306005603-2-3-2023-22-AS-AORZ-CP4NHH-20230216092842

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306005603
Report Date: 02/03/2023
Date Signed: 02/03/2023 10:01:19 AM

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
01/12/2023 and conducted by Evaluator Alvaro Ramirez Jr.

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20230112164247

FACILITY NAME:	CITRUS HILLS ASSISTED LIVING		FACILITY NUMBER:	306005603
ADMINISTRATOR:	JUAN JORGE POEMAPE-DIAZ		FACILITY TYPE:	740
ADDRESS:	142 S PROSPECT ST		TELEPHONE:	(714) 639-3590
CITY:	ORANGE	STATE: CA	ZIP CODE:	92869
CAPACITY:	95	CENSUS: 82	DATE:	02/03/2023
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Yairell Garcia-Wellness Director, Itzayana Barba Aguirre-Operations Manager		TIME COMPLETED:	10:15 AM

ALLEGATION(S):

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Insufficient staff to meet the needs of residents.

INVESTIGATION FINDINGS:

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Licensing Program Analysts (LPAs) Alvaro Ramirez, Jr. and Andrea Mendivil conducted an unannounced complaint visit to deliver findings on the above allegation received on 01/12/23. LPAs were greeted and granted entry into the facility and initially met with Wellness Coordinator (WC) Citlali Galeana. Operations Manager (OM) Itzanaya Barba Aguirre and Wellness Director Yairell Garcia arrived shortly after. LPAs explained the reason for the visit.

This agency has investigated the complaint alleging that facility does not have enough staff to meet resident's needs. LPA Ramirez conducted file reviews and interviews and obtained copies of pertinent documents. Regarding the allegation, the following was revealed: Five of eight residents interviewed reported being satisfied with staff and expressed that staff are “courteous” and “attentive.” One of the remaining three residents reported hearing complaints of dissatisfaction with staff services from fellow residents. The remaining two residents interviewed either could not be qualified and/or refused to answer questions.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Alisa Ortiz	TELEPHONE: (714) 703-2855
LICENSING EVALUATOR NAME: Alvaro Ramirez Jr.	TELEPHONE: 714-703-2840
LICENSING EVALUATOR SIGNATURE:	DATE: 02/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2023

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-20230112164247

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: CITRUS HILLS ASSISTED LIVING	FACILITY NUMBER: 306005603
	VISIT DATE: 02/03/2023

NARRATIVE

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As of 01/20/23 facility reported a total census of seventy-seven residents, of those LPA reviewed a total of eight resident files. Eight of eight resident files reviewed indicate that residents are ambulatory. Records reviewed included the staff schedule. On average there are two caregivers and one medication technician in the morning shift (6a.m.-2p.m), one caregiver and one medication technician in the evening shift (2p.m.-10p.m.), and one caregiver and one medication technician in the night shift (10p.m.-6a.m.) for seventy-seven residents in care.

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

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

LPA Ramirez conducted an exit interview with OM Aguirre, and a copy of this report was provided to the facility.

SUPERVISOR'S NAME: Alisa Ortiz	TELEPHONE: (714) 703-2855
LICENSING EVALUATOR NAME: Alvaro Ramirez Jr.	TELEPHONE: 714-703-2840
LICENSING EVALUATOR SIGNATURE:	DATE: 02/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2023

LIC9099 (FAS) - (06/04)

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