374603778-3-27-2024-08-AS-LTEZ-D3TR26-20240329123750

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374603778
Report Date: 03/27/2024
Date Signed: 03/27/2024 11:45:08 AM

Unsubstantiated

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
04/29/2023 and conducted by Evaluator Dawn Segura

COMPLAINT CONTROL NUMBER: 08-AS-20230429075042

FACILITY NAME:	HERITAGE HILLS		FACILITY NUMBER:	374603778
ADMINISTRATOR:	STEFANIE ANCHETA		FACILITY TYPE:	740
ADDRESS:	2108 EL CAMINO REAL		TELEPHONE:	(760) 206-7930
CITY:	OCEANSIDE	STATE: CA	ZIP CODE:	92054
CAPACITY:	78	CENSUS: 70	DATE:	03/27/2024
		UNANNOUNCED	TIME BEGAN:	10:45 AM
MET WITH:	Stefanie Ancheta, Executive Director		TIME COMPLETED:	11:50 AM

ALLEGATION(S):

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Staff did not seek medical attention for residents.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Dawn Segura conducted an unannounced visit to deliver investigation findings. LPA was granted entry into the facility and met with Stefanie Ancheta, Executive Director, to whom LPA disclosed the reason for the visit.

It was reported to Community Care Licensing that Resident 1 (R1) had a seizure for which 9-1-1 was not called. It was also reported that Resident 2 (R2) fell and hit his/her head, following which staff arrived 30 minutes later and put R2 back into the bed without conducting an assessment or calling 9-1-1.

Community Care Licensing (CCL) has investigated the above-listed complaint allegation. The investigation consisted of a tour of the facility, review of facility records, and interviews of staff and outside source.

Records obtained and reviewed during the investigation reflected that R1 had documented seizure activity. It was also noted that R1 was transported to the hospital, on occasion, following seizure activity. It was further

Unsubstantiated

Estimated Days of Completion: 0

SUPERVISOR'S NAME: Lizzette Tellez	TELEPHONE: (619) 767-2351
LICENSING EVALUATOR NAME: Dawn Segura	TELEPHONE: (619) 417-3928
LICENSING EVALUATOR SIGNATURE:	DATE: 03/27/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/27/2024

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 08-AS-20230429075042

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: 03/27/2024

NARRATIVE

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noted that R1 was prescribed medication to address the seizure activity. The investigation did not yield evidence that indicated that immediate or emergency medical attention was needed each time R1 exhibited seizure activity or that R1 experienced a seizure following which needed medical attention was not sought. Additionally, the investigation produced no evidence that R1 experienced a seizure at the time of the alleged incident.

Records retained relative to R2 reflected that R2 was at risk for falls. Interviews also yielded that the facility had procedures in place for staff to follow in response to resident falls. The investigation did not yield evidence of a fall sustained by R2, following which R2 was not assessed or that needed medical attention was not sought.

Based upon the foregoing, the allegation is unsubstantiated. This finding means that although the allegation may have happened or may be valid, there is not a preponderance of evidence to prove that the alleged violation occurred.

An exit interview was conducted with Stefanie Ancheta, and a copy of this report and Licensee/Appeal Rights (LIC 9058) were provided to the Executive Director at the conclusion of the visit.

SUPERVISOR'S NAME: Lizzette Tellez	TELEPHONE: (619) 767-2351
LICENSING EVALUATOR NAME: Dawn Segura	TELEPHONE: (619) 417-3928
LICENSING EVALUATOR SIGNATURE:	DATE: 03/27/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/27/2024

LIC9099 (FAS) - (06/04)

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