306005678-2-16-2023-22-AS-LADS-CP5N9L-20230217091607

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306005678
Report Date: 02/16/2023
Date Signed: 02/16/2023 11:53:55 AM

Unsubstantiated

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
08/09/2021 and conducted by Evaluator Joseph Alejandre

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20210809162145

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:	02/16/2023
		UNANNOUNCED	TIME BEGAN:	10:42 AM
MET WITH:	Christine Chon		TIME COMPLETED:	12:10 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 complaint findings for the allegation listed above. LPA met with Executive Director Christine Chon and explained the reason for the visit. The investigation into the allegation, illegal eviction revealed the following. It was reported that Resident 1 (R1) was illegally evicted from the facility. R1 was taken to a skilled nursing facility (SNF) for a wound on their foot on 7/23/21 and set to discharge from the facility on 7/26/21. The reporting party and facility staff agree on this report. R1 was reassessed by the facility and a new care plan was sent to the power of attorney (POA) for R1. Facility Administrator reported that R1 would need a higher level of care because of their change in behavior they would require more frequent checks and more assistance. The Administrator reported that R1 did not want any treatment for their foot and had to be convinced that they needed treatment. Facility staff reported they contacted the POA and the POA refused to sign the new care plan unless the facility provided the old care plan so it could be compared. Facility staff reported that due to the facility’s change in ownership and management companies, R1’s file was incomplete so there was no prior care plan for R1. The POA and R1 could not be reached and were not interviewed.

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: 02/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/16/2023

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-20210809162145

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: 02/16/2023

NARRATIVE

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Facility staff reported that R1 had a new assessment completed by the facility and would need a higher level of care. Emails provided show the facility did contact the POA, providing the new care plan and requesting an answer on how they wish to proceed. None of the parties involved who had firsthand knowledge of the events reported (other than Harbor Heights facility staff) responded to the LPA’s attempt to make contact to conduct interviews. Facility Administrator reported no eviction notice was ever served for R1. No information was provided showing R1 did not require a higher level of care. R1 did not return to the facility and their whereabouts are unknown. None of the evidence gathered supports the allegation. Based on the information gathered the allegation, illegal eviction, 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: 02/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/16/2023

LIC9099 (FAS) - (06/04)

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