306005678-1-27-2023-22-AS-LADS-CNLLHN-20230131074634

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306005678
Report Date: 01/27/2023
Date Signed: 01/27/2023 01:13:18 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
08/19/2020 and conducted by Evaluator Joseph Alejandre

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20200819153319

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: 129	DATE:	01/27/2023
		UNANNOUNCED	TIME BEGAN:	12:30 PM
MET WITH:	Roger Cortes		TIME COMPLETED:	01:00 PM

ALLEGATION(S):

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Illegal Eviction

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Joseph Alejandre made an unannounced visit to deliver the findings of the complaint investigation. LPA met with Business Office Manager Roger Cortes. LPA explained the reason for the visit. The investigation into the allegation, illegal eviction, revealed the following. It was alleged Resident 1 (R1) was evicted from the facility in June of 2020 while R1 was temporarily in the hospital. Facility Administrator reported an eviction notice was never served to R1, their responsible party (RP) or their family in 2020. LPA Alejandre attempted to contact R1 numerous times along with their RP, who was listed on the emergency contact information. No response was received so R1 and their RP could not be interviewed. R1’s family reported they were never served with an eviction notice. The Administrator reported that it was recommended that due to R1’s status the family and the RP should decide what the best course of action for R1 would be which could include moving to a new facility that is better suited for R1. The Administrator reported that R1 could come back to the facility when he is discharged from the hospital. R1’s family verified the Administrator’s report. R1’s family reported that it was decided that R1 should move to a different facility, so R1 was moved with their permission to a new facility in July 2020.

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: 01/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2023

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-20200819153319

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: 01/27/2023

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32	Based on the evidence gathered through interviews the allegation, illegal eviction is deemed to be 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: 01/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2023

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
08/19/2020 and conducted by Evaluator Joseph Alejandre

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20200819153319

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: 129	DATE:	01/27/2023
		UNANNOUNCED	TIME BEGAN:	12:30 PM
MET WITH:	Roger Cortes		TIME COMPLETED:	01:00 PM

ALLEGATION(S):

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Staff is not returning resident belongings.
Staff do not answer the phone.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Joseph Alejandre made an unannounced visit to deliver the findings of the complaint investigation. LPA met with Business Office Manager Roger Cortes. LPA explained the reason for the visit. The investigation into the allegation, staff is not returning resident belongings, revealed the following: After Resident 1 (R1) moved to a different facility the facility packed R1’s belongings and moved them to locked storage. R1’s family reported they attempted to contact the facility about R1’s belongings but contact was never made. Facility staff who packed R1’s belongings reported they packed the items and placed them in locked storage until R1 or their representative could get them. Facility Administrator reported they called R1, their responsible party (RP) and their family and left messages that R1’s belongings could be retrieved at any time. R1’s family reported they were never contacted by the facility about R1’s belongings. R1’s family reported that they never went to the facility to pick up R1’s belongings. The facility Administrator reported that no one ever came to the facility to pick up R1’s belongings. LPA Alejandre attempted to contact R1 and the RP, but no response was received so R1 and their RP could not be interviewed. Based on the information gathered from interviews the allegation, staff is not returning resident belongings is deemed, unsubstantiated.

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: 01/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2023

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-20200819153319

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: 01/27/2023

NARRATIVE

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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.

The investigation into the allegation, staff do not answer phone, revealed the following: It was alleged that when Resident 1’s (R1) family call the facility, staff do not answer the phone. No dates and time were provided when the staff do not answer the phone. 6 out of 6 staff interviewed reported that the facility phone is always answered. LPA called the facility on the day of the 10-day visit and 5 times after the initial 10-day visit. Each time the LPA called facility staff answered the phone. 4 out of 4 residents interviewed reported that when they call the front desk from their cell phones someone always answers. Based on the evidence gathered the allegation, staff do not answer phone, 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.

SUPERVISOR'S NAME: Luz Adams	TELEPHONE: (714) 703-2855
LICENSING EVALUATOR NAME: Joseph Alejandre	TELEPHONE: (951) 473-7041
LICENSING EVALUATOR SIGNATURE:	DATE: 01/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2023

LIC9099 (FAS) - (06/04)

Page: 4 of 4