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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306004796
Report Date: 07/10/2026
Date Signed: 07/10/2026 03:20:50 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
09/19/2024 and conducted by Evaluator Taylor Simerly
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20240919164250
FACILITY NAME:HUNTINGTON TERRACEFACILITY NUMBER:
306004796
ADMINISTRATOR:GREGORY CASEFACILITY TYPE:
740
ADDRESS:18800 FLORIDA STTELEPHONE:
(714) 848-8811
CITY:HUNTINGTON BEACHSTATE: CAZIP CODE:
92648
CAPACITY:185CENSUS: 169DATE:
07/10/2026
UNANNOUNCEDTIME BEGAN:
02:43 PM
MET WITH:Timarie Morrisey-Business Office DirectorTIME COMPLETED:
03:20 PM
ALLEGATION(S):
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Staff did not administer medication as prescribed.
INVESTIGATION FINDINGS:
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On July 10, 2026 at approximately 2:45 PM, LPA Taylor Simerly and LPM Alfonso Iniguez conducted an unannounced subsequent complaint visit. LPA and LPM met with Timarie Morrisey Business Office Director. LPA and LPM explained the purpose of this visit.



The Investigation consisted on: records reviews and residents interviews.



Evaluation Report continues on LIC 9099-C...

Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Alfonso Iniguez
LICENSING EVALUATOR NAME: Taylor Simerly
LICENSING EVALUATOR SIGNATURE:

DATE: 07/10/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2026
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 4
Control Number 22-AS-20240919164250
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: HUNTINGTON TERRACE
FACILITY NUMBER: 306004796
VISIT DATE: 07/10/2026
NARRATIVE
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Investigation Revealed the following:

Allegation: Staff did not administer medication as prescribed.

It was alleged that facility staff did not administer medications as prescribed. During the course of the investigation, LPA Lee reviewed facility records pertaining to resident medications. Based on incident reports provided by the facility on 05/22/2026, it was learned that three medication errors occurred during 2024. On 01/09/2024, 01/10/2024, 01/11/2024, and 01/13/2024, Resident 1 (R1) was administered an additional dose of Mirtazapine 30 mg. The medication was prescribed as one tablet by mouth at bedtime only; however, it was also administered in the morning. On 10/14/2024 at approximately 2:00 p.m., a medication technician reported to the Health Services Administrator (HSA) that Resident 2 (R2) had been administered the incorrect dosage of Atorvastatin. R2 received Atorvastatin 20 mg, however, the physician's order prescribed Atorvastatin 10 mg, one tablet by mouth at bedtime. On 05/01/2024 at approximately 9:00 p.m., Resident 3 (R3) was administered another resident's bedtime medications, including Ativan and Norco.

LPA Lee also reviewed Medication Administration Records (MARs) for seven residents for May 2024 and identified two documentation discrepancies. Resident 4 (R4) was prescribed Ocean Blue Omega-3 2100 mg, one capsule by mouth daily, with a start date of 05/02/2024 and an end date of 10/10/2024. The MAR did not have staff initials from 05/02/2024 through 05/06/2024, and no documentation to explain the omission. Resident 5 (R5) was prescribed Methylphenidate 5 mg tablets, two tablets (10 mg) by mouth three times daily, with a start date of 02/29/2024 and an end date of 08/21/2024. The MAR contained no staff initials for the morning, noon, or evening medication passes on 05/02/2024 and from 05/06/2024 through 05/16/2024. No notes were documented explaining the missing entries.

Evaluation Report continues on LIC 9099-C...

SUPERVISORS NAME: Alfonso Iniguez
LICENSING EVALUATOR NAME: Taylor Simerly
LICENSING EVALUATOR SIGNATURE:

DATE: 07/10/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 22-AS-20240919164250
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: HUNTINGTON TERRACE
FACILITY NUMBER: 306004796
VISIT DATE: 07/10/2026
NARRATIVE
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Based on facility incident reports and the review of resident MARs, the investigation revealed medication administration errors, as a result, the allegation is found to be SUBSTANTIATED, meaning the allegation was found to be valid because the preponderance of evidence standard was met.

The following deficiency was cited on the LIC 9099-D pursuant to Title 22, Division 6, of the California Code of Regulations and applicable Health and Safety Code sections.

An exit interview was conducted, and a copy of the complaint report was provided via email to Timarie Morrisey Business Office Director

SUPERVISORS NAME: Alfonso Iniguez
LICENSING EVALUATOR NAME: Taylor Simerly
LICENSING EVALUATOR SIGNATURE:

DATE: 07/10/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 22-AS-20240919164250
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: HUNTINGTON TERRACE
FACILITY NUMBER: 306004796
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/10/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/24/2026
Section Cited
CCR
87465(a)(4)
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THIS DOCUMENT WAS AMENDED DUE TO INCORRECT CITATION.
(a) A plan for incidental medical and dental care shall be developed by each facility. The plan shall encourage routine medical and dental care and provide for assistance in obtaining such care, by compliance with the following:
(4) The licensee shall assist residents with self-administered medications as needed.
This was not met as evidence by:
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The Administrator shall conduct an in-service training regarding medication administration to ensure that residents' medications are administered in accordance with physicians' orders. Copies of the training materials and staff sign-in sheet shall be submitted to the LPM no later than 7/24/26 by 5:00 PM.
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Based on record review, the facility reported three medication errors. Additionally, a review of residents' MARs revealed multiple discrepancies involving three residents, indicating that medications were not administered in accordance with physicians' orders. This poses a potential health and safety risk to residents 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: Czarrina A Camilon-Lee
LICENSING EVALUATOR NAME: Pang Lee
LICENSING EVALUATOR SIGNATURE:

DATE: 07/10/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2026
LIC9099 (FAS) - (06/04)
Page: 4 of 4