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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306004192
Report Date: 07/02/2024
Date Signed: 07/02/2024 11:06:20 AM

Unsubstantiated


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
06/28/2024 and conducted by Evaluator Sean Haddad
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20240628153302
FACILITY NAME:WHITTEN HEIGHTS ASSISTED LIVING AND MEMORY CAREFACILITY NUMBER:
306004192
ADMINISTRATOR:STEVE SHENFACILITY TYPE:
740
ADDRESS:200 WEST WHITTIER BLVD.TELEPHONE:
(562) 691-1200
CITY:LA HABRASTATE: CAZIP CODE:
90631
CAPACITY:196CENSUS: 126DATE:
07/02/2024
UNANNOUNCEDTIME BEGAN:
07:30 AM
MET WITH:Faye ShenTIME COMPLETED:
11:20 AM
ALLEGATION(S):
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Licensee failed to eradicate insect infestation
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 Chief Operating Officer (COO) Faye Shen, discussed the purpose of the inspection, and explained the allegation.

The investigation into the allegation that the licensee failed to eradicate insect infestation revealed the following: During the course of the investigation, LPA inspected the facility, interviewed COO and residents, and obtained and reviewed copies of the resident roster, staff roster, and the facility’s recent pest control invoices.

CONTINUED
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Armando J LuceroTELEPHONE: (714) 703-2840
LICENSING EVALUATOR NAME: Sean HaddadTELEPHONE: (714) 335-7094
LICENSING EVALUATOR SIGNATURE:

DATE: 07/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/02/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
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Control Number 22-AS-20240628153302
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: 07/02/2024
NARRATIVE
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Regarding the allegation that the licensee failed to eradicate insect infestation: it was alleged that the facility was recently investigated for an insect infestation, the facility did not correct the issue, and the insect infestation is getting worse. LPA reviewed the facility’s compliance history and noted the facility was issued a deficiency for an insect infestation on June 18, 2024 in connection with Complaint Control No. 22-AS-20240617103710. LPA inspected six resident rooms and observed no evidence of insects or an insect infestation. LPA interviewed six residents, five or whom reported no issues with insects in their rooms. One resident reported that they previously had insects in their room, the facility had addressed the issue, but that the insects had returned, and the facility is not taking adequate steps to address the issue. LPA interviewed COO who stated that the facility was aware of insects in this resident’s room, the exterminator had sprayed this resident’s room on June 19, 2024, facility staff have been spraying this resident’s room on an as-needed basis, facility staff clean this resident’s room regularly to prevent insects from returning, the exterminator is scheduled to spray this resident’s room again three weeks from June 19, 2024, and the facility is able to call the exterminator in at any time for additional spraying, but this resident’s room does not need it because no insects have been observed and the facility does not want to unnecessarily expose the resident to pesticide as they spend most of their time in their room. LPA reviewed the facility’s recent pest control invoices corroborating that this resident’s room was recently sprayed on June 19, 2024. The information obtained did not corroborate that the facility was not taking adequate steps to address the infestation. LPA observed the resident in question likes to keep food in their room and eat in their bed and COO stated they will move the resident’s mini-fridge and microwave closer to their bed to allow them to store food and eat in bed while minimizing crumbs that would attract insects.

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 LuceroTELEPHONE: (714) 703-2840
LICENSING EVALUATOR NAME: Sean HaddadTELEPHONE: (714) 335-7094
LICENSING EVALUATOR SIGNATURE:

DATE: 07/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/02/2024
LIC9099 (FAS) - (06/04)
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