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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306003744
Report Date: 09/27/2024
Date Signed: 09/27/2024 03:15:24 PM

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
07/05/2024 and conducted by Evaluator Kevin Saborit-Guasch
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20240705133632
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: 65DATE:
09/27/2024
UNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Marjan Arastoo, AdministratorTIME COMPLETED:
03:30 PM
ALLEGATION(S):
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Licensee does not ensure that facility is free from mold.
INVESTIGATION FINDINGS:
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On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility for the purpose of following up on the investigation of the allegations listed above. LPA was greeted and granted entry by facility administrator Marjan Arastoo after explaining the purpose of the visit.

An initial complaint investigation visit was held on July 12, 2024. LPA accompanied by facility staff toured the three shared bathrooms located on each of the two levels of the facility and documented the condition of the premises via photographs. LPA conducted three staff interviews during the visit. LPA additionally requested and copied the facility's staff roster and schedule as well as the agenda and hand-written minutes from the latest meeting of the resident's council held on May 10, 2024.

During the present visit, LPA requested the facility census and conducted or attempted five resident interviews and two additional staff interviews. Additional tour of the common bathrooms was conducted.
CONTINUED ON FORM LIC9099-C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Kevin Saborit-Guasch
LICENSING EVALUATOR SIGNATURE:

DATE: 09/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2024
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 5
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
07/05/2024 and conducted by Evaluator Kevin Saborit-Guasch
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20240705133632

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: 65DATE:
09/27/2024
UNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Marjan Arastoo, AdministratorTIME COMPLETED:
03:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff member yells at other staff member(s) in the presence of residents in care.
INVESTIGATION FINDINGS:
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2
3
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5
6
7
8
9
10
11
12
13
On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility for the purpose of following up on the investigation of the allegations listed above. LPA was greeted and granted entry by facility administrator Marjan Arastoo after explaining the purpose of the visit.

An initial complaint investigation visit was held on July 12, 2024. LPA accompanied by facility staff toured the three shared bathrooms located on each of the two levels of the facility and documented the condition of the premises via photographs. LPA conducted three staff interviews during the visit. LPA additionally requested and copied the facility's staff roster and schedule as well as the agenda and hand-written minutes from the latest meeting of the resident's council held on May 10, 2024.

During the present visit, LPA requested the facility census and conducted or attempted six resident interviews and an additional staff interview.
CONTINUED ON FORM LIC9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Kevin Saborit-Guasch
LICENSING EVALUATOR SIGNATURE:

DATE: 09/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 22-AS-20240705133632
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: QUALITY CARE PLUS
FACILITY NUMBER: 306003744
VISIT DATE: 09/27/2024
NARRATIVE
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CONTINUED FROM FORM LIC9099-A
Regarding the allegation that Staff member yells at other staff member(s) in the presence of residents in care, the following has been concluded: Based on five staff interviews and five client interviews, no clear occurrence of staff members loudly arguing or yelling in the presence of clients could be evidenced. No defined circumstances during which the clients' personal rights were infringed upon or an uncomfortable environment was created as a result of staff members' behavior emerged from the investigation either.

As a result, the department is unable to corroborate this specific allegation. Therefore, the allegation is deemed Unsubstantiated, meaning that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violation occurred.

An exit interview was conducted and a copy of this report was provided to facility.
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Kevin Saborit-Guasch
LICENSING EVALUATOR SIGNATURE:

DATE: 09/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 22-AS-20240705133632
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: QUALITY CARE PLUS
FACILITY NUMBER: 306003744
VISIT DATE: 09/27/2024
NARRATIVE
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CONTINUED FROM FORM LIC9099
Regarding the allegation that Licensee does not ensure that facility is free from mold, the following has been concluded: Based on the two tours of the physical plant conducted during the initial and follow-up visits to the facility, it has been concluded that facility bathrooms were not kept in good repair, with mold and/or water damage, rust and blistered paint present in multiple locations throughout the facility, as evidenced in photographs taken by LPA during the initial visit. A commode was additionally found non-operational with feces present during the walk-through conducted in July 2024.

As a result, the allegation is found to be Substantiated, meaning that the preponderance of evidence standard has been met. One type B deficiency is being cited on the attached form LIC 9099-D.

An exit interview was conducted with and a copy of this report, LIC9099-D, along with appeal rights were provided to a facility representative.
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Kevin Saborit-Guasch
LICENSING EVALUATOR SIGNATURE:

DATE: 09/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2024
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 22-AS-20240705133632
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: QUALITY CARE PLUS
FACILITY NUMBER: 306003744
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/27/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/25/2024
Section Cited
CCR
80087(e)(3)
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Per California Code of Regulations Section 80087(e)(3) "All toilets, hand washing and bathing facilities shall be maintained in safe and sanitary operating condition". This requirement is not met as evidenced by:
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Licensee has initiated cleaning and repairs between the initial and follow-up visit. Remaining water damage observed will be repaired and documentation provided to LPA before the plan of corrections
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The presence of mold, blisters in the paint, water damage and rust in multiple bathrooms throughout the physical plant. This constitutes a potential risk to the health, safety and personal rights of individuals 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: Sheila Santos
LICENSING EVALUATOR NAME: Kevin Saborit-Guasch
LICENSING EVALUATOR SIGNATURE:

DATE: 09/27/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2024
LIC9099 (FAS) - (06/04)
Page: 5 of 5