306005678-2-10-2023-22-AS-LADS-CP5M8R-20230217082334

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306005678
Report Date: 02/10/2023
Date Signed: 02/10/2023 02:06:28 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
01/19/2021 and conducted by Evaluator Joseph Alejandre

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20210119092535

FACILITY NAME:	HARBOR HEIGHTS ASSISTED LIVING & MEMORY CARE		FACILITY NUMBER:	306005678
ADMINISTRATOR:	PAUL BROWN		FACILITY TYPE:	740
ADDRESS:	525 W. LA PALMA AVE		TELEPHONE:	(714) 459-3353
CITY:	ANAHEIM	STATE: CA	ZIP CODE:	92801
CAPACITY:	199	CENSUS: 132	DATE:	02/10/2023
		UNANNOUNCED	TIME BEGAN:	12:55 PM
MET WITH:	Christine Chon		TIME COMPLETED:	02:25 PM

ALLEGATION(S):

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Facility is not providing activities for residents.
Staff not meeting residents needs.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Joseph Alejandre made an unannounced visit to deliver the findings of the complaint investigation regarding the allegations listed above. LPA met with Executive Director Christine Chon. LPA explained the reason for the visit. The investigation into the allegation, facility is not providing activities for residents, revealed the following: The Administrator reported that the facility still has activities but most of the activities available to residents are individual activities such as games, books and puzzles. 5 out of 6 residents interviewed verified this report. Facility staff reported that activities are scheduled everyday but none of residents who wish to participate will follow the Covid-19 precautions such as, wearing a mask and social distancing from others of at least 6 feet. Facility staff reported that activities are scheduled but no one stays to participate because they do not want to follow the Covid-19 precautions. 6 out of 6 residents interviewed reported they would not participate in activities if they had to wear a mask or social distance. Facility staff reported that residents requested to play bingo and the facility schedules bingo every other day but none of the residents will social distance or wear a mask so the activity is not conducted.

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: 02/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/10/2023

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-20210119092535

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: 02/10/2023

NARRATIVE

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It was alleged that the residents in memory care had no activities and the staff in memory care verified this report. No details were provided with this report. 4 out of 4 staff interviewed reported that there weren’t group activities because of Covid-19 mitigation procedures but there were activities for the residents. 4 out of 4 staff reported that staff walked with all the residents in memory care and would take them outside to the patio if it wasn’t too cold. Staff reported that the activity room in memory care was available to residents and residents regularly used the TV and the puzzles and games. The Administrator reported that because of the Covid-19 mitigation procedures the regular group activities which included residents sitting in a circle tossing a beach ball or a balloon and singing were discontinued so most of the activities are individual. 4 out of 4 staff who work in memory care reported the same information.

Based on the evidence gathered through interviews the allegation, facility is not providing activities for residents is deemed unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis.

Regarding the allegation, staff not meeting residents needs, the investigation revealed the following: It was alleged that Resident 1 (R1) was not being assisted and staff refused to help R1 with dressing and showering/grooming. 4 out of 4 staff reported that R1 is always assisted unless R1 requests they leave R1’s room and informs them they do not need assistance. R1 verified this report. 4 out of 4 staff reported that on most days R1 is assisted with dressing and showering/grooming but sometimes R1 wants to complete all dressing and showering/grooming on their own and requests staff do not assist them and asks them to leave their room. R1 verified this report. Based on the evidence gathered through interviews the allegation, staff not meeting resident’s needs is deemed unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis.

SUPERVISOR'S NAME: Luz Adams	TELEPHONE: (714) 703-2855
LICENSING EVALUATOR NAME: Joseph Alejandre	TELEPHONE: (951) 473-7041
LICENSING EVALUATOR SIGNATURE:	DATE: 02/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/10/2023

LIC9099 (FAS) - (06/04)

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