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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306003744
Report Date: 09/03/2021
Date Signed: 09/08/2021 04:23:07 PM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 09/08/2021 04:23 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
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
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: 74DATE:
09/03/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Marjan Arastoo, Abdul ArastooTIME COMPLETED:
12:10 PM
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This unannounced inspection is being conducted by Licensing Program Manager (LPM) Marina Stanic and Licensing Program Analysts (LPA) Lydia Martinez, Norman Woodridge, and Sean Haddad for the purpose of conducting an Annual Inspection. LPM and LPAs met with Administrator (AD) Marjan Arastoo and facility staff Abdul Arastoo and discussed the purpose of the inspection.

During the inspection, LPM, LPAs, and AD conducted a tour of the inside and outside of the facility, common areas, resident rooms, and kitchen, interviewed residents and staff, and requested and reviewed facility records.

Due to time constraints, the full report will be issued at a future date. An exit interview was conducted and a copy of this report was discussed with and provided to facility representative.
SUPERVISORS NAME: Marina Stanic
LICENSING EVALUATOR NAME: Sean Haddad
LICENSING EVALUATOR SIGNATURE: DATE: 09/03/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/03/2021
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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