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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306005678
Report Date: 02/22/2024
Date Signed: 02/22/2024 05:07:27 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
02/15/2024 and conducted by Evaluator Jerome Haley
COMPLAINT CONTROL NUMBER: 22-AS-20240215084636
FACILITY NAME:HARBOR HEIGHTS ASSISTED LIVING & MEMORY CAREFACILITY NUMBER:
306005678
ADMINISTRATOR:CHRISTINE CHONFACILITY TYPE:
740
ADDRESS:525 W. LA PALMA AVETELEPHONE:
(714) 459-3353
CITY:ANAHEIMSTATE: CAZIP CODE:
92801
CAPACITY:199CENSUS: 171DATE:
02/22/2024
UNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Christine Chon - AdministratorTIME COMPLETED:
02:14 PM
ALLEGATION(S):
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Staff are serving cold food to residents
INVESTIGATION FINDINGS:
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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 are serving cold 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) resident have complained that their food is not warm enough but never that the food is cold.
Continued on LIC9099C
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Luz AdamsTELEPHONE: (714) 222-3821
LICENSING EVALUATOR NAME: Jerome HaleyTELEPHONE: 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
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S1 says if the resident says the food is cold, staff will take the food and reheat it. S1 says, the facility uses food warmers and soup is not served until it reached a boiling point, then it’s served at the correct temperature. Staff 3 (S3), and Staff 4 (S4) both denied resident are served cold food. Staff 3 says when the food is served, you can see steam coming from the food. According to the Administrator, the facility uses hot boxes when serving the food to residents.

Based on the information gathered during the investigation through interviews, document review, and observations, the Department is unable to ascertain if the allegation: Staff are serving cold food to residents. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove or refute the alleged violation occurred; therefore, this allegation is deemed Unsubstantiated.

An exit interview was conducted, and a copy of this report was provided.
SUPERVISOR'S NAME: Luz AdamsTELEPHONE: (714) 222-3821
LICENSING EVALUATOR NAME: Jerome HaleyTELEPHONE: 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