306006452-3-24-2026-22-AS-APAO-DSJ6HG-20260325204930

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306006452
Report Date: 03/24/2026
Date Signed: 03/24/2026 07:48:02 PM

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
01/27/2026 and conducted by Evaluator Samer Haddadin

COMPLAINT CONTROL NUMBER: 22-AS-20260127120310

FACILITY NAME:	HARBOR HEIGHTS ASSISTED LIVING AND MEMORY CARE		FACILITY NUMBER:	306006452
ADMINISTRATOR:	DUSUN LEE		FACILITY TYPE:	740
ADDRESS:	525 W. LA PALMA AVE		TELEPHONE:	(714) 459-3353
CITY:	ANAHEIM	STATE: CA	ZIP CODE:	92801
CAPACITY:	199	CENSUS: 195	DATE:	03/24/2026
		UNANNOUNCED	TIME BEGAN:	08:22 AM
MET WITH:	Sammy Lee		TIME COMPLETED:	01:15 PM

ALLEGATION(S):

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Resident fell due to alleged neglect.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Samer Haddadin conducted an unannounced visit to the facility to deliver findings regarding the above-mentioned allegation. Upon arrival, LPA met with Sammy Lee, Administrator Assistant, and explained the purpose of the visit. During the investigation, LPA conducted a record review, obtained and reviewed facility documents, completed a facility walk-through, and conducted five staff interviews and five resident interviews.
It was alleged that Resident 1 (R1) “fell due to alleged neglect.” LPA conducted five staff interviews and five resident interviews, and all denied the allegation. LPA also interviewed R1, who stated that they became dizzy while in the hallway and fell. During staff interviews, two staff members reported that they assisted R1 immediately after the fall, contacted emergency services, and arranged for R1 to be transported to a local hospital. Staff also stated that R1’s responsible party (RP) was notified right away.
{***CONTINUE9099C***}

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Samer Haddadin
LICENSING EVALUATOR SIGNATURE:	DATE: 03/24/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2026

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-20260127120310

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: HARBOR HEIGHTS ASSISTED LIVING AND MEMORY CARE	FACILITY NUMBER: 306006452
	VISIT DATE: 03/24/2026

NARRATIVE

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LPA conducted a phone interview with R1’s RP, who stated that R1 is ambulatory, physically active, and that the facility had been caring for R1 appropriately with no prior concerns.
LPA also reviewed records and observed that the Physician’s Report, dated 08/05/2025, documented that R1 was ambulatory, able to follow instructions, able to communicate needs, able to leave the facility unassisted, and able to bathe independently. The report further reflected that R1’s overall health status was assessed as fair.
Based on interviews conducted and records reviewed, there was insufficient evidence to support that the alleged violation occurred. Although the allegation may have happened or may be valid, there is not a preponderance of evidence to prove or disprove that a violation took place. Therefore, the allegation is deemed unsubstantiated.
An exit interview was conducted with the Administrator Assistant, and a copy of this report was provided to the facility representative.

SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Samer Haddadin
LICENSING EVALUATOR SIGNATURE:	DATE: 03/24/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2026

LIC9099 (FAS) - (06/04)

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