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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374603778
Report Date: 11/23/2022
Date Signed: 11/23/2022 01:28:38 PM

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
03/04/2022 and conducted by Evaluator Ramon Serrano
COMPLAINT CONTROL NUMBER: 08-AS-20220304100637
FACILITY NAME:HERITAGE HILLSFACILITY NUMBER:
374603778
ADMINISTRATOR:LEMASTER, SUZY PFACILITY TYPE:
740
ADDRESS:2108 EL CAMINO REALTELEPHONE:
(760) 206-7930
CITY:OCEANSIDESTATE: CAZIP CODE:
92054
CAPACITY:74CENSUS: 64DATE:
11/23/2022
UNANNOUNCEDTIME BEGAN:
12:59 PM
MET WITH:Amanda TogiaTIME COMPLETED:
01:39 PM
ALLEGATION(S):
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Unlawful Eviction
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Ramon Serrano conducted an unannounced complaint visit to deliver findings on the above allegation. LPA met with Business Office Director Amanda Togia and we discussed the purpose of the visit and elements of the complaint.

Community Care Licensing (CCL) has investigated the above allegation. The investigation consisted of LPA direct observation, records review, and interviews with facility staff.

In response to the allegation, it was alleged that Resident was unlawfully evicted (R1) [an LIC 811 Confidential Names List was provided to the facility representative to identify the resident.] Records review revealed facility staff was in communication with R1’s responsible party as of January 2022 regarding R1's change in health care coverage. Records review also revealed a signed document by R1’s responsible party acknowledging R1 would be immediately removed from the facility should a lapse or termination of health insurance occur.






Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Denise PowellTELEPHONE: (619) 767-2317
LICENSING EVALUATOR NAME: Ramon SerranoTELEPHONE: (619) 458-2583
LICENSING EVALUATOR SIGNATURE:

DATE: 11/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/23/2022
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 3
Control Number 08-AS-20220304100637
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: 11/23/2022
NARRATIVE
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Interview with facility staff revealed as of January 2022 facility staff was in communication with R1’s responsible party regarding the resident being dropped from their health care provider. This same staff member advised the responsible party of the monthly fees that R1 would need to pay monthly to continue their stay at the facility. Staff stated that R1’s responsible party eventually decided to move them to a different facility.

Interview with Executive Director (ED) revealed minimal knowledge regarding R1’s eviction since they were recently hired. ED stated that although the facility was working with R1’s responsible party in finding them new placement, a 30-day eviction notice was never issued to R1 or submitted to CCL.

Based upon records review and interviews, the above allegation is substantiated. This finding means that the preponderance of the evidence standard has been met and the allegation is valid. Deficiency is cited in accordance with California Code of Regulations, Title 22.

An exit interview was conducted with Amanda Togia and a copy of this report and Licensee/Appeal Rights (LIC 9058) were provided to Amanda Togia whose signature below confirms receipt of documents.
SUPERVISOR'S NAME: Denise PowellTELEPHONE: (619) 767-2317
LICENSING EVALUATOR NAME: Ramon SerranoTELEPHONE: (619) 458-2583
LICENSING EVALUATOR SIGNATURE:

DATE: 11/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/23/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 08-AS-20220304100637
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: 11/23/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/30/2022
Section Cited
CCR
87224(a)(1)
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The licensee may evict a resident for one or more of the reasons listed in Section 87224(a)(1)...Thirty (30) days written notice to the resident is required...Nonpayment of the rate for basic services within ten days of the due date.This requirement has not been met as evidenced by:
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Per ED Stefanie Ancheta they will comply by issuing a 30 day notice for non-payment. Ed will conduct staff inservice with department heads. Will send LPA roster of staff that attended by 11/30/22.
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Based on interviews and records review, Thirty (30) days written notice to the resident was not issued for Nonpayment of the rate for basic services...for 1 in 1 of 64 persons in care [R1] which posed an immediate safety and personal rights risk to 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: (619) 767-2317
LICENSING EVALUATOR NAME: Ramon SerranoTELEPHONE: (619) 458-2583
LICENSING EVALUATOR SIGNATURE:

DATE: 11/23/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/23/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 3