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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306004796
Report Date: 07/11/2023
Date Signed: 07/11/2023 01:30:00 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE & INLAND A/SC, 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
04/25/2023 and conducted by Evaluator Jenifer Tirre
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20230425075310
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: 146DATE:
07/11/2023
UNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Business Director Natasha O'Sullivan and Health Services director Alysia NoriegaTIME COMPLETED:
01:45 PM
ALLEGATION(S):
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Facility failed to provide records to Attorney
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Jenifer Tirre and Licensing Program Manager (LPM) Alisa Ortiz made an unannounced visit on this day for the purpose of delivering findings for the above-mentioned allegation. LPA & LPM was greeted by staff and met with Business Manager Natasha O'Sullivan and Health Services Director Alysia Noriega.

The investigation consisted of obtained records and interviews with Huntington Terrace Staff. On 4/25/23 the department received allegations that facility failed to provide records to family attorney. The Investigation was completed by the department and revealed the following:
Based on interviews with staff, facility received records request from Law Firm with a two day due date. Interview with Administrator confirm that facility sent records. On 7/10/23 department contacted representative at Law Firm to verify documents received. Law Firm Representative stated facility did submit requested documents. Requested documents were received on May 17, 2023 according to Law Firm Representative. CONTINUED ON 9099C
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Luz AdamsTELEPHONE: (714) 222-3812
LICENSING EVALUATOR NAME: Jenifer TirreTELEPHONE: (714) 401-6844
LICENSING EVALUATOR SIGNATURE:

DATE: 07/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2023
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 2
Control Number 22-AS-20230425075310
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE & INLAND A/SC, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME: HUNTINGTON TERRACE
FACILITY NUMBER: 306004796
VISIT DATE: 07/11/2023
NARRATIVE
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 Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the above allegation is deemed UNSUBSTANTIATED.
An exit interview was conducted with Staff and copy of this report along with appeal rights was left at facility.
SUPERVISOR'S NAME: Luz AdamsTELEPHONE: (714) 222-3812
LICENSING EVALUATOR NAME: Jenifer TirreTELEPHONE: (714) 401-6844
LICENSING EVALUATOR SIGNATURE:

DATE: 07/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2