306005603-8-29-2024-22-AS-LMOA-D9M4Y9-20240930193044

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306005603
Report Date: 08/29/2024
Date Signed: 08/29/2024 05:43:12 PM

Unsubstantiated

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
08/20/2024 and conducted by Evaluator Jerome Haley

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20240820120724

FACILITY NAME:	CITRUS HILLS ASSISTED LIVING		FACILITY NUMBER:	306005603
ADMINISTRATOR:	ITZAYANA BARBA AGUIRRE		FACILITY TYPE:	740
ADDRESS:	142 S PROSPECT ST		TELEPHONE:	(714) 639-3590
CITY:	ORANGE	STATE: CA	ZIP CODE:	92869
CAPACITY:	95	CENSUS: 79	DATE:	08/29/2024
		UNANNOUNCED	TIME BEGAN:	03:40 PM
MET WITH:	Itzayana Barba		TIME COMPLETED:	05:55 PM

ALLEGATION(S):

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Facility does not provide nutrious, well balanced meals.

INVESTIGATION FINDINGS:

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Regarding the allegation: Facility does not provide nutritious, well balanced meals.

10 of 10 individuals interviewed were unable to corroborate the complaint allegation. All the residents interviewed know they have an alternative menu available to them and if they don’t like whats being served they can request something else. 3 of the residents interviewed stated if they don’t want what the kitchen is serving, they will go and buy themselves something to eat, and all three of the residents who made that statement are aware they can order off the alternative menu as well.1 resident that was interviewed said, the food is terrible, but said it’s not the staff’s fault, they do the best they can. It’s the material they use. Staff 2 (S2) explained how the alternative menu works and stated 10:30 am is the cut off time for lunch and 3:30 is the cut off time for dinner. S2 stated it’s easy to prepare something for breakfast, but if the resident wants something like a breakfast burrito, they need to order the night before. 2 staff members who were interviewed think the food is of good quality and stated they eat the food sometimes.
Continued on LIC9099C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Jerome Haley
LICENSING EVALUATOR SIGNATURE:	DATE: 08/29/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2024

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-20240820120724

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: CITRUS HILLS ASSISTED LIVING	FACILITY NUMBER: 306005603
	VISIT DATE: 08/29/2024

NARRATIVE

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Based on the information gathered during the investigation through interviews, 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, the allegation is deemed Unsubstantiated.

An exit interview was conducted, and a copy of this report was provided.

SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Jerome Haley
LICENSING EVALUATOR SIGNATURE:	DATE: 08/29/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2024

LIC9099 (FAS) - (06/04)

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