306005678-3-10-2023-22-AS-LADS-CPZT2G-20230317142043

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306005678
Report Date: 03/10/2023
Date Signed: 03/10/2023 01:38:37 PM

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
09/22/2021 and conducted by Evaluator Joseph Alejandre

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20210922130630

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: 138	DATE:	03/10/2023
		UNANNOUNCED	TIME BEGAN:	12:30 PM
MET WITH:	Christine Chon		TIME COMPLETED:	01:00 PM

ALLEGATION(S):

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Staff will not allow resident to share a room with her spouse.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Joseph Alejandre made an unannounced visit to deliver the findings of the complaint investigation into the allegation listed above. LPA met with Executive Director Christine Chon. LPA explained the reason for the visit. The investigation into the allegation, staff will not allow resident to share a room with her spouse, revealed the following: Resident 1 (R1) and Resident 2 (R2) were married in August 2021. R1 and R2 informed the former facility Administrator Paul Brown (was the Administrator at the time the complaint was filed) that they wanted to share a room together. The Administrator informed R1 and R2 that they owed back rent and the facility has started the process to evict R1 and R2 so the facility would not enter into a new admission agreement with R1 and R2 because of this. R1 and R2 verified this information. After the complaint was filed the facility Administrator was changed twice. No action was taken to evict R1 and R2 from the facility. R1 and R2 reported that they were not prevented from visiting each other and spending time together in either of their rooms. No action was taken by the facility from 9/1/21 to 11/1/22 to evict R1 and R2.

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: 03/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/10/2023

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-20210922130630

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: 03/10/2023

NARRATIVE

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R1 and R2 reported they spoke with the new Administrator Christine Chon in November 2022 and it was agreed that R1 and R2 could share a room together and the facility was not moving forward with the eviction for past due rent. R1 and R2 agreed to a payment plan to pay the past due rent. Based on the evidence gathered the allegation, staff will not allow resident to share a room with her spouse 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 was provided.

SUPERVISOR'S NAME: Luz Adams	TELEPHONE: (714) 703-2855
LICENSING EVALUATOR NAME: Joseph Alejandre	TELEPHONE: (951) 473-7041
LICENSING EVALUATOR SIGNATURE:	DATE: 03/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/10/2023

LIC9099 (FAS) - (06/04)

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