306004796-3-17-2022-22-AS-LADS-CD9PPA-20220407112913

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306004796
Report Date: 03/17/2022
Date Signed: 03/17/2022 10:23:16 AM

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
03/03/2022 and conducted by Evaluator Ruth Martinez

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20220303125631

FACILITY NAME:	HUNTINGTON TERRACE		FACILITY NUMBER:	306004796
ADMINISTRATOR:	GREGORY CASE		FACILITY TYPE:	740
ADDRESS:	18800 FLORIDA ST		TELEPHONE:	(714) 848-8811
CITY:	HUNTING BEACH	STATE: CA	ZIP CODE:	92648
CAPACITY:	185	CENSUS: 139	DATE:	03/17/2022
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Gregory Case		TIME COMPLETED:	10:35 AM

ALLEGATION(S):

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-Facility is not following admission agreement.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Ruth Martinez visited the facility to deliver findings for the investigation into the above identified complaint allegation. LPA arrived at the facility was greeted and granted entry by receptionist. LPA met with Gregory Case, Administrator and explained the purpose of the visit.

Findings are based upon this investigation which included documentation review of the following: Admissions agreement, resident handbook, employment ad for driver, and transportation logs.
It is alleged that facility is not following admissions agreement indicating transportation is not being used for group outings and recreational outings. Per review of admissions agreement page 2 number 8D indicates Local "schedule" transportation (refer to the resident Handbook [attached as Exhibit "B"]). Resident handbook page 13 under transportation reads: Transportation: the bus schedule and sign up logs are posted

Continued on LIC9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Sheila Santos	TELEPHONE: (714) 334-2062
LICENSING EVALUATOR NAME: Ruth Martinez	TELEPHONE: (657) 285-1397
LICENSING EVALUATOR SIGNATURE:	DATE: 03/17/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2022

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-20220303125631

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: HUNTINGTON TERRACE	FACILITY NUMBER: 306004796
	VISIT DATE: 03/17/2022

NARRATIVE

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at the front desk. The staff will provide scheduled transportation to the nearest medical facility or within a five mile radius. Should you require special transportation, other than the scheduled runs, we will endeavor to accommodate you, but cannot guarantee that special transportation will be available at all times. Please allow us to assist you in planning appointment times that will fit into your schedule as well as others. In review of transportation logs indicates that Mondays, Wednesdays, and Fridays are errand days, Tuesday and Thursday are for appointments and Sundays are for Church Services. Logs reflect residents have signed up for various times and dates for the past two years and have been providing the transportation as indicated. The facility also has a bus that seats 28 people but due to Covid driver resigned and facility has not been able to hire a new driver. However, the facility has a facility van that seats up to 6-8 passengers at one time which has provided transportation at all times. Although the facility was readily available at all times with transportation due to certain circumstances like Covid transportation may have been put on hold for group outing or recreational outings.

Based on the information gathered during the investigation, review of all documents obtained, the Department is unable to ascertain if the allegation occurred as reported. Although the allegations 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 with Administrator, and a copy of this LIC9099 report was left at facility.

SUPERVISOR'S NAME: Sheila Santos	TELEPHONE: (714) 334-2062
LICENSING EVALUATOR NAME: Ruth Martinez	TELEPHONE: (657) 285-1397
LICENSING EVALUATOR SIGNATURE:	DATE: 03/17/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2022

LIC9099 (FAS) - (06/04)

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