Heritage Haven

On 3/27/2026 at 12:30 PM, Licensing Program Analyst (LPA) Y. Brown arrived unannounced to conduct a Case Management visit. LPA met with Ferdinand Gutierrez, Administrator and explained the purpose of the visit. Licensee Jene Snipes accompanied the discussion via telephone. During the visit, LPA, Administrator and Licensee discussed the update on the construction timeline and the delay of the funding. Licensee stated that there has been a delay in the construction timeline due to the City of San Leandro sending revisions to the permits. Licensee stated that they are waiting for the City to give a date on the next inspection. Licensee stated that minor construction is getting done at this time but there is a delay in funding. Exit interview conducted with Ferdinand and a copy of this report provided.

On 12/30/2021 LPA G. Clark and LPM Y. Flores-Larios arrived unannounced to conduct a case management visit related to information received for complaint #15-AS-202001128094628. LPA and LPM met with Jhemierly Morales, Caregiver. Ferdinand Gutierrez, administrator arrived shortly after. On 9/23/2021 while conducting interview with Administrator, Administrator denied knowing that R1 was hospitalized in February 2020. R1 states that nobody told him about R1’s hospitalization. Administrator also informed LPA that he does not have any hospital discharge on file for R1. Administrator states that the facility only admits residents who are independent. During the telephone interview, Administrator asked S2 if R1 was hospital. S2 confirmed with Administrator that R1 was indeed hospitalized in February 2020. The following deficiencies are being cited (see LIC 809D) from the California Code of Regulations, Title 22. Failure to correct the deficiencies and/or repeat deficiencies within a 12-month period may result in civil penalties. Exit interview conducted. Appeal Rights and a copy of this report was provided to Administrator

On 8/4/2025 at 10:00 am, Licensing Program Analysts (LPAs) Y. Brown and J. Sampair arrived unannounced to conduct a plan of correction (POC) visit. LPAs met with Administrator Ferdinand Gutierrez and explained the purpose of the visit. LPAs toured the facility including but not limited to resident's bedrooms, bathrooms, common area, kitchen, garage and outdoor area. LPAs discussed next plans for repairs that are needed within the facility as per 2/14/2024 POCs. Administrator will send a plan over to LPAs that details how residents will be accommodated during the construction at the facility by 8/11/2025. No deficiency issue on today date. Exit interview conducted and a copy of this report is provided.

On 1/29/2025 at 7:30 AM, Licensing Program Analyst (LPA) James Sampair arrived unannounced to conduct a Plan of Correction (POC) visit. Upon arrival, LPA stated the purpose of the visit to Caregiver Laila Deguzman. Administrator Ferdinand Gutierrez joined the LPA at approximately 8:45 AM. The LPA toured the facility inside and outside with the Caregiver and the Administrator. The LPA observed that the smoke detectors have been installed and functioning, but the physical plant remains in disrepair. The LPA and Administrator spoke with the Licensee Jene Snipe over the phone who stated that the work on the physical plant has again been delayed because the distribution of the money they are receiving from Alameda County to pay for the repairs will not be available until March of 2025. Fire extinguishers were last serviced on 1/6/2025. No citations issued. Required Annual Inspection incomplete. LPA shall return unannounced to complete the inspection at a later date and time. Exit interview conducted and a copy of this report provided.

On 1/29/2025 at 7:30 AM, Licensing Program Analyst (LPA) James Sampair arrived unannounced to conduct a Plan of Correction (POC) visit. Upon arrival, LPA stated the purpose of the visit to Caregiver Laila Deguzman. Administrator Ferdinand Gutierrez joined the LPA at approximately 8:45 AM. The LPA toured the facility inside and outside with the Caregiver and the Administrator. The LPA observed that the smoke detectors have been installed and functioning, but the physical plant remains in disrepair. The LPA and Administrator spoke with the Licensee Jene Snipe over the phone who stated that the work on the physical plant has again been delayed because the distribution of the money they are receiving from Alameda County to pay for the repairs will not be available until March of 2025. No citations issued. Exit interview conducted and a copy of this report provided.

On 01/14/2025 at 1:50 PM Licensing Program Analyst (LPA) K. Nguyen conducted an unannounced Case Management visit regarding information obtained that a resident was missing from an Unusual Incident Report (UIR) received on 1/6/2025. LPA met with Administrator, Ferdinand Gutierrez and explained the purpose of the visit. LPA K. Nguyen interviewed S1 that confirmed that R1 was missing on 1/03/2025 and returned back to the facility on 01/07/2025. S1 stated that R1 leaves almost every day since R1 were admitted which was 08/5/2024. However, on this particular day, R1 did not return. S1 stated that R1 went to see R1 husband in Oakland without informing any staff. R1 had a court order that R1 husband are not to be near R1, and R1 husband are not supposed to be at the facility as well. S1 stated that R1 is trying to find ways to see R1 husband. We cannot stop R1 from leaving the facility. LPA interviewed R1 and R1 stated that R1 went to see R1 husband because R1 haven’t seen R1 husband for 3 months. R1 stay at R1 husband house, and R1 husband brought R1 back to the facility. R1's Physician's Report indicates that R1 are able to leave the facility unassisted. LPA reviewed R1 files and confirmed R1 physician report that R1 is able to leave the facility unassisted. No deficiency issue on today date. Exit interview conducted and a copy of this report is provided.

On 10/17/2024 at 11:05 am Licensing Program Analyst (LPA) L. Alexander conducted an unannounced Plan of Correction (POC) visit regarding Case Management visit on 09/10/2024. LPA met with Administrator, Ferdinand Gutierrez and explained the purpose of the visit. On 09/10/2024, LPA conducted an Case Management visit in which deficiency were cited. The POC due date was 10/08/2024. Deficiency not cleared during visit: 87466 $100.00 x 9 Days = $900.00 Civil Penalties in the total amount of $900.00 is assessed today for failure to meet POC date for deficiency. Facility is subject to ongoing daily civil penalties until deficiency is corrected. Exit interview conducted. A copy of this report, appeal rights provided and LIC421FC provided.

On 05/04/22 at 11:15 a.m., Licensing Program Analyst (LPA) Greg Clark arrived unannounced to conduct Infection Control Inspection. Administrator, Ferdinand Gutierrez arrived at 11:40 a.m., LPA explained the purpose of the visit. During the Infection Control Inspection, LPA toured facility including but not limited to: front entrance, screening station, hand washing stations, bedrooms, common areas, kitchen and backyard. Facility has a sufficient 2-day perishable and one week non-perishable food supply. Visitors policy is posted on the front entrance. There is one central entry point for universal screening for staff, residents and visitors. A sign-in policy and hand sanitizer were observed at the screening station. Cough/sneeze etiquette, social distancing and hand washing posters were observed. Facility staff were observed to be wearing proper PPE. Facility has a 30-day supply of PPE maintained at central location and easily accessible for staff. Facility has a mitigation plan and maintains record of routine screening for residents and staff. No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.

On 09/10/2024 at 1:20 PM Licensing Program Analyst (LPA) L. Alexander conducted an unannounced Case Management visit regarding information obtained that a resident was missing. LPA met with Administrator, Ferdinand Gutierrez and explained the purpose of the visit. LPA L. Alexander interviewed S1 that confirmed that R1 was missing on 09/05/2024 and returned back to the facility on 09/06/2024. S1 stated that R1 leaves almost everyday since they were admitted which was 08/13/2024. However, on this particular day, R1 did not return. S1 stated that R1 got lost. LPA interviewed R1 and R1 stated that they got lost but came back to the facility on the bus. R1's Physician's Report indicates that they are able to leave the facility unassisted. S1 stated that they will send an incident report via e-mail to Community Care Licensing (CCLD). LPA L. Alexander collected the following documents: Current Resident Roster and R1's Physician's Report. The deficiencies were observed (see LIC809D) and cited from the California Code of Regulation, Title 22. Failure to correct the deficiencies may result in civil penalties. Exit interview conducted. A copy of this report and appeal rights provided

On 8/23/2023 at 10:05am, Licensing Program Analyst (LPA) L. Hall arrived unannounced to conduct proof of correction (POC) visit. LPA met with Jhemierly Morales, Caregive r , and explained the purpose of the visit. Administrator, Ferdinand Guiterrez, arrived at 10:50am. LPA conducted a case management visit on 8/10/2023 and cited facility for the following: Broken window - LPA observed during today's visit window have been replaced. Broken cabinet door - LPA observed cabinet doors have been repaired. Broken exit door - LPA observed door have been repaired. Fire extinguisher - Administrator submitted photo that fire department check extinguisher on 8/14/2023. Food - LPA observed food and also receipts for additional food delivery for today First aid certification for staff - LPA observed first aid and CPR certification for all three (3) staff. Appraisal needs and services plan for clients - Plans have been updated for clients Continued on LIC809C. 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 Continued from LIC809. LPA observed that all deficiencies have been corrected, except the training for the staff. LPA extended the POC date to September 11, 2023, to complete training. No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.

Based on interviews conducted and records reviewed, the above allegation is Unsubstantiated. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated. Based on interviews conducted by LPA, Administrator states there are residents who refuse to take showers or clean themselves up. Administrator states that staff can only encourage residents but if they refuse, staff cannot force them to take showers. S2 and S3 state that the odor at the facility comes from the residents who refuse to take showers. Based on interviews conducted, the above allegation is Unsubstantiated. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated. On 9/23/2021, LPA L. Fontanilla interviewed Administrator via telephone regarding R1’s hospitalization. Administrator denied knowing that R1 was hospitalized. Administrator states he was not informed by the staff. During the interview, Administrator asked S2 if R1 was hospitalized. S2 confirmed with Administrator that R1 was hospitalized. However, Administrator states he does not have a copy of the discharge summary. On 11/3/2021, LPA contacted RP to find out if RP has a copy of the discharge papers. RP states RP does not have a copy of the discharge papers. LPA asked RP how R1 came back to the facility. RP states R1 might have been brought back to the facility by an ambulance. On 11/4/2021, LPA interviewed R1 by telephone. R1 remembers being sick and being in the hospital in February 2020. R1 also mentioned about staying in a convalescent home for two weeks to recover. However, R1 does not remember which hospital he went to, the diagnosis and getting any discharge papers. LPA is not able to obtain hospitalization records due to facility’s failure to provide LPA with R1’s discharge papers. R1 and R1’s family also did not have any records of R1’s discharge papers. Based on interviews conducted, the above allegation is Unsubstantiated. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated.

On 8/10/2023 at 11:10am, Licensing Program Analyst (LPA) L. Hall arrived unannounced to conduct a Case Management visit. LPA met with Ferdinand Guiterrez, Adminstrator, and explained the purpose of the visit. While LPA L. Hall was conducting a complaint investigation (15-AS-20230807161348 ) on 8/10/2023, LPA toured the kitchen and garage of the facility. LPA also reviewed ten (10) resident files and three (3) staff files. At 10:10am, LPA observed an unexplainable amount of flies on the porch. And when inside facility flies were everywhere. At 10:22am, LPA observed a broken window and cabinet doors located in the kitchen. At 10:25am, LPA observed the fire extinguisher was last serviced on 3/3/2020. At 10:30am, LPA observed an exit door leading to the back was broken. At 11:45pm, LPA observed during record review eight (8) of ten (10) physician reports was not current and eight (8) of the (10) appraisal needs and services plan was not current. At 12:30pm, LPA observed during records review all three (3) staff does not have first aid or CPR certification. At 12:30pm, LPA observed during record review that all three (3) staff do not have current required training. Continued on LIC809. 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 Continued from LIC809. LPA is requesting the following documents to be submitted to CCLD by 8/17/2023. Liability insurance Emergency disaster plan (LIC610E) Surety bond LIC500 (Personnel record) LIC308 (Designation of facility responsibility) Deficiency is cited per Title 22 California Code of Regulations and listed on LIC9099D. Failure to submit proof of corrections (POC) by plan of correction due date and/or any repeat deficiencies within a 12-month period may result in civil penalties. Exit interview conducted. A copy of, appeal rights, and this report provided.