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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306004192
Report Date: 11/18/2025
Date Signed: 11/18/2025 04:11:59 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
12/08/2023 and conducted by Evaluator Andrea Mendivil
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20231208162507
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: 113DATE:
11/18/2025
UNANNOUNCEDTIME BEGAN:
11:46 AM
MET WITH:Faye Shen - COO TIME COMPLETED:
12:59 PM
ALLEGATION(S):
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Facility is unable to meet resident's needs.
Resident sustained multiple falls due to neglect.
INVESTIGATION FINDINGS:
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On this day, Licensing Program Analyst (LPA) Andrea Mendivil made an unannounced visit to deliver complaint findings. LPA was greeted and granted entry into the facility by staff and explained the reason for the visit. Chief Operating Officer (COO) Faye Shen and Administrator Steve Shen arrived at 11:00 am

The Department recieved a complaint on 12/08/2023 and LPA Mendivil conducted the initial 10 day visit on 12/15/2023. LPA Mendivil obtained copies of pertinent documents such as physician report and admission agreement and interviewed staff and residents. Regarding the allegation facility is unable to meet residents' needs and Resident sustained multiple falls due to neglect., the investigation revealed the following:

It was reported faciltiy is unable to meet residents needs for Resident 1 (R1), per review of R1's file there is no care plan or needs/services plan on record. It was reported that R1 had mutliple falls in the six weeks they were at the facility. Based on interviews with staff it was reported that R1 was a fall risk, per reivew no documented care plans on record to mitagate falls.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Andrea Mendivil
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2025
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 5
Control Number 22-AS-20231208162507
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: 11/18/2025
NARRATIVE
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Therefore based on records reviewed the allegation facility is unable to meet resident's needs and resident sustained multiple falls due to neglect is determined to be SUBSTANTIATED, meaning the complaint allegation is valid and that a violation has occurred.

The following is being cited per California Code of Regulations Title 22 Division 6 Chapter 8.

An exit interview was conducted and a copy of this report and appeal rights was provided to the facility representative.

SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Andrea Mendivil
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 22-AS-20231208162507
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: 11/18/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/21/2025
Section Cited
CCR
87463(a)
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(a) The pre-admission appraisal, as specified in Section 87457.., shall be updated, in writing as frequently as necessary... This requirement was not met as evidence by there was no appraisal conducted for R1 and therefore facility cannot meet needs that are not identified.
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Adminstrator stated will conduct in service on appraisals and when to update based on change of condition.
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This poses an immediate health and safety risks to persons in care.
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Type A
11/19/2025
Section Cited
CCR
87464(f)(4)
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(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...
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Administrator to conduct in service regarding fall risk/mitagation of falls and provide to LPA by POC due date.
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This requirement was not met as evidence by R1 did not have a care plan for fall mitagation which resulted in resident sustaining multiple falls due to neglect. This poses an immediate health and safety risks 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.
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Andrea Mendivil
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 5
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
12/08/2023 and conducted by Evaluator Andrea Mendivil
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20231208162507

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: 113DATE:
11/18/2025
UNANNOUNCEDTIME BEGAN:
11:46 AM
MET WITH:Faye Shen- COO TIME COMPLETED:
12:59 PM
ALLEGATION(S):
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9
Resident sustained unexplained injuries due to staff being rough
INVESTIGATION FINDINGS:
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2
3
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5
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7
8
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10
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On this day, Licensing Program Analyst (LPA) Andrea Mendivil made an unannounced visit to deliver complaint findings. LPA was greeted and granted entry into the faciltiy by staff and explained the reason for the visit. Chief Operating Offiicer (COO) Faye Shen arrived at 11am.

The Department received a complaint on 12/08/2023 and LPA Mendivil conducted initial 10 day visit on 12/15/2023. LPA Mendivil obtained copies of residents file including : physician's report and progress notes as well as interviewed staff and residents. Regarding the allegation resident sustained unexplained injuries due to staff being rough, the investigation revealed the following:

Per interviews with 4 out of 4 staff stated they have not witnessed staff being rough with residents. Per interview with COO Faye stated staff receives annual training.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Andrea Mendivil
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 22-AS-20231208162507
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: 11/18/2025
NARRATIVE
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Per interviews with 3 out of 3 residents stated no one has been rough or mean to them while at the facility. Residents stated they have no been injured while in care.

Therefore based on the preponderance of evidence through records reviewed and interviews the allegation resident sustained unexplained injuries due to staff being rough is determined to be UNSUBSTANTIATED, meaning athough the allegation may have happened or is valid, there is not a preponderance of evidence to prove or refute the alleged violation occurred.

An exit interview was conducted and a copy of this report was provided.
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Andrea Mendivil
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 5