306005678-6-17-2021-22-AS-LADS-C4FMMF-20210629094352

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306005678
Report Date: 06/17/2021
Date Signed: 06/17/2021 04:27:40 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
08/13/2020 and conducted by Evaluator Joseph Alejandre

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20200813090800

FACILITY NAME:	HARBOR HEIGHTS ASSISTED LIVING & MEMORY CARE		FACILITY NUMBER:	306005678
ADMINISTRATOR:	AHAOMA S. ONYEBUCHI		FACILITY TYPE:	740
ADDRESS:	525 W. LA PALMA AVE		TELEPHONE:	(714) 860-4016
CITY:	ANAHEIM	STATE: CA	ZIP CODE:	92801
CAPACITY:	199	CENSUS: 38	DATE:	06/17/2021
		UNANNOUNCED	TIME BEGAN:	04:36 PM
MET WITH:	Khatera Bahadory		TIME COMPLETED:	04:45 PM

ALLEGATION(S):

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Staff not refilling residents medication prescription in a timely manner.
Resident bathroom is not wheelchair accessible.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA), Joseph Alejandre made an unannounced visit to deliver the findings on the allegations listed above. LPA Alejandre identified himself and discussed the findings with Wellness Director Khatera Bahadory. In regards to the allegation; Staff not refilling residents medication prescription in a timely manner, the investigation revealed the following. Review of records did not reveal any discrepancies. Facility is tracking the medication and administering medication to Resident 1 (R1) as prescribed except for ointments and nasal sprays which R1 verified they (R1) use more than is required which causes the medication to run out before the expected refill date. Staff reported that R1 is given medication as prescribed and has instructed R1 on proper use of nasal sprays and ointments. R1 verified staff has instructed him on proper use of medication. Staff reported medication is ordered before prescriptions run out and medication will be ordered earlier if it is apparent R1 would run out of medication quickly. Staff reported sometimes the pharmacy delays delivery of medication and they have no control over the delivery schedule so medication has been delayed even though it was ordered timely. None of the evidence gathered corroborate the allegation.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Luz Adams	TELEPHONE: (714) 703-2855
LICENSING EVALUATOR NAME: Joseph Alejandre	TELEPHONE: (951) 473-7041
LICENSING EVALUATOR SIGNATURE:	DATE: 04/16/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/16/2021

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-20200813090800

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

FACILITY NAME: HARBOR HEIGHTS ASSISTED LIVING & MEMORY CARE	FACILITY NUMBER: 306005678
	VISIT DATE: 06/17/2021

NARRATIVE

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Therefore, the allegation is deemed UNFOUNDED, meaning the allegation is false could not have happened and/or is without a reasonable basis. In regards to the allegation Resident bathroom is not wheelchair accessible, the investigation revealed the following. Resident 1(R1) resides in a room where the bathroom door is narrow and R1's wheelchair will not fit through the bathroom doorway. When this was reported to the Administrator the Administrator verified the doorway for the bathroom is narrow and is not wide enough for R1's wheelchair to fit. The Administrator offered R1 a new room with a bathroom door that would accommodate R1's wheelchair. The new room would be the same price as the old room and the staff would move all of the resident's belongs at no charge. R1 verified the Administrator made the offer at no cost to the resident. R1 reported that they refused and insisted the doorway be made wider in his current room. Staff reported that the construction required would be difficult, timely and costly and moving to a new room seemed like a logical solution. R1 verified that he was made aware of those details. R1 refused to move until the Administrator informed R1 there was going to be a remodel and R1 agreed to move to a new room where the bathroom doorway would accommodate the wheelchair. R1 no longer resides in the room where the bathroom doorway is too narrow to accommodate the wheelchair. Therefore, the allegation is deemed UNFOUNDED, meaning the allegation is false could not have happened and/or is without a reasonable basis. An exit interview was conducted with the Wellness Director and a copy of this report was provided.

SUPERVISOR'S NAME: Luz Adams	TELEPHONE: (714) 703-2855
LICENSING EVALUATOR NAME: Joseph Alejandre	TELEPHONE: (951) 473-7041
LICENSING EVALUATOR SIGNATURE:	DATE: 04/16/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/16/2021

LIC9099 (FAS) - (06/04)

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