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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306004796
Report Date: 12/02/2025
Date Signed: 12/02/2025 04:28:00 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 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
07/31/2024 and conducted by Evaluator Jessica Cho
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20240731232601
FACILITY NAME:HUNTINGTON TERRACEFACILITY NUMBER:
306004796
ADMINISTRATOR:GREGORY CASEFACILITY TYPE:
740
ADDRESS:18800 FLORIDA STTELEPHONE:
(714) 848-8811
CITY:HUNTINGTON BEACHSTATE: CAZIP CODE:
92648
CAPACITY:185CENSUS: 173DATE:
12/02/2025
UNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Mike Marion- Executive Director
Timarie Morrissey- Business Office Manager 		TIME COMPLETED:
03:45 PM
ALLEGATION(S):
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5
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8
9
Staff threatened to evict a resident in care.
INVESTIGATION FINDINGS:
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2
3
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5
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8
9
10
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12
13
Licensing Program Analyst (LPA) Jessica Cho made an unannounced subsequent vist for the purpose of continuing the investigation and delivering the findings into the above allegation. LPA met with Business Office Manager (BOM) Timarie Morrissey and explained the reason for the visit. During the course of the investigation, LPA interviewed one resident, two staff, and a witness, and obtained the following documentation for review: Resident Rosters, Personnel Report, Staff Contacts, Face Sheet, Physician's Report, Admission Agreement, Resident Assessments/Needs and Services Plans, Narrative Charting, and Warning Notice involving Resident #1 (R1).

The investigation revealed the following: The Department received said complaint on July 31, 2024. The complaint was initiated by LPA on August 8, 2024. Regarding the allegation, Staff threatened to evict a resident in care, it is alleged that a Registered Nurse (RN) and R1 was engaged in an interaction where an eviction threat was made to R1. The Narrative Charting revealed that RNs were a third-party contractor in 2024 to provide the facility support which was corroborated by one staff.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Jessica Cho
LICENSING EVALUATOR SIGNATURE:

DATE: 12/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2025
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 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 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
07/31/2024 and conducted by Evaluator Jessica Cho
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20240731232601

FACILITY NAME:HUNTINGTON TERRACEFACILITY NUMBER:
306004796
ADMINISTRATOR:GREGORY CASEFACILITY TYPE:
740
ADDRESS:18800 FLORIDA STTELEPHONE:
(714) 848-8811
CITY:HUNTINGTON BEACHSTATE: CAZIP CODE:
92648
CAPACITY:185CENSUS: 173DATE:
12/02/2025
UNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Mike Marion- Executive Director
Timarie Morrissey- Business Office Manager 		TIME COMPLETED:
03:45 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Resident's signature was forged on a document.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Jessica Cho made an unannounced subsequent vist for the purpose of continuing the investigation and delivering the findings into the above allegations. LPA met with Business Office Manager (BOM) Timarie Morrissey and explained the reason for the visit. During the course of the investigation, LPA interviewed one resident, two staff, and a witness, and obtained the following documentation for review: Resident Rosters, Personnel Report, Staff Contacts, Face Sheet, Physician's Report, Admission Agreement, Resident Assessments/Needs and Services Plans, Narrative Charting, and Warning Notice involving Resident #1 (R1).

The investigation revealed the following: The Department received said complaint on July 31, 2024, and the complaint was initiated by LPA on August 8, 2024. Regarding the allegation, Resident's signature was forged on a document, it is alleged that R1's Level of Care (LOC) was reduced to a level 2. R1 is solely responsible for making their own decisions as outlined in the admission agreement dated on July 26, 2018.
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Jessica Cho
LICENSING EVALUATOR SIGNATURE:

DATE: 12/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 22-AS-20240731232601
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME: HUNTINGTON TERRACE
FACILITY NUMBER: 306004796
VISIT DATE: 12/02/2025
NARRATIVE
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Based on the review of the resident assessments, the resident assessment dated July 26, 2018 indicates R1 began receiving care at a level 5. However, LOC was reduced to a level 1 as per resident assessment dated October 25, 2022. It was noted on this assessment that the LOC was dropped after speaking to R1's wife. There was no signature obtained on this assessment. On November 22, 2022, LOC increased to a Level 3. It was noted on the assessment and narrative charting dated November 23, 2022 at 6:37pm that R1 refused to sign updated assessment. The records reveal that the signatures were not forged and was left blank.

Therefore, this agency has investigated the complaint and based on the interviews which were conducted and the records that were reviewed, the following allegation, Resident's signature was forged on a document is deemed UNFOUNDED. We have found that the complaint was unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. We have therefore dismissed the complaint.

An exit interview was conducted with Executive Director Mike Marion, and a copy of this report was provided at exit.
SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Jessica Cho
LICENSING EVALUATOR SIGNATURE:

DATE: 12/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 22-AS-20240731232601
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME: HUNTINGTON TERRACE
FACILITY NUMBER: 306004796
VISIT DATE: 12/02/2025
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
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The witness who had observed the interaction reported that the RN did not issue threats, but instead explained to R1 that their behavior and actions could result in an eviction due to policy violations regarding medications. The witness indicated that R1 had immediately reached out to their attorney which aligns with the narrative charting noted on July 24, 2024 at 2:29pm. The charting documented that R1's attorney agreed to facilitate R1's return of their medications. One out of three staff confirmed that R1 had prior history of not returning their medications after leaving the community.

Therefore, based on the interviews which were conducted and the records that were reviewed, although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the following allegation, Staff threatened to evict a resident in care is deemed UNSUBSTANTIATED.

An exit interview was conducted with Executive Director Mike Marion, and a copy of this report was provided at exit.
SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Jessica Cho
LICENSING EVALUATOR SIGNATURE:

DATE: 12/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 4