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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306004192
Report Date: 12/09/2024
Date Signed: 12/09/2024 05:05:23 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, 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
12/04/2024 and conducted by Evaluator Sean Haddad
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20241204160626
FACILITY NAME:WHITTEN HEIGHTS ASSISTED LIVING AND MEMORY CAREFACILITY NUMBER:
306004192
ADMINISTRATOR:STEVE SHENFACILITY TYPE:
740
ADDRESS:200 WEST WHITTIER BLVD.TELEPHONE:
(562) 691-1200
CITY:LA HABRASTATE: CAZIP CODE:
90631
CAPACITY:196CENSUS: 125DATE:
12/09/2024
UNANNOUNCEDTIME BEGAN:
01:22 PM
MET WITH:Faye ShenTIME COMPLETED:
05:20 PM
ALLEGATION(S):
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Facility staff are not properly addressing roaches in the facility
INVESTIGATION FINDINGS:
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This unannounced inspection is being conducted by Licensing Program Analysts (LPAs) Sean Haddad and Edward Kim for the purpose of investigating the above-mentioned complaint allegation. LPAs met with Chief Operating Officer (COO) Faye Shen, discussed the purpose of the inspection, and explained the allegation.

The investigation into the allegation that facility staff are not properly addressing roaches in the facility revealed the following: During the course of the investigation, LPAs inspected the facility, interviewed COO and residents, and obtained and reviewed copies of the resident roster, staff roster, and the facility’s recent pest control records.

CONTINUED
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Sean Haddad
LICENSING EVALUATOR SIGNATURE:

DATE: 12/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2024
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 22-AS-20241204160626
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME: WHITTEN HEIGHTS ASSISTED LIVING AND MEMORY CARE
FACILITY NUMBER: 306004192
VISIT DATE: 12/09/2024
NARRATIVE
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It was alleged that multiple large roaches were observed in Resident #1’s (R1) room, that R1’s room has had roaches for about a year, and that facility staff have not properly addressed the roach infestation. LPAs inspected 13 resident rooms and observed no roaches or insects, but LPAs did observe cat food left out in R1’s new room. LPAs interviewed 13 residents, two of whom reported seeing roaches at the facility. LPAs interviewed COO who admitted that R1’s room did have multiple roaches and that after learning of the roaches on December 4, 2024, the facility relocated R1 to another room on December 6, 2024, in order to address the infestation. COO stated that the facility’s measures to address insects in the facility include caregivers checking for food left out in residents’ rooms during their twice daily checks, a deep cleaning of residents’ rooms weekly, and regular pest control inspections and spraying approximately every 21 days by a professional exterminator. LPAs reviewed the facility’s recent pest control records which show that R1 refused the professional exterminator’s services on July 10, 2024 and September 13, 2024. Per COO, R1 sometimes refused pest control services in their room because they have a cat in their room and it is possible the infestation in R1’s room may have been caused by cat food in R1’s room. However, COO stated that the facility did not issue R1 notices of violation of the house rules for refusing pest control services and for leaving cat food out in their rooms and the information obtained corroborated that the facility’s current measures are not properly addressing roaches in the facility.

During the course of the investigation, the Department obtained sufficient evidence to substantiate the allegation mentioned above. The preponderance of evidence standard has been met; therefore, the above allegation is Substantiated. See LIC9099D for cited deficiencies per Title 22 Division 6 of the California Code of Regulations. Civil penalties for repeat violations are being assessed. See LIC421FC. An exit interview was conducted and a copy of this report and appeal rights was discussed with and provided to facility representative.
SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Sean Haddad
LICENSING EVALUATOR SIGNATURE:

DATE: 12/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 22-AS-20241204160626
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

FACILITY NAME: WHITTEN HEIGHTS ASSISTED LIVING AND MEMORY CARE
FACILITY NUMBER: 306004192
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/09/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
12/10/2024
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… This requirement was not met as evidenced by:
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Licensee stated that they relocated R1 and are addressing the infestation in R1’s room with a professional exterminator. Licensee stated they will create a plan to address future infestations and submit proof to LPA by POC due date.
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Based on interviews, the licensee did not ensure the facility was safe and sanitary when R1’s room was infested with roaches, which poses an immediate health risk to persons in care. CIVIL PENALTY ASSESSED.
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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.
SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Sean Haddad
LICENSING EVALUATOR SIGNATURE:

DATE: 12/09/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2024
LIC9099 (FAS) - (06/04)
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