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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306005678
Report Date: 07/20/2023
Date Signed: 07/20/2023 12:13:22 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
11/01/2021 and conducted by Evaluator Joseph Alejandre
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20211101150321
FACILITY NAME:HARBOR HEIGHTS ASSISTED LIVING & MEMORY CAREFACILITY NUMBER:
306005678
ADMINISTRATOR:PAUL BROWNFACILITY TYPE:
740
ADDRESS:525 W. LA PALMA AVETELEPHONE:
(714) 459-3353
CITY:ANAHEIMSTATE: CAZIP CODE:
92801
CAPACITY:199CENSUS: 158DATE:
07/20/2023
UNANNOUNCEDTIME BEGAN:
10:25 AM
MET WITH:Christine ChonTIME COMPLETED:
12:30 PM
ALLEGATION(S):
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Residents call pendent not operating
Residents restroom call light are not operating properly
Staff do not answer facility phone
Licensee spoke inappropriately about a resident
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 Executive Director Christine Chon and explained the reason for the visit. The investigation into the allegation, residents call pendent not operating, revealed the following; 5 out of 5 staff interviewed reported the call system including the pendants is operating properly and doesn't have any issues. LPA tested the call system including pendants on 11/4/21 and 12/15/21 in multiple rooms. Staff responded within 5 minutes on each visit. 6 out of 7 residents interviewed reported they had no issues with the call system including pendants. Dates and times of when the call system including pendants was not operating and requests for assistance through the call system that were not answered, were not provided. Based on the evidence gathered the allegation 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.

Regarding the allegation, residents restroom call light are not operating properly (continued)
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Luz AdamsTELEPHONE: (714) 703-2855
LICENSING EVALUATOR NAME: Joseph AlejandreTELEPHONE: (951) 473-7041
LICENSING EVALUATOR SIGNATURE:

DATE: 07/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/20/2023
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 2
Control Number 22-AS-20211101150321
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: 07/20/2023
NARRATIVE
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(continued) the investigation revealed the following; 5 out of 5 staff interviewed reported the call system including the bathroom pull cords is operating properly and doesn't have any issues. LPA tested the call system including the pull cords on 11/4/21 and 12/15/21 in multiple rooms. Staff responded within 5 minutes on each visit. 6 out of 7 residents interviewed reported they had no issues with the call system including the pull cords. Dates and times of when the call system including the pull cords, was not operating and requests for assistance through the call system that were not answered, were not provided. Based on the evidence gathered the allegation 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.

Regarding the allegation, staff do not answer facility phone, the investigation revealed the following. LPA called the facility on 11/3/21 and 11/5/21 and a staff member answered the phone. 5 out of 5 staff members reported they always answer the phone and after hours all calls are sent to the medication room where there is a cordless phone the med-techs always have with them so all calls can be answered. 6 out of 7 residents reported they have had no issues calling the facility phone and someone always answers. No dates or times were provided of when staff did not answer the phone. Based on the evidence gathered the allegation, staff do not answer facility 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.

Regarding the allegation, licensee spoke inappropriately about a resident, the investigation revealed the following; On 10/7/2021 there was a resident council meeting. All witnesses interviewed verified this information. It was reported that during the meeting the Administrator spoke inappropriately about a resident. The Administrator denied this report. 5 out of 5 staff reported they have never heard the Administrator or any staff speak inappropriately about any resident. 6 out of 7 residents present at the resident council meeting on 10/7/2021 reported they did not hear the Administrator say anything inappropriate about any resident. Based on the evidence gathered the allegation, licensee spoke inappropriately about a resident 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 AdamsTELEPHONE: (714) 703-2855
LICENSING EVALUATOR NAME: Joseph AlejandreTELEPHONE: (951) 473-7041
LICENSING EVALUATOR SIGNATURE:

DATE: 07/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/20/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2