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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306003744
Report Date: 12/01/2021
Date Signed: 12/03/2021 10:38:54 AM

Document Has Been Signed on 12/03/2021 10:38 AM - 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: 73DATE:
12/01/2021
TYPE OF VISIT:Case Management - Health ChecksUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Marjan ArastooTIME COMPLETED:
01:30 PM
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Licensing Program Analyst (LPA) Lydia Martinez made an unannounced Case Management Health and Safety check visit on today's date. LPA met with Licensee/Administrator Marjan Arastoo and reason for visit was explained.

LPA Martinez toured the inside of facility and no immediate health/safety hazards were observed. LPA inspected random client rooms and spoke to random clients who stated they had no complaints. 73 clients are currently living at the facility. LPA Martinez inspected facility food supply and was observed to be in quantity to meet the regulatory requirements during this inspection. Hygiene supplies were observed centrally stored in the office.



Staffing was observed as Administrator/MedTech, 2 Housekeepers, 1 Handyman, and 1 Cook.

Administrator was provided with the Resources which AD Marjan acknowledged she received and was reminded facility is to hire the following staff as discussed at the Non-Compliance Conference of 11/16/2021 by 12/15/2021: Office Staff, Cooks, 3 Caregivers per shift, Activity Staff, 24 Hour Security and to institute sign in and out log.

No deficiencies are being cited in the areas observed during today's visit.

LPA Martinez conducted an exit interview with Administrator Marjan Arastoo and a copy of this report will be provided to AD via email.
SUPERVISORS NAME: Marina Stanic
LICENSING EVALUATOR NAME: Lydia Martinez
LICENSING EVALUATOR SIGNATURE: DATE: 12/01/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/01/2021
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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