306005678-6-3-2021-22-AS-LADS-C3VM4G-20210611091641

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306005678
Report Date: 06/03/2021
Date Signed: 06/03/2021 05:08:24 PM

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
05/24/2021 and conducted by Evaluator Joseph Alejandre

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20210524084248

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: 39	DATE:	06/03/2021
		UNANNOUNCED	TIME BEGAN:	04:00 PM
MET WITH:	Paul Brown		TIME COMPLETED:	05:19 PM

ALLEGATION(S):

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Resident room is below regulation temperature.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Joseph Alejandre made an unannounced visit to conduct the required 10-day visit to begin the investigation into the allegation listed above. LPA was greeted and granted entry by Administrator Paul Brown. LPA Alejandre explained the reason for the visit. LPA toured the facility with the Administrator and measured the room temperature in resident 1's (R1) and resident 2's (R2) shared room at 73.5 degrees Fahrenheit. LPA interviewed R1 and R2, they reported the room temperature was ok and did not need to be adjusted. R1 reported that one day last week the temperature was lower than usual but could not recall any details. R1 and R2 reported that there are no issues and they get along ok. LPA interviewed the Administrator who stated that the temperature is set for 72 degrees Fahrenheit. Based on the information gathered during the investigation, the allegation, resident room is below regulation temperature, 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 the Administrator was provided a copy of the report.

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: 06/03/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/03/2021

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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