306005678-2-22-2024-22-AS-LMOA-D4U6U7-20240430210636

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306005678
Report Date: 02/22/2024
Date Signed: 02/22/2024 05:03:39 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

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20240215092244

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:	04:00 PM
MET WITH:	Christine Chon - Administrator		TIME COMPLETED:	05:15 PM

ALLEGATION(S):

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Staff left centrally stored medications unattended in resident's room

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 left centrally stored medications unattended in resident's room.

12 of 12 individuals interviewed were unable to support the allegation. The Administrator strongly denied the allegation and said that’s something that the facility is very strict on. The Administrator takes pride in how well trained the staff is.
Continued onLIC9099C

Unsubstantiated

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)

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Control Number 22-AS-20240215092244

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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Staff 5 (S5) also strongly denied the allegation and said you can’t do that because the residents have memory issues so you must watch them when they take their medications. Staff 7 (S7) also strongly denied the allegation. According to S7 residents are watched when they are given their meds, given water and asked to open their mouth to ensure the medication has been swallowed.

Based on the information gathered during the investigation through interviews, document review, and observations, the Department is unable to ascertain if the allegation: Staff left centrally stored medications unattended in resident's room. 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 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)

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