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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306003744
Report Date: 09/06/2023
Date Signed: 09/06/2023 11:13:36 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
09/05/2023 and conducted by Evaluator Joseph Alejandre
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20230905074254
FACILITY NAME:QUALITY CARE PLUSFACILITY NUMBER:
306003744
ADMINISTRATOR:MARJAN ARASTOOFACILITY TYPE:
735
ADDRESS:1652 W. BROADWAYTELEPHONE:
(714) 635-6561
CITY:ANAHEIMSTATE: CAZIP CODE:
92802
CAPACITY:80CENSUS: 71DATE:
09/06/2023
UNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Marjan ArastooTIME COMPLETED:
11:20 AM
ALLEGATION(S):
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Facility is not in good repair.
INVESTIGATION FINDINGS:
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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 Marjan Arastoo and explained the reason for the visit. The investigation into the allegation, facility is not in good repair revealed the following. It was alleged that the sliding glass door in the activiity room which leads to the outdoor patio was broken and there was broken glass inside and outside of the patio. The Administrator reported that the glass in the sliding door was shattered but stayed in the frame and was in one piece. The Administrator reported that this was observed on 8/27/23. The Administrator reported that a door and window contractor was contacted on 8/28/23 to repair the sliding glass door but they never showed up at the facility. Staff reported on 9/4/23 the glass on the sliding door fell. The Administrator and staff reported that on 9/4/23 that the broken glass was swept up and the remaining broken glass on the sliding door was removed. The sliding glass door was double paned so there is still glass in the door. The Administrator reported that the edges of the sliding glass door were taped. The Administrator reported that there were no injuries because of the broken sliding glass door. The sliding glass door was observed to be broken on 8/27/23.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Luz Adams
LICENSING EVALUATOR NAME: Joseph Alejandre
LICENSING EVALUATOR SIGNATURE:

DATE: 09/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/06/2023
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-20230905074254
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME: QUALITY CARE PLUS
FACILITY NUMBER: 306003744
VISIT DATE: 09/06/2023
NARRATIVE
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The facility called a contractor to repair the sliding glass door but the contractor never showed up. No other action was taken to repair the sliding glass door until the glass fell off the door on 9/4/23. LPA observed the sliding glass door only has one pane of glass. Based on the evidence gathered through observation and interviews, the preponderance of evidence standard has been met. Therefore the allegation, facility is not in good repair, is substantiated. Violations are being cited per California Code of Regulations, Title 22, Division 6, Chapter 1. An exit interview was conducted and a copy of this report along with citation and Appeal Rights (LC 9058 3/22) was provided.
SUPERVISORS NAME: Luz Adams
LICENSING EVALUATOR NAME: Joseph Alejandre
LICENSING EVALUATOR SIGNATURE:

DATE: 09/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/06/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 22-AS-20230905074254
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

FACILITY NAME: QUALITY CARE PLUS
FACILITY NUMBER: 306003744
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/06/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/14/2023
Section Cited
CCR
80087(a)
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The facility shall be clean, safe, sanitary and in good repair at all times for the safety and well-being of clients, employees and visitors. This requirement is not being met as evidenced by
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Licensee states that the sliding glass door will be repaired/replaced to its original condition. Licensee to forward proof of correction to LPA by POC due date.
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Based on interviews and observation the sliding glass door was broken on 8/27/23 and has not been repaired as of 9/6/23. This poses a potential safety risk to clients 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: Luz Adams
LICENSING EVALUATOR NAME: Joseph Alejandre
LICENSING EVALUATOR SIGNATURE:

DATE: 09/06/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/06/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 3