306003744-1-5-2023-22-AS-SSAS-CMY4WD-20230110182746

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306003744
Report Date: 01/05/2023
Date Signed: 01/05/2023 04:42:43 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE & INLAND A/SC, 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
12/28/2022 and conducted by Evaluator Kevin Saborit-Guasch

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20221228154629

FACILITY NAME:	QUALITY CARE PLUS		FACILITY NUMBER:	306003744
ADMINISTRATOR:	MARJAN ARASTOO		FACILITY TYPE:	735
ADDRESS:	1652 W. BROADWAY		TELEPHONE:	(714) 635-6561
CITY:	ANAHEIM	STATE: CA	ZIP CODE:	92802
CAPACITY:	80	CENSUS: 65	DATE:	01/05/2023
		UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Marjan Arastoo, Administrator		TIME COMPLETED:	04:00 PM

ALLEGATION(S):

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Facility failed to safeguard a client's belongings

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 investigating the allegation listed above. LPA was greeted and granted entry by Administrator Marjan Arastoo after explaining the purpose of the visit and detailing the allegation.

LPA requested and obtained the Admission Agreement for client C1 signed and dated on 11/2/2021, as well as the Client Personal Property and Valuables signed and dated on 11/02/2021. The incident log for client C1 was also provided, however no incidents or events are documented at all after April 2022. A copy of the applicable house rules was provided along with the current facility census. The night round reports for 12/24/2022 and 12/25/2022 were provided, along with the Medication Administration Report for client C3.

CONTINUED ON FORM LIC9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Kevin Saborit-Guasch
LICENSING EVALUATOR SIGNATURE:	DATE: 01/05/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/05/2023

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

LIC9099 (FAS) - (06/04)

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Control Number 22-AS-20221228154629

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE & INLAND A/SC, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

FACILITY NAME: QUALITY CARE PLUS	FACILITY NUMBER: 306003744
	VISIT DATE: 01/05/2023

NARRATIVE

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CONTINUED FROM FORM LIC9099

LPA and administrator toured the physical plant. One functional security camera is observed on each of the two levels of the building. The ground level camera is directed towards the Medication and Administrator office across the hall while the second floor camera is pointed down the hallway towards unit 207, which client C1 was occupying along with client C3 at the time of the allegation.

LPA conducted interviews with Clients C1 and C3. Client C2 was absent from the facility at the time of the visit and therefore could not be interviewed by LPA. LPA additionally interviewed Administrator Marjan Arastoo, along with staff members S1, S2.

Upon review of the records presented, it appears that the inventory included in client C1's client records does not include any indication of valuable items being present upon admission. Administrator states that she had no particular knowledge of client C1's phone prior to the alleged theft.

LPA and administrator reviewed the facility's security footage from the second floor camera. Footage shows client C2 walking up and down the hallway before being greeted into the room by an unidentified person inside the room. C2 then exits the room with visible empty hands approximately a minute after entering. Client C3 states that he was out on pass for Christmas at the time of the event and has no direct knowledge of what may have happened.

Interviews with staff and administrator evidenced that clients are provided with key to their own personal unit and are expected to lock their rooms when not present to avoid theft or unwanted company, although clients only sometimes lock their units as instructed. Most individuals interviewed had either no direct or only partial knowledge of the events being alleged and could not infirm or confirm the alleged failure to safeguard a client's belongings.

Although the allegation that the facility failed to safeguard a client's personal property may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is deemed unsubstantiated.

SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Kevin Saborit-Guasch
LICENSING EVALUATOR SIGNATURE:	DATE: 01/05/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/05/2023

LIC9099 (FAS) - (06/04)

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