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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374603778
Report Date: 05/18/2023
Date Signed: 05/19/2023 09:39:21 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/28/2023 and conducted by Evaluator Sabel Martinez
COMPLAINT CONTROL NUMBER: 08-AS-20230228142235
FACILITY NAME:HERITAGE HILLSFACILITY NUMBER:
374603778
ADMINISTRATOR:STEFANIE ANCHETAFACILITY TYPE:
740
ADDRESS:2108 EL CAMINO REALTELEPHONE:
(760) 206-7930
CITY:OCEANSIDESTATE: CAZIP CODE:
92054
CAPACITY:74CENSUS: 69DATE:
05/18/2023
UNANNOUNCEDTIME BEGAN:
04:15 PM
MET WITH:Business Office Director, Amanda Togia, Resident Service Director, Yesenia Reyes TIME COMPLETED:
05:15 PM
ALLEGATION(S):
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Staff did not clean facility
Staff did not assist resident with dressing needs
Staff drinking while on duty
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA), Sabel Martinez, conducted an unannounced complaint investigation visit to deliver findings. The LPA introduced himself and disclosed the purpose of the visit to Business Office Director, Amanda Togia, Resident Service Director, Yesenia Reyes.

Throughout the investigation, the Department secured pertinent records and conducted interviews with internal and external sources.

It was alleged staff did not clean the facility. It was reported to the department staff did not maintain the facility, residents’ rooms and bathrooms clean. Interviews with internal and external sources revealed facility floors, resident rooms and bathroom were witnessed to be dirty. Care staff not having access to cleaning supplies resulted in these areas to be uncleaned. Observations by the LPA on multiple visits to the facility corroborated facility floors, residents’ rooms, and bathroom were not clean.

Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Denise PowellTELEPHONE: (610) 767-2317
LICENSING EVALUATOR NAME: Sabel MartinezTELEPHONE: (619) 767-2301
LICENSING EVALUATOR SIGNATURE:

DATE: 05/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/18/2023
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 4
Control Number 08-AS-20230228142235
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME: HERITAGE HILLS
FACILITY NUMBER: 374603778
VISIT DATE: 05/18/2023
NARRATIVE
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It was alleged staff did not assist residents with dressing needs. It was reported to the Department staff would leave residents in dirty clothes and not assist them with dressing. Interviews with internal and external sources revealed it residents were witnessed with dirty clothing and wearing clothing for several days. Interviews with internal sources corroborated it was the staff’s responsibility to assess and assist residents with dressing needs daily.

It was alleged staff was drinking while on duty. It was reported to the Department one staff member was witnessed to be under the influence of alcohol at the facility. Interviews with internal and external sources revealed Staff #1 (S1) had been witnessed to be intoxicated while at work on multiple occasions. Interviews and review of records corroborated S1 was no longer employed at the facility.

Based on evidence obtained, the preponderance of evidence standard was met, therefore, the allegations were Substantiated. The deficiencies were cited in accordance with California Code of Regulations, Title 22, and listed on the LIC 9099D. A plan of correction was jointly formulated with Business Office Director, Amanda Togia, Resident Service Director, Yesenia Reyes.

An exit interview was conducted with Business Office Director, Amanda Togia, Resident Service Director, Yesenia Reyes, to whom a copy of this report, LIC 9099D and Licensee/Appeals Rights (LIC 9058) were provided via email. An email read receipt confirms the documents were received.
SUPERVISOR'S NAME: Denise PowellTELEPHONE: (610) 767-2317
LICENSING EVALUATOR NAME: Sabel MartinezTELEPHONE: (619) 767-2301
LICENSING EVALUATOR SIGNATURE:

DATE: 05/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/18/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 08-AS-20230228142235
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: HERITAGE HILLS
FACILITY NUMBER: 374603778
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/18/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/18/2023
Section Cited
CCR
87303(a)
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87303 Maintenance and Operation (a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors. This requirement was not as evidence by:
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Business Office Director agreed for facility to provide in service training to all staff regarding cleaning procedures, by 6/16/23.

Business Office Director agreed to submit proof to the department of staff who attended the training, subjects discussed and date, by 6/16/23.
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Based on interviews and observations, the Licensee did not ensure the facility was clean and sanitary, whcih posed a potential health, safety, and personal rights risk to 69 of 69 persons in care.
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Type B
05/18/2023
Section Cited
CCR
87464(f)(4)
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87464 Basic Services (f) Basic services shall at a minimum include:(4) Personal assistance and care as needed by the resident and as indicated in the pre-admission appraisal, with those activities of daily living such as dressing, eating, bathing and assistance with taking prescribed medications, as specified in Section 87608, Postural Supports. This requirement was not met as evidence by:
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Business Office Director agreed for facility to provide in service training to all staff regarding activities of daily living, by 6/16/23.

Business Office Director agreed to submit proof to the department of staff who attended the training, subjects discussed and date, by 6/16/23.
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Based on interviews, the Licensee did not ensure staff assisted residents with activities of daily living such as dressing, which posed a potential health, safety and personal rights risk to 69 of 69 person in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Denise PowellTELEPHONE: (610) 767-2317
LICENSING EVALUATOR NAME: Sabel MartinezTELEPHONE: (619) 767-2301
LICENSING EVALUATOR SIGNATURE:

DATE: 05/18/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/18/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 08-AS-20230228142235
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: HERITAGE HILLS
FACILITY NUMBER: 374603778
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/18/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/18/2023
Section Cited
CCR
87411(a)(
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87411 Personnel Requirements - General (a) Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs. In facilities licensed for sixteen or more, sufficient support staff shall be employed to ensure provision of personal assistance and care as required in Section 87608, Postural Supports. Additional staff shall be employed as necessary to perform office work, cooking, house cleaning, laundering, and maintenance of buildings, equipment and grounds. The licensing agency may require any facility to provide additional staff whenever it determines through documentation that the needs of the particular residents, the extent of services provided, or the physical arrangements of the facility require such additional staff for the provision of adequate services. This requirement was not met as evidence by:
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Business Office Director agreed for facility to provide in service training to all staff regarding Personnel Requirements, by 6/16/23.

Business Office Director agreed to submit proof to the department of staff who attended the training, subjects discussed and date, by 6/16/23.
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Based on interviews and review of records, the Licensee did not ensure staff were competent to provide services necessary, which posed a potential health, safety, and personal rights risk to 69 of 69 persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Denise PowellTELEPHONE: (610) 767-2317
LICENSING EVALUATOR NAME: Sabel MartinezTELEPHONE: (619) 767-2301
LICENSING EVALUATOR SIGNATURE:

DATE: 05/18/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/18/2023
LIC9099 (FAS) - (06/04)
Page: 4 of 4