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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306004192
Report Date: 10/31/2024
Date Signed: 10/31/2024 04:17:29 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 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
10/22/2024 and conducted by Evaluator Alvaro Ramirez Jr.
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20241022080554
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: 130DATE:
10/31/2024
UNANNOUNCEDTIME BEGAN:
08:29 AM
MET WITH:Faye Shen- Chief Operating OfficerTIME COMPLETED:
04:31 PM
ALLEGATION(S):
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Facility does not have a full-time activity director
Facility is in disrepair
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Alvaro Ramirez, Jr. conducted an unannounced initial 10-Day complaint visit to initiate the investigation into the above allegations and to deliver the findings of the investigation. LPA was greeted and granted entry into the facility and met with Receptionist Gerardo Reyes. LPA explained the reason for the visit. Chief Operating Officer (COO) Faye Shen arrived during the visit.

This agency has investigated the complaint alleging that facility does not have a full-time activity director
and facility is in disrepair. Regarding the allegations, the following was revealed: During the course of the investigation LPA reviewed documents including the October 2024 Activities Schedule. Per Activities schedule Staff 1 (S1) is schedule to work from 6:00am-4:00pm, Monday through Friday. During the course of the interviews with staff, Staff 1 (S1) reported that from 6:00am-9:00am she does housekeeping duties. Per S1 from 09:00am-4:00pm she does the activities as she is also the Activities Director.
Regarding the allegation that facility is in disrepair, the following was revealed:
CONTINUED ON LIC9099-C...
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Sheila SantosTELEPHONE: (714) 334-2062
LICENSING EVALUATOR NAME: Alvaro Ramirez Jr.TELEPHONE: 714-705-6007
LICENSING EVALUATOR SIGNATURE:

DATE: 10/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/31/2024
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-20241022080554
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME: WHITTEN HEIGHTS ASSISTED LIVING AND MEMORY CARE
FACILITY NUMBER: 306004192
VISIT DATE: 10/31/2024
NARRATIVE
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During the initial visit on October 31, 2024 LPA tour the facility and observed that on the second and third floors there are couches with brown and black discoloration. LPA observed that the couches' leather and/or cloth is ripped or cracked. On the Memory Care units located on the second and third floors LPA observed that the wood floor is broken and missing parts of the tiles. LPA observed that some of the disrepair tiles can be a hazard trip for residents in care. On the Memory Care units LPA observed chipped tables, tables missing paint and chairs with ripped plastic covers. During the tour LPA observed that the baseboards throughout the facility are chipped and have brown and/or black discoloration. On the first floor LPA observed that the dryer is missing the top cover which exposes the flame. On the first floor LPA also observed that one of two washing machines is missing the front cover exposing the washing machine's cables. LPA also observed that the elevator by the first floor laundry room is out of service. Two of three elevators are operating properly.

Based on observations and the interviews which were conducted, the preponderance of evidence standard has been met, therefore the following allegations: facility does not have a full-time activity director
and facility is in disrepair are deemed SUBSTANTIATED. California Code of Regulations, Title 22, Division 6, Chapter 8 is being cited on the attached LIC 9099D.

An exit interview was conducted with facility representative and a copy of this report along with the Appeal Rights were provided at the time of this visit.
SUPERVISOR'S NAME: Sheila SantosTELEPHONE: (714) 334-2062
LICENSING EVALUATOR NAME: Alvaro Ramirez Jr.TELEPHONE: 714-705-6007
LICENSING EVALUATOR SIGNATURE:

DATE: 10/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/31/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 22-AS-20241022080554
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 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: 10/31/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/07/2024
Section Cited
CCR
87219(f)
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87219 Planned Activities(f)In facilities licensed for fifty (50) persons or more, one staff member shall have full-time responsibility to organize, conduct and evaluate planned activities,...The program of activities shall be written, planned in advance, kept up-to-date, and made
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Per Licensee a Plan of Action to have a full-time Activities Director will be develop. Licensee to email proof to LPA by POC due date.
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available to all residents. This requirement was not met as evidence by: Based on interviews and records reviewed the facility does not have a full-time Activities Director. This poses a potential health, safety or personal rights risk to persons in care.
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Type B
11/14/2024
Section Cited
CCR
87303(a)
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87303 Maintenance and Operation (a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors. This requirement is not met as evidence by:
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Licensee to repair the floor, tables, chairs, couches, baseboards, dryer, washer and elevator. Licensee to email LPA proof by POC due date.
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LPA observed ripped couches with brown and black discoloration, LPA observed that the wood floor is broken and missing parts of the tiles, LPA observed chipped tables, tables missing paint and chairs with ripped plastic covers, LPA observed that the baseboards throughout the facility are chipped and have brown and/or black discoloration and on the first floor LPA observed that the dryer is missing the top cover which exposes the flame. This poses a potential health, safety or personal rights risk to persons in care
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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: Sheila SantosTELEPHONE: (714) 334-2062
LICENSING EVALUATOR NAME: Alvaro Ramirez Jr.TELEPHONE: 714-705-6007
LICENSING EVALUATOR SIGNATURE:

DATE: 10/31/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/31/2024
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
ORANGE COUNTY RO, 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
10/22/2024 and conducted by Evaluator Alvaro Ramirez Jr.
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20241022080554

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: 130DATE:
10/31/2024
UNANNOUNCEDTIME BEGAN:
08:29 AM
MET WITH:Faye Shen- Chief Operating OfficerTIME COMPLETED:
04:31 PM
ALLEGATION(S):
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Facility is not posting its activity calendar
Facility is not maintaining a comfortable temperature for residents
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Alvaro Ramirez, Jr. conducted an unannounced initial 10-Day complaint visit to initiate the investigation into the above allegations and to deliver the findings of the investigation. LPA was greeted and granted entry into the facility and met with Receptionist Gerardo Reyes. LPA explained the reason for the visit. Chief Operating Officer (COO) Faye Shen arrived shortly after.

This agency has investigated the complaint alleging that facility is not posting its activity calendar and facility is not maintaining a comfortable temperature for residents. Regarding the allegations, the following was revealed: During the initial visit on October 31, 2024 LPA tour the facility and observed that there was an October 2024 Calendar posted on the first floor by the main entryway and one in the Memory Care unit. During the course of the interviews with residents, Resident 1 (R1) reported that the Activities calendar is by the entrance and stated that they offer activities such as bingo, live music, and an exercise classes. Per R2 he has seen the Activities calendar by the front and reported that he likes the activities.
CONTINUED ON LIC9099-C...
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Sheila SantosTELEPHONE: (714) 334-2062
LICENSING EVALUATOR NAME: Alvaro Ramirez Jr.TELEPHONE: 714-705-6007
LICENSING EVALUATOR SIGNATURE:

DATE: 10/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/31/2024
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-20241022080554
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME: WHITTEN HEIGHTS ASSISTED LIVING AND MEMORY CARE
FACILITY NUMBER: 306004192
VISIT DATE: 10/31/2024
NARRATIVE
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Regarding the allegation that facility is not maintaining a comfortable temperature for residents, the following was revealed: Eight of eleven individuals interviewed denied the allegation. During the initial visit LPA tested the temperature throughout the facility and it tested between 72.5 and 77.3 Degrees Fahrenheit. During the course of the interviews with residents, R1 reported that the temperature is comfortable and stated that he can adjust the temperature. Per R3 the temperature is comfortable and reported that she can adjust the air conditioning and heater.

Based on the information gathered during the investigation and review of documents obtained, LPA is unable to ascertain if the allegations occurred as reported due to conflicting information. Although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove or refute the alleged violations occurred; therefore, this allegations are deemed UNSUBSTANTIATED.

For today’s visit, there were no citations issued per Title 22, Division 6 of the California Code of Regulations.


LPA conducted an exit interview with facility representative, and a copy of this report was provided to the facility.
SUPERVISOR'S NAME: Sheila SantosTELEPHONE: (714) 334-2062
LICENSING EVALUATOR NAME: Alvaro Ramirez Jr.TELEPHONE: 714-705-6007
LICENSING EVALUATOR SIGNATURE:

DATE: 10/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/31/2024
LIC9099 (FAS) - (06/04)
Page: 5 of 5