306005678-3-2-2023-22-AS-MSTC-CPPLZ4-20230307081115

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306005678
Report Date: 03/02/2023
Date Signed: 03/02/2023 04:30:51 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
07/14/2021 and conducted by Evaluator Joseph Alejandre

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20210714123657

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: 135	DATE:	03/02/2023
		UNANNOUNCED	TIME BEGAN:	04:00 PM
MET WITH:	Christine Chon		TIME COMPLETED:	04:30 PM

ALLEGATION(S):

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Staff threatened resident.
Staff did not allow resident to contact ombudsman.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Joseph Alejandre made an unannounced visit to deliver the findings of the allegations listed above. LPA met with Executive Director (ED) Christine Chon and explained the reason for the visit. The investigation into the allegation, staff threatened resident, revealed the following: It was alleged that the Administrator threatened Resident 1 (R1) and that if they (R1) didn’t do what the Administrator said, R1 would be put in the hospital and would have to find a new place to live. The Administrator denied the allegations. R1 reported that the Administrator never threatened them and did not tell them to find a new place to live or threaten to put them in the hospital if they didn’t comply. All witnesses interviewed reported they have never witnessed any staff threaten any residents in any way. The evidence gathered refutes the allegation. Based on the evidence gathered through interviews the allegation, staff threatened resident, is deemed unfounded, meaning the allegation is false, could not have happened and/or is without a reasonable basis.

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: 03/02/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2023

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-20210714123657

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: 03/02/2023

NARRATIVE

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Regarding the allegation, staff did not allow resident to contact ombudsman, the investigation revealed the following: It was alleged that the Administrator met with R1 without anyone else present. All witnesses corroborated that it was agreed that all meetings between facility staff and R1 would be conducted with the Ombudsman present and participating. R1 and the Administrator both reported they did not have any meetings without the Ombudsman present. It was reported that R1 was prevented from contacting the Ombudsman. No specific details were provided with this report. The Administrator and facility staff reported residents have never been prevented from calling the Ombudsman. R1 reported they have not been prevented from calling anyone including the Ombudsman. Based on the evidence gathered the allegation, staff did not allow resident to contact Ombudsman 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: 03/02/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2023

LIC9099 (FAS) - (06/04)

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