306005678-9-22-2021-22-AS-MVAO-CBNQLB-20220215111540

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306005678
Report Date: 09/22/2021
Date Signed: 09/22/2021 01:54:12 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
07/17/2020 and conducted by Evaluator Joseph Alejandre

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20200717122144

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: 48	DATE:	09/22/2021
		UNANNOUNCED	TIME BEGAN:	01:46 PM
MET WITH:	Paul Brown		TIME COMPLETED:	02:15 PM

ALLEGATION(S):

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Staff threatens residents.
Staff yells at residents.

INVESTIGATION FINDINGS:

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In regards to the allegations, staff threatens residents and staff yells at residents, the investigation revealed the following. LPA interviewed 7 residents, 7 out of 7 residents reported that they have not been threatened or yelled at by staff. 7 out of 7 residents reported that they have not witnessed any abuse by staff. All 7 residents reported that the staff does help, but they are not enthusiastic or happy to help. Staff interviewed did not report any incidents of abuse including yelling or physical abuse. 7 out of 7 residents stated they did not believe they have ever had their rights violated by the facility staff. LPA interviewed the Administrator of the facility Sam Onyebuchi. The Administrator reported that he has never yelled at or threatened any resident in any manner. Administrator reported that sometimes he talks to residents and must inform them about breaking house rules or not following Covid-19 cautionary measures, this makes some residents upset but he does not yell or threaten anyone. Administrator reported that he has not witnessed any type of abuse and if he did, he would terminate the staff member immediately. Staff interviewed reported that they have not witnessed or abused any residents verbally or physically.

Unsubstantiated

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: 09/22/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2021

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 4

Control Number 22-AS-20200717122144

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: 09/22/2021

NARRATIVE

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The only report of anyone yelling or threatening residents is from the complainant. The Administrator denies both allegations. Based on the evidence gathered the allegations, Staff threatens residents and the allegation, staff yells at residents, are deemed unsubstantiated, meaning that although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violations occurred. An exit interview was conducted, and a copy of the report provided.

SUPERVISOR'S NAME: Luz Adams	TELEPHONE: (714) 703-2855
LICENSING EVALUATOR NAME: Joseph Alejandre	TELEPHONE: (951) 473-7041
LICENSING EVALUATOR SIGNATURE:	DATE: 09/22/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2021

LIC9099 (FAS) - (06/04)

Page: 2 of 4

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
07/17/2020 and conducted by Evaluator Joseph Alejandre

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20200717122144

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: 66	DATE:	09/22/2021
		UNANNOUNCED	TIME BEGAN:	01:46 PM
MET WITH:	Paul Brown		TIME COMPLETED:	02:15 PM

ALLEGATION(S):

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Food service is inadequate.

INVESTIGATION FINDINGS:

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Regarding the allegation, food service is inadequate, the investigation revealed the following. 7 of 7 residents reported that the food was ok. All 7 residents reported that the menu had variety, they received 3 meals a day and snacks. All 7 Residents reported that the menu is followed. None of the residents reported that the amount of food provided is inadequate. Residents reported that the items available were not their first choice and they would prefer to eat out but that the food was ok. Kitchen staff stated that they have never run out of food. Kitchen staff reported that some of the residents complain about the food not being what they want, or they rather have something else, but no one complained the food was bad. Kitchen staff reported that resident’s food is delivered because the dining room is closed because of Covid-19 pre-cautionary measures. Staff reported that residents have complained that sometimes the food delivered is warm or cool. Staff reported that they deliver all meals and it takes time so not everyone gets a hot meal, sometimes they are warm. LPA inspected the kitchen and dining room. LPA observed the facility had 2-day perishable and 7-day non-perishable food on hand.

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: 09/22/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2021

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 3 of 4

Control Number 22-AS-20200717122144

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: 09/22/2021

NARRATIVE

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The food supply meets regulation standards. Staff reported that the facility follows the posted menu. Staff reported that they provide the food to residents as quickly as possible but sometimes residents aren’t in their rooms, so they have to come back later. LPA observed the food being prepared and sent out for the lunch service. Meal was well balanced and the amount of food being served was more than adequate, an entree, two side dishes with a vegetable, potatoes and a roll along with a drink. Administrator reported that the food service for the facility does a good job and provides the resident 3 meals a day and snacks. Administrator reported that the facility has never run out of food and no one has reported to him that they did not get enough food. None of the evidence gathered supports the allegation, the evidence contradicts the allegation. 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 and a copy of the report provided.

SUPERVISOR'S NAME: Luz Adams	TELEPHONE: (714) 703-2855
LICENSING EVALUATOR NAME: Joseph Alejandre	TELEPHONE: (951) 473-7041
LICENSING EVALUATOR SIGNATURE:	DATE: 09/22/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2021

LIC9099 (FAS) - (06/04)

Page: 4 of 4