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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306006146
Report Date: 12/12/2025
Date Signed: 12/12/2025 04:13:26 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 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
09/25/2025 and conducted by Evaluator Kevin Saborit-Guasch
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20250925212426
FACILITY NAME:SEA CLIFF ASSISTED LIVINGFACILITY NUMBER:
306006146
ADMINISTRATOR:CLARK, TAYLORFACILITY TYPE:
740
ADDRESS:18851 FLORIDA STREETTELEPHONE:
(714) 847-3999
CITY:HUNTINGTON BEACHSTATE: CAZIP CODE:
92648
CAPACITY:84CENSUS: 61DATE:
12/12/2025
UNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Taylor Clark, administratorTIME COMPLETED:
04:25 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff does not ensure resident is provided a comfortable living space.

Staff does not ensure resident's health needs are being met
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility for the purpose of following up on the investigation of the allegations listed above. LPA was greeted and granted entry by facility staff after introducing himself and stating the purpose of the visit. Administrator Taylor Clark was present on the premises and assisted with the visit.

An initial investigation visit was conducted on September 29, 2025. LPA requested and obtained records for six current residents. LPA accompanied by licensing staff completed a tour of the facility's first level and reviewed multiple shared and private units. LPA conducted three resident interviews and one staff interview during the visit. After the visit, facility staff provided LPA with the facility's current plan of operations, dementia care plan, visitor check-in log, resident daily sign-out sheet, charting notes for resident R1 for the month of September 2025, assistance log for R1, incontinence log for R1. Home health plan of care and admission assessments were also obtained directly from the provider.
CONTINUED ON FORM LIC9099-C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Kevin Saborit-Guasch
LICENSING EVALUATOR SIGNATURE:

DATE: 12/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2025
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 7
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 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
09/25/2025 and conducted by Evaluator Kevin Saborit-Guasch
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20250925212426

FACILITY NAME:SEA CLIFF ASSISTED LIVINGFACILITY NUMBER:
306006146
ADMINISTRATOR:CLARK, TAYLORFACILITY TYPE:
740
ADDRESS:18851 FLORIDA STREETTELEPHONE:
(714) 847-3999
CITY:HUNTINGTON BEACHSTATE: CAZIP CODE:
92648
CAPACITY:84CENSUS: 61DATE:
12/12/2025
UNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Taylor Clark, administratorTIME COMPLETED:
04:25 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff does not ensure resident's diapering needs are being met.

Staff does not ensure resident is provided clean clothing.

Staff does not ensure the safety of residents by monitoring entry and egress
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility for the purpose of following up on the investigation of the allegations listed above. LPA was greeted and granted entry by facility staff after introducing himself and stating the purpose of the visit. Administrator Taylor Clark was present on the premises and assisted with the visit.

An initial investigation visit was conducted on September 29, 2025. LPA requested and obtained records for six current residents. LPA accompanied by licensing staff completed a tour of the facility's first level and reviewed multiple shared and private units. LPA conducted three resident interviews and one staff interview during the visit. After the visit, facility staff provided LPA with the facility's current plan of operations, dementia care plan, visitor check-in log, resident daily sign-out sheet, charting notes for resident R1 for the month of September 2025, assistance log for R1, incontinence log for R1. Home health plan of care and admission assessments were also obtained directly from the provider.
CONTINUED ON FORM LIC9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Kevin Saborit-Guasch
LICENSING EVALUATOR SIGNATURE:

DATE: 12/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 7
Control Number 22-AS-20250925212426
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME: SEA CLIFF ASSISTED LIVING
FACILITY NUMBER: 306006146
VISIT DATE: 12/12/2025
NARRATIVE
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3
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5
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7
8
9
10
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12
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32
CONTINUED FROM FORM LIC9099-A
During the present visit, LPA requested the facility's resident census and toured the physical plant again. Additional resident records were requested and reviewed.

Regarding the allegation that Staff does not ensure resident's diapering needs are being met, the following has been concluded: Based on assistance logs and incontinence logs provided, regular checks and diaper changes were being performed and documented during each shift in order to manage R1's assessed incontinence. Resident interviews failed to evidence any failure to address incontinence issues in a timely manner.

Regarding the allegation that Staff does not ensure resident is provided clean clothing, the following has been concluded: During the initial investigation visit, LPA observed R1 relaxing in bed dressed in clothing that appeared to be free of visible stains and odors. Logs provided by facility staff appear to evidence due diligence conducted in order to ensure R1 was not provided with soiled clothing.

Regarding the allegation that Staff does not ensure the safety of residents by monitoring entry and egress, the following has been conducted: Per the current plan of operation in place, the facility did not staff a front desk full time. However, facility policies required that visitors systematically sign-in as well as residents sign out prior to exiting the premises. Alert system preventing exits that would not be monitored are stated to be in place. Entry logs and sign-out logs were provided and appear to demonstrate most visitors do indeed abide by the facility's policy.

As a result, all three allegations listed above are found to be Unsubstantiated, meaning that although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violations occurred.

An exit interview was conducted and a copy of this report was provided to a facility representative.
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Kevin Saborit-Guasch
LICENSING EVALUATOR SIGNATURE:

DATE: 12/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 7
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 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
09/25/2025 and conducted by Evaluator Kevin Saborit-Guasch
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20250925212426

FACILITY NAME:SEA CLIFF ASSISTED LIVINGFACILITY NUMBER:
306006146
ADMINISTRATOR:CLARK, TAYLORFACILITY TYPE:
740
ADDRESS:18851 FLORIDA STREETTELEPHONE:
(714) 847-3999
CITY:HUNTINGTON BEACHSTATE: CAZIP CODE:
92648
CAPACITY:84CENSUS: 61DATE:
12/12/2025
UNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Taylor Clark, administratorTIME COMPLETED:
04:25 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff does not ensure residents are provided adequate bedroom lighting
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility for the purpose of following up on the investigation of the allegations listed above. LPA was greeted and granted entry by facility staff after introducing himself and stating the purpose of the visit. Administrator Taylor Clark was present on the premises and assisted with the visit.

An initial investigation visit was conducted on September 29, 2025. LPA requested and obtained records for six current residents. LPA accompanied by licensing staff completed a tour of the facility's first level and reviewed multiple shared and private units. LPA conducted three resident interviews and one staff interview during the visit. After the visit, facility staff provided LPA with the facility's current plan of operations, dementia care plan, visitor check-in log, resident daily sign-out sheet, charting notes for resident R1 for the month of September 2025, assistance log for R1, incontinence log for R1. Home health plan of care and admission assessments were also obtained directly from the provider.
CONTINUED ON FORM LIC9099-C
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Kevin Saborit-Guasch
LICENSING EVALUATOR SIGNATURE:

DATE: 12/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 5 of 7
Control Number 22-AS-20250925212426
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME: SEA CLIFF ASSISTED LIVING
FACILITY NUMBER: 306006146
VISIT DATE: 12/12/2025
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
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27
28
29
30
31
32
CONTINUED FROM FORM LIC9099-A
During the present visit, LPA requested the facility's resident census and toured the physical plant again. Additional resident records were requested and reviewed.

Regarding the allegation that Staff does not ensure residents are provide adequate bedroom lighting, the following has been concluded: During the initial complaint investigation visit, LPA observed ceiling lights in addition to an accessible lamp by the side of R1's bed. Lamp was verified to be in operation. Per resident interview, staff was available to turn the light on if R1 wished to benefit from brighter lighting.

As a result, the allegation is determined to be Unfounded, meaning that the allegation is 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 to a facility representative.
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Kevin Saborit-Guasch
LICENSING EVALUATOR SIGNATURE:

DATE: 12/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2025
LIC9099 (FAS) - (06/04)
Page: 6 of 7
Control Number 22-AS-20250925212426
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME: SEA CLIFF ASSISTED LIVING
FACILITY NUMBER: 306006146
VISIT DATE: 12/12/2025
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
CONTINUED FROM FORM LIC9099
During the present visit, LPA toured the physical plant again. Additional resident records were requested and reviewed.

Regarding the allegation that Staff does not ensure resident is provided a comfortable living space, the following has been concluded: Based on observation conducted during the initial investigation visit, it was determined that during a COVID outbreak that occurred at the facility in September 2025, R1 was moved from unit #153 to unit #167 where she was during the initial visit. Unit 167 was assigned to resident R1 along with another resident was divided unevenly between the two residents as multiple storage boxes were placed at the foot of R1's roommate's bed. The partition used did not leave sufficient circulation room on both sides of the bed in order for R1 to transfer safely onto their wheelchair. R1 eventually returned to unit 153B which was set up differently and provided sufficient space until they moved out on November 21, 2025.

Regarding the allegation that Staff does not ensure resident's health needs are being met, the following has been concluded: During the investigation, photographs were provided showing that R1's lower extremities were not being attended to and their toe nails were not being trimmed. Staff interviewed stated that it had been assumed that the resident's home health provider was in charge of these health needs, however a review of R1's home health plan of care in place at the time found no indication that this was actually the case.

As a result, both allegations are found to be Substantiated, meaning that the preponderance of evidence threshold has been met. See attached form LIC9099-D for cited deficiencies per Title 22 Division 6 of the California Code of Regulations.

An exit interview was conducted and a copy of this report and appeal rights was discussed with and provided to facility representative.
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Kevin Saborit-Guasch
LICENSING EVALUATOR SIGNATURE:

DATE: 12/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 7
Control Number 22-AS-20250925212426
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

FACILITY NAME: SEA CLIFF ASSISTED LIVING
FACILITY NUMBER: 306006146
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/12/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
12/13/2025
Section Cited
HSC
1569.2(c)
1
2
3
4
5
6
7
Health and Safety Code 1569.2(c) provides: "Care and supervision" means the facility assumes responsibility for (...) ongoing assistance with activities of daily living. Assistance includes assistance with personal care. This requirement is not met as evidenced by: Based on observation (...)
1
2
3
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5
6
7
Licensee will conduct an in-service training in order to ensure facility staff has adequate knowledge of the content of hospice and home health plans of care for residents receiving services from such third parties.
8
9
10
11
12
13
14
 of photographs, interviews conducted and records reviewed, it was assumed that the home health services included services not included in R1's plan of care. This constitutes an immediate risk to the health, safety and personal rights of residents in care.
8
9
10
11
12
13
14
Type B
12/13/2025
Section Cited
CCR
87307(a)(2)
1
2
3
4
5
6
7
Per CCR87307(a)(2) on Personal accomodations: "Bedrooms shall be large enough to allow for easy passage between and comfortable usage of beds and other required items of furniture specified below, and any resident assistant devices such as wheelchairs or walkers". This requirement is
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7
R1 was moved back to their original unit after an outbreak concluded. Unit verified to be providing sufficient space for a wheelchair. Deficiency cleared.\
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12
13
14
not met as evidenced by: Based on observation, the partitioned half of R1's unit did not allow easy passage via wheelchair on the sides of the bed. This constitute a potential risk to the health, safety and personal rights of individuals in care.
8
9
10
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12
13
14
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Kevin Saborit-Guasch
LICENSING EVALUATOR SIGNATURE:

DATE: 12/12/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2025
LIC9099 (FAS) - (06/04)
Page: 7 of 7