306005678-2-22-2024-22-AS-LMOA-D4U6FY-20240430204705

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306005678
Report Date: 02/22/2024
Date Signed: 02/22/2024 05:06:39 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
02/15/2024 and conducted by Evaluator Jerome Haley

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20240215084636

FACILITY NAME:	HARBOR HEIGHTS ASSISTED LIVING & MEMORY CARE		FACILITY NUMBER:	306005678
ADMINISTRATOR:	CHRISTINE CHON		FACILITY TYPE:	740
ADDRESS:	525 W. LA PALMA AVE		TELEPHONE:	(714) 459-3353
CITY:	ANAHEIM	STATE: CA	ZIP CODE:	92801
CAPACITY:	199	CENSUS: 171	DATE:	02/22/2024
		UNANNOUNCED	TIME BEGAN:	11:15 AM
MET WITH:	Christine Chon - Administrator		TIME COMPLETED:	01:29 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff was sleeping in residents apartment.
Staff do not offer choices of food to residents

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA) Jerome Haley made unannounced visit to investigate the complaint received February 15, 2024. LPA Haley was greeted by staff and explained the reason for the visit.

During the visit, LPA Haley toured the kitchen area, laundry area, memory care and assisted living units and interviews were conducted with residents, and staff. A total of 12 interviews were conducted and 3 interviews were attempted. Documents were reviewed, observations were made, and photos were taken.

Regarding the allegation: Staff was sleeping in resident’s apartment.

12 of 12 individuals interviewed denied the complaint allegation and/or could not provide any evidence to support the allegation. 9 of the individuals interviewed were staff members and all staff members denied the allegation.
Continued on LIC9099C

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Luz Adams	TELEPHONE: (714) 222-3821
LICENSING EVALUATOR NAME: Jerome Haley	TELEPHONE: 714-703-2840
LICENSING EVALUATOR SIGNATURE:	DATE: 02/22/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/22/2024

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-20240215084636

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: 02/22/2024

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

According to Staff 3 (S3), no one has been seen sleeping in a residents room and S3 has not heard of anyone sleeping in a resident room. S3 says when they are tired, they will take a 10 minute break, but does not go to sleep.

Regarding the allegation: Staff do not offer choices of food to residents.

12 of 12 individuals interviewed denied the complaint allegation and/or could not provide any evidence to support the allegation. According to Staff 1 (S1) the residents are offered a few alternative food items and additional alternative side dishes if they don’t like what is being served. During the visit, S1 provided three weeks of menus (previous week, current week, and next week) and the alternative options were listed. While walking through the facility, lunch was being served and what was served was consistent with what was on the menu including the alternative options. During interviews with the Administrator, Staff 3 (S3), and Staff 4 (S4) some of the alternative options were discussed. According to S4 the memory care residents rarely complain about the food, and they usually eat what is served.

Based on the information gathered during through interview, observation, and document review, the following allegations: Staff was sleeping in resident’s apartment, and Staff do not offer choices of food to residents, is deemed Unfounded, meaning the allegations are false, could not have happened and/or is without a reasonable basis.

An exit interview was conducted and a copy of this report was provided.

SUPERVISOR'S NAME: Luz Adams	TELEPHONE: (714) 222-3821
LICENSING EVALUATOR NAME: Jerome Haley	TELEPHONE: 714-703-2840
LICENSING EVALUATOR SIGNATURE:	DATE: 02/22/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/22/2024

LIC9099 (FAS) - (06/04)

Page: 2 of 2