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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306006146
Report Date: 01/15/2026
Date Signed: 01/16/2026 02:24:47 PM

Unfounded


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
10/23/2025 and conducted by Evaluator Samer Haddadin
COMPLAINT CONTROL NUMBER: 22-AS-20251023144519
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: DATE:
01/15/2026
UNANNOUNCEDTIME BEGAN:
08:32 AM
MET WITH:TIME COMPLETED:
12:51 PM
ALLEGATION(S):
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Facility staff failed to report scabies outbreak.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Samer Haddadin conducted an unannounced visit to the facility to deliver findings to the above-referenced allegation. Upon arrival, LPA Haddadin was greeted and granted entry by Administrator Taylor Clark (AD).
The investigation included interviews with six staff members and six residents, a review of facility records, and observations of the physical plant. It was alleged that “Facility staff failed to report scabies outbreak”. LPA Haddadin reviewed facility records and confirmed that, on October 17, the facility’s Wellness Director notified Community Care Licensing and submitted an incident report regarding one resident (R1) who tested positive for scabies.
LPA Haddadin interviewed six residents, and six of six denied that the facility experienced an outbreak or failed to report. LPA Haddadin also interviewed six staff members, and all six denied the allegation.
{***CONTINUE9099C***}
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Samer Haddadin
LICENSING EVALUATOR SIGNATURE:

DATE: 01/15/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2026
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-20251023144519
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: 01/15/2026
NARRATIVE
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During record review of R1’s file, LPA Haddadin confirmed the facility updated documentation to reflect the change in condition by updating the LIC 603 (Resident Appraisal). LPA Haddadin also conducted a walk-through of the facility and did not observe any indications consistent with an outbreak, including visible signs of illness or an increased presence of PPE (Personal Protective Equipment).
Based on the preponderance of evidence obtained through record review, interviews, and observations, the allegation is determined to be UNFOUNDED, meaning the allegation is false, could not have happened, and/or is without a reasonable basis. No deficiencies were cited during today’s visit. An exit interview was conducted with the Administrator, and a copy of this report was provided.
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Samer Haddadin
LICENSING EVALUATOR SIGNATURE:

DATE: 01/15/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2