’s call. AD also stated that the call system was checked thoroughly about 1 month ago for technical issues. LPA interviewed 5 residents regarding the call system. 2 residents stated they never use the call system. 3 residents stated they use the call system regularly, their calls are always answered, and the longest they have had to wait for a response was 15 minutes. Per interviews with facility maintenance staff, the call system is checked every month to make sure every living room and bathroom call system works properly. During the inspection, facility maintenance staff checked on the call system in R1’s room and confirmed it is working properly. Based on the interviews conducted and records reviewed, facility staff did not respond to R1’s call light in a timely manner and this allegation is substantiated.

During the course of the investigation, the Department obtained sufficient evidence to substantiate the allegation mentioned above. The preponderance of evidence standard has been met; therefore, the above allegation is Substantiated. See LIC9099D for cited deficiencies per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted and a copy of this report and appeal rights was discussed with and provided to facility representative.

SUPERVISOR'S NAME: Armando J Lucero	TELEPHONE: (714) 703-2840
LICENSING EVALUATOR NAME: Sean Haddad	TELEPHONE: (714) 335-7094
LICENSING EVALUATOR SIGNATURE:	DATE: 04/15/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2022

LIC9099 (FAS) - (06/04)

Page: 2 of 5

Control Number 22-AS-20220408162727

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: WHITTEN HEIGHTS ASSISTED LIVING AND MEMORY CARE	FACILITY NUMBER: 306004192
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 04/15/2022

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 04/16/2022 Section Cited CCR 87303(i)(1)	1 2 3 4 5 6 7	87303 Maintenance and Operation (i) … (1) All facilities licensed for 16 or more and all residential facilities having separate floors or buildings shall have a signal system which shall: (A) Operate from each resident's living unit… This requirement was not met as evidenced by:	1 2 3 4 5 6 7	During the inspection, facility maintenance staff checked on the call system in R1’s room and confirmed it is working properly. Licensee stated they will continue conducting monthly checks for technical issues with the call system and will begin keeping records of these checks.
	8 9 10 11 12 13 14	Based on interviews, facility staff did not respond to R1’s call light in a timely manner, which poses an immediately health and safety risk to residents in care.	8 9 10 11 12 13 14	Licensee stated they will train all staff to report any issues with the call system to the Administrator in the future.
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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: Armando J Lucero	TELEPHONE: (714) 703-2840
LICENSING EVALUATOR NAME: Sean Haddad	TELEPHONE: (714) 335-7094
LICENSING EVALUATOR SIGNATURE:	DATE: 04/15/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2022

LIC9099 (FAS) - (06/04)

Page: 3 of 5

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
04/08/2022 and conducted by Evaluator Sean Haddad

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20220408162727

FACILITY NAME:	WHITTEN HEIGHTS ASSISTED LIVING AND MEMORY CARE		FACILITY NUMBER:	306004192
ADMINISTRATOR:	CHIN SHUN LEE LIAU		FACILITY TYPE:	740
ADDRESS:	200 WEST WHITTIER BLVD.		TELEPHONE:	(562) 691-1200
CITY:	LA HABRA	STATE: CA	ZIP CODE:	90631
CAPACITY:	196	CENSUS: 89	DATE:	04/15/2022
		UNANNOUNCED	TIME BEGAN:	08:58 AM
MET WITH:	Carol Lee		TIME COMPLETED:	11:30 AM

ALLEGATION(S):

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Facility has insects

INVESTIGATION FINDINGS:

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This unannounced inspection is being conducted by Licensing Program Analyst (LPA) Sean Haddad for the purpose of investigating the above-mentioned complaint allegation. LPA met with Administrator (AD) Carol Lee, discussed the purpose of the inspection, and explained the allegation.

The investigation into the allegation that the facility has insects revealed the following: During the course of the investigation, LPA inspected the facility’s kitchen, common areas, hallways, and 9 resident rooms, interviewed 3 staff and 6 residents, and requested and reviewed the resident roster, staff roster, staff schedule, photographs of insects at the facility, and pest control records.

The investigation into the allegation that the facility has insects revealed the following: LPA reviewed recent photographs showing dozens of flying insects in Resident #2’s (R2) room.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Armando J Lucero	TELEPHONE: (714) 703-2840
LICENSING EVALUATOR NAME: Sean Haddad	TELEPHONE: (714) 335-7094
LICENSING EVALUATOR SIGNATURE:	DATE: 04/15/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2022

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

LIC9099 (FAS) - (06/04)

Page: 4 of 5

Control Number 22-AS-20220408162727

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: WHITTEN HEIGHTS ASSISTED LIVING AND MEMORY CARE	FACILITY NUMBER: 306004192
	VISIT DATE: 04/15/2022

NARRATIVE

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Per interviews with R2, R2 noticed the insects in their room, reported the situation to staff, and was relocated to new room temporarily. Facility staff addressed the insect problem in R2’s original room and now R2 reports no issues with insects. On 4/15/22, LPA inspected the facility’s kitchen, common areas, hallways, and 9 resident rooms along with facility staff and AD and observed no insects. LPA interviewed 5 residents who reported no insect infestations. Per resident interviews, the insects may have been drawn to R2’s original room because R2 left food inside. During the inspection, LPA observed food, including jam, placed on a table in the hallway near R2’s new temporary room. LPA also observed the same jam on the floor of R2’s new temporary room. Per interviews with AD, AD stated that a pest control company sprays for insects every other week. AD also stated that the facility makes a note of whenever a resident or staff sees insects and provides those notes to the pest control company when they arrive to notify them of where to look for insects. LPA requested and reviewed recent pest control records that show the pest control company comes every other week to spray for inspects. Based on the observations made, interviews conducted, and records reviewed, while there were recently insects in R2’s room, the insects were quickly addressed by the facility, the facility has a regular process for identifying and addressing insect infestations, LPA observed no insects at the facility, and the residents interviewed did not report any insect infestation. This allegation is unsubstantiated.

Based on the information gathered during the investigation and review of all documents obtained, the Department is unable to ascertain if the allegation occurred as reported. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove or refute the alleged violation occurred; therefore, this allegation is deemed Unsubstantiated. An exit interview was conducted and a copy of this report was discussed with and provided to facility representative.

SUPERVISOR'S NAME: Armando J Lucero	TELEPHONE: (714) 703-2840
LICENSING EVALUATOR NAME: Sean Haddad	TELEPHONE: (714) 335-7094
LICENSING EVALUATOR SIGNATURE:	DATE: 04/15/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2022

LIC9099 (FAS) - (06/04)

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