306005678-9-30-2022-22-AS-LADS-CJS6ZM-20220930211523

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306005678
Report Date: 09/30/2022
Date Signed: 09/30/2022 11:49:47 AM

Unfounded

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
09/22/2022 and conducted by Evaluator Joseph Alejandre

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20220922161553

FACILITY NAME:	HARBOR HEIGHTS ASSISTED LIVING & MEMORY CARE		FACILITY NUMBER:	306005678
ADMINISTRATOR:	CHRISTINE CHON		FACILITY TYPE:	740
ADDRESS:	525 W. LA PALMA AVE		TELEPHONE:	(714) 459-3353
CITY:	ANAHEIM	STATE: CA	ZIP CODE:	92801
CAPACITY:	199	CENSUS: 104	DATE:	09/30/2022
		UNANNOUNCED	TIME BEGAN:	09:20 AM
MET WITH:	Christine Chon		TIME COMPLETED:	11:57 AM

ALLEGATION(S):

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Licensee failed to keep the facility free of pests.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Joseph Alejandre made an unannounced visit to conduct the required 10-day visit to begin the investigation into the allegation listed above. LPA was greeted and granted entry by staff. LPA met with Executive Director (ED) Christine Chon. LPA explained the reason for the visit. LPA and ED toured the facility including the kitchen and dining room. LPA observed the kitchen and dining room are clean and organized. There was no trash or litter and food was stored properly in the kitchen. LPA did not observe any evidence of pests in the kitchen or dining room. ED provided the LPA with the pest control log and monthly service bill. ED reported the facility has a pest control service that visits the facility regularly. LPA interviewed staff and residents. Only 1 out of 5 residents interviewed reported seeing any pests recently and could not recall specific details. LPA inspected 11 rooms and checked storage closets and kitchen storage rooms. LPA did not observe any evidence of pests inside or outside of the facility. Based on the evidence gathered the allegation, licensee failed to keep the facility free of pests, 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.

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: 09/30/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/30/2022

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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