306000295-3-12-2025-22-AS-RMRT-DEPVJB-20250312162827

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 306000295
Report Date: 03/12/2025
Date Signed: 03/12/2025 04:28:50 PM

Document Has Been Signed on 03/12/2025 04:28 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

FACILITY NAME:	KARLTON RESIDENTIAL CARE CENTER		FACILITY NUMBER:	306000295
ADMINISTRATOR/ DIRECTOR:	ELENA WEINER		FACILITY TYPE:	740
ADDRESS:	3615 WEST BALL RD.		TELEPHONE:	(714) 236-1170
CITY:	ANAHEIM	STATE: CA	ZIP CODE:	92804
CAPACITY: 76	TOTAL ENROLLED CHILDREN: 0	CENSUS: 48	DATE:	03/12/2025
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	01:00 PM
MET WITH:	Elena Weiner, Administrator (AD)		TIME VISIT/ INSPECTION COMPLETED:	04:45 PM

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	Licensing Program Analyst (LPA) Rose Ruppert made an unannounced visit to the facility today to conduct an Annual Required Evaluation. LPA was greeted and granted entry and met with Elena Weiner, Administrator (AD). The facility is a single story building with an approved fire clearance of seventy-six non-ambulatory and bedridden residents of which fifteen may be on hospice. The facility currently has a census of forty-eight residents in care with eight receiving hospice services. During today’s visit, LPA toured the facility and inspected the physical plant, including but not limited to testing hot water temperature in five of five resident bathrooms. The hot water temperature measured between 114.9 and 117.5 degrees Fahrenheit. Fire extinguishers were charged and serviced on July 2, 2024. The facility’s last fire drill was conducted on January 4, 2025. Building sprinklers, smoke and carbon monoxide alarms were tested with an outside vendor on April 10, 2024. LPA and AD inspected the facility kitchen food supply and observed the facility retained a minimum of two days perishable and seven days non-perishable food on hand. Food expiration dates were clearly written on food items. LPA observed medication storage and reviewed the centrally stored medications with AD and MedTech. LPA discussed with AD and MedTech writing start dates on bubble packs for easier inventory and audit. Per review medications are being given as prescribed. The facility has an enclosed indoor courtyard and shaded seating areas were observed. There were no hazards or obstructed passageways outdoors. LPA toured the laundry area which is separate from the main building which is inaccessible to residents. (Continued on LIC 809-C)

Alisa Ortiz	TELEPHONE: (714) 287-4084
RoseMarie Ruppert	TELEPHONE: 714-703-2840
	DATE: 03/12/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2025

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION 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: KARLTON RESIDENTIAL CARE CENTER	FACILITY NUMBER: 306000295
	VISIT DATE: 03/12/2025

NARRATIVE

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(Continued from LIC 809)

LPA reviewed five of five staff training and fingerprint records and reviewed five of five resident records. LPA interviewed alert residents regarding their quality of care and spoke to staff present regarding care provided. LPA observed residents participating in a music sing-a-long and in Bingo. LPA confirmed that administrator has a current administrator certificate which expires on July 20, 2025.

Based on the observations made during today’s visit, the facility appears to be in compliance with Title 22 Division 6 of the California Code of Regulations, no deficiencies cited on this date. An exit interview was conducted with Elena Weiner, Administrator and a copy of the report and files reviewed (LIC 858 & LIC 859) were given at the time of the visit.

SUPERVISOR'S NAME: Alisa Ortiz	TELEPHONE: (714) 287-4084
LICENSING EVALUATOR NAME: RoseMarie Ruppert	TELEPHONE: 714-703-2840
LICENSING EVALUATOR SIGNATURE:	DATE: 03/12/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2025

LIC809 (FAS) - (06/04)

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