306004192-3-12-2024-22-AS-AJLO-D3JPEM-20240320111519

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306004192
Report Date: 03/12/2024
Date Signed: 03/12/2024 02:32:53 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
03/06/2024 and conducted by Evaluator Sean Haddad

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20240306120233

FACILITY NAME:	WHITTEN HEIGHTS ASSISTED LIVING AND MEMORY CARE		FACILITY NUMBER:	306004192
ADMINISTRATOR:	STEVE SHEN		FACILITY TYPE:	740
ADDRESS:	200 WEST WHITTIER BLVD.		TELEPHONE:	(562) 691-1200
CITY:	LA HABRA	STATE: CA	ZIP CODE:	90631
CAPACITY:	196	CENSUS: 118	DATE:	03/12/2024
		UNANNOUNCED	TIME BEGAN:	08:10 AM
MET WITH:	Allen Nishikawa		TIME COMPLETED:	02:45 PM

ALLEGATION(S):

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Facility did not provide adequate notice of rate change to residents and/or POA/responsible party

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) Allen Nishikawa and explained the reason for today’s inspection.

The investigation into the allegation that the facility did not provide adequate notice of rate change to residents and/or POA/responsible party revealed the following: During the course of the investigation, LPA inspected the facility, interviewed AD, and obtained and reviewed copies of the resident roster, staff roster, and a rent increase notice dated 02/26/24.

Regarding the allegation that the facility did not provide adequate notice of rate change to residents and/or POA/responsible party: it was alleged that the facility did not provide proper notice of a rate change to residents. LPA requested and reviewed a rent increase notice dated 02/26/24 which indicates a rate increase will be effective on 03/31/24.

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: 03/12/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2024

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-20240306120233

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: 03/12/2024

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 04/09/2024 Section Cited CCR 87507(g)(4)	1 2 3 4 5 6 7	87507 Admission Agreements … (g) Admission agreements shall specify the following: (4) Modification conditions, including the requirement for the provision of at least 60 days prior written notice to the resident of any rate or rate structure change...	1 2 3 4 5 6 7	Licensee stated they will create a new notice of rate change specifying the amount of the increase, the reason, and a general description of the additional costs, and will give the notice to each resident and mail it to each responsible party at least 60 days prior to the
	8 9 10 11 12 13 14	This requirement was not met as evidenced by: Based on interviews and documents, the licensee did not provide at least 60 days’ notice of a rate change to residents, which poses a potential personal rights risk to persons in care.	8 9 10 11 12 13 14	effective date and will provide proof to LPA by POC due date.
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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: 03/12/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2024

LIC9099 (FAS) - (06/04)

Page: 2 of 5

Control Number 22-AS-20240306120233

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: 03/12/2024

NARRATIVE

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LPA interviewed AD who stated this notice was used by the facility to provide notice of a rate change to residents, was posted at the front of the facility and distributed at a resident council meeting where 12 residents were present, and was placed in the mailbox of each resident at the facility. However, because the notice does not provide at least 60 day’s notice of a rate increase as required, the facility did not provide adequate notice of the rate change to residents.

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: 03/12/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2024

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
03/06/2024 and conducted by Evaluator Sean Haddad

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20240306120233

FACILITY NAME:	WHITTEN HEIGHTS ASSISTED LIVING AND MEMORY CARE		FACILITY NUMBER:	306004192
ADMINISTRATOR:	STEVE SHEN		FACILITY TYPE:	740
ADDRESS:	200 WEST WHITTIER BLVD.		TELEPHONE:	(562) 691-1200
CITY:	LA HABRA	STATE: CA	ZIP CODE:	90631
CAPACITY:	196	CENSUS: 118	DATE:	03/12/2024
		UNANNOUNCED	TIME BEGAN:	08:10 AM
MET WITH:	Allen Nishikawa		TIME COMPLETED:	02:45 PM

ALLEGATION(S):

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The quality and quantity of food for residents is inadequate

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) Allen Nishikawa and explained the reason for today’s inspection.

The investigation into the allegation that the quality and quantity of food for residents is inadequate revealed the following: During the course of the investigation, LPA inspected the facility, interviewed AD and residents, and obtained and reviewed copies of the resident roster, staff roster, facility menus for the last three months, Sysco invoices, US Foods invoices, and Dairy King invoices.

Regarding the allegation that the quality and quantity of food for residents is inadequate: it was alleged that food portions have decreased and residents are not getting the appropriate quantity for a meal.

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: 03/12/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2024

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-20240306120233

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: 03/12/2024

NARRATIVE

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LPA inspected the kitchen and observed it to be clean and organized, the facility has a 2-day supply of perishables and a 7-day supply of non-perishable food is available as required by regulations, the refrigerator and freezer were at proper temperatures, there were no spoiled or expired foods, and the perishable food appeared fresh and included fresh fruit and vegetables. LPA observed lunch being served in the dining room and via room service in resident rooms on 03/12/24 and LPA’s observations did not corroborate the allegation. The meals were generous in size and included a quesadilla with a side of rice, beans, salad and salsa, a soup with meat and vegetables, a salad, and a cookie. LPA interviewed 10 residents, including both residents who eat in the dining room and residents who receive their meals in their rooms. Of the 10 residents interviewed, none had any complaints about the quality of the food. 4 residents reported that portions are sometimes smaller, but all residents that responded confirmed they are getting enough to eat and that they are able to ask for more and always receive more food if they request it. None of the residents interviewed had any complaints about the quantity of food provided. LPA reviewed facility menus for the last three months and noted a proper variety of meat and vegetables in the meals. Residents interviewed corroborated that the meals balance meat, vegetables, and other items. LPA interviewed AD who did not corroborate the allegation and reported the facility orders its food from Sysco, US Foods, and Dairy King. LPA reviewed Sysco, US Foods, and Dairy King invoices for the month of February 2024 and those from approximately a year prior and noted the facility spent approximately 13.5% more on food in February 2024 than a year previous.

Based on the information gathered during the investigation and review of all documents obtained, the Department is unable to ascertain if the above 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: 03/12/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2024

LIC9099 (FAS) - (06/04)

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