306005678-9-8-2022-22-AS-LADS-CJXTN2-20221006145201

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306005678
Report Date: 09/08/2022
Date Signed: 09/08/2022 05:24:17 PM

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
09/01/2022 and conducted by Evaluator Joseph Alejandre

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20220901091114

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: 102	DATE:	09/08/2022
		UNANNOUNCED	TIME BEGAN:	10:31 AM
MET WITH:	Christine Chon		TIME COMPLETED:	05:36 PM

ALLEGATION(S):

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Resident are not served a variety of foods for their food habits.

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 Christine Chon. LPA explained the reason for the visit. LPA interviewed 7 staff members and 10 residents. LPA toured the facility. LPA observed lunch and dinner service. In regards to the allegation, residents are not served a variety of foods for their food habits, the investigation revealed the following. LPA observed the food served matched the posted menu. LPA observed there were alternative options such as, salads, sandwiches or quesadillas available. Residents would have to order the items from the kitchen staff. Staff and residents interviewed verified this information. 5 out 10 residents stated they did not like the menu items but could always get an alternative. The 10 residents interviewed stated the food was ok and they would eat the food but the items on the menu would not be their first choice for any meal. LPA toured the facility and the kitchen. LPA observed a 2 day perishable and a 7 day non-perishable food supply on hand in the kitchen. LPA observed a variety of fresh produce and refrigerated ingredients. LPA observed the kitchen is clean and organized.

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: 09/08/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/08/2022

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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Control Number 22-AS-20220901091114

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: 09/08/2022

NARRATIVE

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Staff reported that vegetables, bread, french fries, rice and kimchi are always available at any meal. 7 out of 10 residents interviewed verified this. 3 out of the 10 residents interviewed stated they had not requested any meal alternatives. It was alleged that the facility only offers Korean meals. A review of the facility menu lists of a variety of meals that would not be considered Korean, such as beef lasagna, pastrami Reuben sandwich, herb baked flounder and oven fried chicken. 10 out of 10 residents interviewed reported that there are different types of food are served including Korean and American style dishes. On the day of the visit, lunch was turkey breast with white wine gravy, lemon seasoned new potatoes and French green bean medley and Greek salad. Dinner was baked ham with harvest squash bake, spinach with garlic, Greek salad, beef noodle soup and for desert tiramisu. The beverages offered for both meals were, tea, coffee, milk, water, iced tea, orange juice, cranberry juice and apple juice. Based on the evidence gathered the allegation, residents are not served a variety of foods for their food habits, 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: 09/08/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/08/2022

LIC9099 (FAS) - (06/04)

Page: 2 of 3

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
09/01/2022 and conducted by Evaluator Joseph Alejandre

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20220901091114

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: 102	DATE:	09/08/2022
		UNANNOUNCED	TIME BEGAN:	10:31 AM
MET WITH:	Christine Chon		TIME COMPLETED:	05:36 PM

ALLEGATION(S):

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Staff speak inappropriately to residents.

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 allegations listed above. LPA was greeted and granted entry by staff. LPA met with Executive Director Christine Chon. LPA explained the reason for the visit. LPA interviewed 7 staff members and 10 residents. LPA toured the facility. In regards to the allegation, staff speak inappropriately to residents, the investigation revealed the following. No details about how staff speak inappropriately to residents was provided with the complaint. 10 out of 10 residents interviewed reported staff has never spoken inappropriately to them and felt their rights have not been violated by staff. None of the 10 residents interviewed had heard about any resident being spoken to inappropriately or being abused in any way. 7 out of 7 staff interviewed reported they have never witnessed any type of verbal abuse or spoken inappropriately to any residents. Based on the evidence gathered through interviews the allegation, staff speak inappropriately to residents is deemed unsubstantiated, although the allegation may have happened or is valid, there is no preponderance of evidence to prove the alleged violation did or did not occur. An exit interview was conducted and a copy of the report provided.

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: 09/08/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/08/2022

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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