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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306006345
Report Date: 01/27/2025
Date Signed: 01/27/2025 10:00:50 AM

Substantiated


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
01/22/2025 and conducted by Evaluator Ruth Martinez
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20250122145257
FACILITY NAME:SEA BLUFFS, THEFACILITY NUMBER:
306006345
ADMINISTRATOR:BRENT BROADHURSTFACILITY TYPE:
740
ADDRESS:25421 AND 25401 SEA BLUFFS DRTELEPHONE:
(949) 234-3000
CITY:DANA POINTSTATE: CAZIP CODE:
92629
CAPACITY:88CENSUS: 66DATE:
01/27/2025
UNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Brent BroadhurstTIME COMPLETED:
10:30 AM
ALLEGATION(S):
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Staff accepted money from a resident
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Ruth Martinez visited the facility to deliver findings for the investigation into the above identified complaint allegation.

Based on the information obtained during this investigation the department has concluded the investigation into the above mentioned allegation. Findings are based upon this investigation which included interviews conducted, tour of the physical plant of the facility and copies of pertinent documents obtained. It is alleged that staff accepted money from a resident. Interview with staff 1 (S1) indicated that resident 1 (R1) had given them a monitory gift of $1000 dollars. S1 stated that they took the gift, but that they had not spent any of it. S1 indicated that they spoke with R1’s POA about the gift and POA gave S1 indications to hold the money until they came to visit R1 the following month. Interview with 3 of 3 staff indicated that it is company policy that no staff member is allowed to take any monetary gifts from any of the residing residents of the facility.

Continued on LIC9099-C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Ruth Martinez
LICENSING EVALUATOR SIGNATURE:

DATE: 01/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2025
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 3
Control Number 22-AS-20250122145257
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: SEA BLUFFS, THE
FACILITY NUMBER: 306006345
VISIT DATE: 01/27/2025
NARRATIVE
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Based on the information gathered the preponderance of evidence standard has been met, therefore, the allegation, facility staff is in disrepair, is found to be SUBSTANTIATED.

Based on this inspection, deficiencies were observed at this time in the areas evaluated per Title 22 Division 6 Chapter 8 of the California Code of Regulations. See LIC9099-D for deficiencies.

This report was reviewed with Administrator and a copy of this LIC9099, LIC9099-D report was provided and left at facility. Appeal rights reviewed, and a copy provided.
SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Ruth Martinez
LICENSING EVALUATOR SIGNATURE:

DATE: 01/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 22-AS-20250122145257
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: SEA BLUFFS, THE
FACILITY NUMBER: 306006345
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/27/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Deficiency Dismissed
Type B
02/10/2025
Section Cited
CCR
87468.1(a)(3)
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Personal Rights of Residents in All Facilities. (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (3) To be free from punishment, humiliation, intimidation, abuse, or other actions of a punitive nature, such as withholding residents' money...
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Executive Director agrees to review regulation section 87468.1 Personal Rights of Residents in All Facilities with all staff. Executive Director will send a signed statement of understanding along with a sign in sheet for all staff trained on the regulation section cited by POC due date of 2/10/25.
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This requirement is not being met as evidenced by: base oon iterview with S1 they indicated that they accepted a monitary gift from R1. This presents a potential health, safety, and personal rights to resident 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: Armando J Lucero
LICENSING EVALUATOR NAME: Ruth Martinez
LICENSING EVALUATOR SIGNATURE:

DATE: 01/27/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3