306004796-7-11-2023-22-AS-AORZ-CU2MM8-20230724094327

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306004796
Report Date: 07/11/2023
Date Signed: 07/11/2023 01:15:15 PM

Substantiated

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
03/07/2022 and conducted by Evaluator Jenifer Tirre

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20220307083232

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: 146	DATE:	07/11/2023
		UNANNOUNCED	TIME BEGAN:	08:32 AM
MET WITH:	Business Office Managerr Natasha O'Sullivan and Director of wellness Alysia Noriega		TIME COMPLETED:	01:15 PM

ALLEGATION(S):

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Staff denied hospice visit for resident

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 Office Manager Natasha O'Sullivan.

The investigation consisted of obtained records and interviews with Huntington Terrace Staff and family member. On 3/7/2022 the department received allegations that staff denied hospice visit for resident. The Investigation was completed by the department and revealed the following:

Based off staff interviews, 2 of 5 facility staff interviewed stated that on 3/5/22, a hospice nurse from a Hospice care agency attempted visit with Resident 1 (R1). The remaining staff interviewed did not have direct knowledge of this specific incident. Staff knowledgeable of incident claimed that facility was verifying if Hospice agency was allowed visitation due to a pending lawsuit between the facility and hospice agency at time of visit. CONTINUED ON 9099C

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Luz Adams	TELEPHONE: (714) 222-3812
LICENSING EVALUATOR NAME: Jenifer Tirre	TELEPHONE: (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 3

Control Number 22-AS-20220307083232

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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Based off interview with R1’s family, Family claimed that they were informed by R1’s hospice nurse regarding denial of visitation. Family contacted R1’s primary doctor, who happens to also be hospice doctor. Interview confirmed that doctor resolved issue with facility at a later time.

During interview with former Administrator Case, it was reported that R1’s Doctor barged their way into facility refusing to follow visitation policy by signing in; However, copies of the facility visitation log dated 3/5/2022 confirms R1 had three visitors sign in that day: a Family member, Hospice Nurse, and R1’s Doctor. Hospice Nurse was logged in for 95 minutes and Doctor for 2 hours. Hospice documents confirm that Hospice made initial hospice visit on 3/8/22, three days after the initial attempted visit was denied.

Facility guidelines state that Home Health/ Outside Agencies are expected to check in with the Director of Health Services when arriving at the community and upon leaving. Facility policy further states Residents have the right to select their own physicians, pharmacies, personal assistants, hospice agency and health care providers that is consistent with residents admission agreement.

Based off interviews conducted and records obtained the preponderance of evidence has been met, deeming the allegation Staff denied hospice visit for resident to be SUBSTANTIATED. per California Code of Regulations, (Title 22, Division 6, Chapter 8).

An exit interview was conducted with staff and a copy of this report, along with copy of citation and copy of Appeal Rights have been provided to Facility.

SUPERVISOR'S NAME: Luz Adams	TELEPHONE: (714) 222-3812
LICENSING EVALUATOR NAME: Jenifer Tirre	TELEPHONE: (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)

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Control Number 22-AS-20220307083232

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
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/11/2023

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 07/12/2023 Section Cited HSC 1569.269(a)(20)	1 2 3 4 5 6 7	(a)Residents of residential care facilities for the elderly shall have all of the following rights: (20)To select their own physicians, pharmacies, privately paid personal assistants, hospice agency, and health care providers, in a manner that is consistent with the resident's contract	1 2 3 4 5 6 7	Facility to do formal inservice training on educating staff with hospice choices regarding Personal rights and set date of inservice within 24 hours.Facility provided set date of 7/20/23 for inservice. Facility to provide proof of inservice training by close of business date 7/21/23.
	8 9 10 11 12 13 14	of admission or other rules of the facility, and in accordance with this act. This regulation was not met as evidenced by facility failed R1's choice of hospice company was denied access. This poses an immediate health and safety risk to residents in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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: Luz Adams	TELEPHONE: (714) 222-3812
LICENSING EVALUATOR NAME: Jenifer Tirre	TELEPHONE: (714) 401-6844
LICENSING EVALUATOR SIGNATURE:	DATE: 07/11/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2023

LIC9099 (FAS) - (06/04)

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