306005603-6-6-2024-22-AS-SSAS-DGP98Z-20250514230933

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306005603
Report Date: 06/06/2024
Date Signed: 06/06/2024 06:22:44 PM

Unfounded

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
05/30/2024 and conducted by Evaluator Joseph Alejandre

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20240530105511

FACILITY NAME:	CITRUS HILLS ASSISTED LIVING		FACILITY NUMBER:	306005603
ADMINISTRATOR:	ITZAYANA BARBA AGUIRRE		FACILITY TYPE:	740
ADDRESS:	142 S PROSPECT ST		TELEPHONE:	(714) 639-3590
CITY:	ORANGE	STATE: CA	ZIP CODE:	92869
CAPACITY:	95	CENSUS: 81	DATE:	06/06/2024
		UNANNOUNCED	TIME BEGAN:	03:00 PM
MET WITH:	Itzyzna Aguirre		TIME COMPLETED:	06:15 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff did not ensure facility was kept free of bedbugs

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA) Joseph Alejandre made an unannounced visit to conduct the required 10-day visit to begin the investigation into the allegation listed above. LPA met with Administrator Itzyzna Aguirre and explained the reason for the visit. The investigation into the allegation staff did not ensure the facility was kept free of bed bugs revealed the following. It was alleged that the facility did not address the issue of bed bugs being present in resident rooms at the facility. LPA interviewed staff and residents at the facility. LPA and the Administrator toured the facility. LPA did not observe any bed bugs or any insects in the facility or the rooms that were alleged to have bed bugs. On May 1, 2024 Resident 1 (R1) reported they saw bed bugs in their room. The maintenance director reported they were notified about the bed bugs on May 1, 2024 and they called the pest control company to the facility to treat the room. A review of facility records shows that the room in question was treated by the pest control company for bed bugs on May 2, 2024. The Administrator reported that after this was reported she ordered staff to check each room. It was discovered after the first room was treated that 2 other rooms were in need of treatment. The review of records shows that after bed bugs were reported in the other rooms staff called the pest control company

Unfounded

Estimated Days of Completion:

SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Joseph Alejandre
LICENSING EVALUATOR SIGNATURE:	DATE: 06/06/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/06/2024

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-20240530105511

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: CITRUS HILLS ASSISTED LIVING	FACILITY NUMBER: 306005603
	VISIT DATE: 06/06/2024

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

to have the rooms treated. The invoices provided by the facility show both rooms were treated the day after the report of bed bugs. The facility documents show the facility has monthly pest control service. The last service was provided on May 7, 2024. Staff reported that the next service should be on June 7, 2024. The Administrator reported that on June 10, 2024 the entire facility will be checked by the pest control company and any rooms found with bed bug activity will be treated. This information was verified with an invoice from the Pest Control Company, The Administrator reported that after the first report of bed bugs the facility began the search to find the best company to inspect and possibly treat the whole facility. None of the witnesses interviewed knew how the bed bugs go into the facility. LPA observed that residents who had their rooms treated for bed bugs had new beds and all of their clothes were washed. Staff reported and residents interviewed verified that after the rooms were treated for bed bugs they were cleaned by staff before residents moved back in. LPA observed during the visit that new mattresses are stored in secured packaging that includes the mattress being sealed in plastic before they are used. It is unclear how the bed bugs made it into the facility. What is clear is that the facility addressed the issue in a timely manner and took steps to have the bed bugs removed once they were reported. The facility is being proactive and making an effort to ensure there are no more bed bugs at the facility. Based on the information provided the allegation is deemed unfounded, meaning the allegations are false, could not have happened and/or is without a reasonable basis. An exit interview was conducted and a copy of the report provided.

SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Joseph Alejandre
LICENSING EVALUATOR SIGNATURE:	DATE: 06/06/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/06/2024

LIC9099 (FAS) - (06/04)

Page: 2 of 3