306006146-5-12-2026-22-AS-KSGH-DU3UHM-20260514153608

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306006146
Report Date: 05/12/2026
Date Signed: 05/12/2026 11:47:15 AM

Unsubstantiated

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
06/19/2025 and conducted by Evaluator Ruth Martinez

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20250619132018

FACILITY NAME:	SEA CLIFF ASSISTED LIVING		FACILITY NUMBER:	306006146
ADMINISTRATOR:	CLARK, TAYLOR		FACILITY TYPE:	740
ADDRESS:	18851 FLORIDA STREET		TELEPHONE:	(714) 847-3999
CITY:	HUNTINGTON BEACH	STATE: CA	ZIP CODE:	92648
CAPACITY:	84	CENSUS: 66	DATE:	05/12/2026
		UNANNOUNCED	TIME BEGAN:	11:07 AM
MET WITH:	Taylor Clark, Administrator		TIME COMPLETED:	12:30 PM

ALLEGATION(S):

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Lack of care and supervision
Resident not treated with dignity and respect

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Ruth Martinez conducted an unannounced visit to the facility to conclude investigation into the above identified complaint allegations. LPA spoke with Taylor Clark, Administrator, and explained the purpose of the visit.

Findings are based upon this investigation which included tour of the facility, facility file review, resident file review, interviews conducted, and copies of pertinent records.
It is alleged there is lack of care and supervision, specifically to leaving resident (R1) soiled and adjusting R1’s bed at mealtime. Record review revealed that physicians report states resident is able to feed self, able to do own toileting with minimal assistance, and able to independently transfer to and from bed. Service plan reflects resident meal tray as requested, toileting incontinence care will be maintaining the

Continued on LIC9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Kevin Saborit-Guasch
LICENSING EVALUATOR NAME: Ruth Martinez
LICENSING EVALUATOR SIGNATURE:	DATE: 05/12/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2026

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-20250619132018

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: 05/12/2026

NARRATIVE

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highest practicable level of independence when toileting, transfer self independently, offer reminder to call for assistance when transferring. Interview with 4 of 4 staff stated R1 always gets changed and not left soiled, and when resident ask for tray services staff adjust R1 in bed for mealtime. R1 gets changed often and does not get left soiled for extended periods. Interview with 6 of 6 residents stated that they get the help they need from staff, have seen staff help R1, see staff providing help to R1 with meal trays, and staff always come to help them when they call for help.

It is alleged that R1 is not treated with dignity and respect, specifically to R1 being treated roughly, unable to communicate with staff, and often being ignored by staff. Records review reflect resident appraisal states R1 diagnosed with depression, a little sign of confusion and forgetfulness, cognitive communication deficits, and not interested in socializing. Service plan reflects occasional forgetfulness with reminders, reminders to person, place, time, task, or personal hygiene. Interview with 6 of 6 residents stated staff treat them well, they have no issues to report. Residents can communicate with staff with no problem, do not wait a long time for help, and they are not rough with them. Residents state they have not see staff be rough with any residents. Interview with R1’s roommate stated that they have seen staff assist R1 with their needs, see staff able to communicate with R1. They have seen staff help R1 with feeding, changing them, and come to help when R1 calls for help.

Based on the information mentioned above, the Department is unable to ascertain if the allegations occurred as reported. Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove or refute the alleged violations occurred; therefore, the allegations are deemed Unsubstantiated.

An exit interview was conducted with the Administrator and a copy of this LIC9099 report was left at facility.

SUPERVISORS NAME: Kevin Saborit-Guasch
LICENSING EVALUATOR NAME: Ruth Martinez
LICENSING EVALUATOR SIGNATURE:	DATE: 05/12/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2026

LIC9099 (FAS) - (06/04)

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