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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306003744
Report Date: 12/08/2021
Date Signed: 12/10/2021 10:43:28 AM

Document Has Been Signed on 12/10/2021 10:43 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:
12/08/2021
TYPE OF VISIT:Case Management - Health ChecksUNANNOUNCEDTIME BEGAN:
09:20 AM
MET WITH:Marjan ArastooTIME COMPLETED:
02:00 PM
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Licensing Program Analyst (LPA) Lydia Martinez, made an unannounced visit to the facility to conduct a Case Management visit to check on Health and Safety and Plan of Corrections for the violations cited during previous visits. LPA met with Licensee/Administrator (AD) Marjan Arastoo and stated the reason for the visit.

LPA Martinez conducted a tour of the facility’s physical plant and no immediate health/safety hazards were observed. LPA inspected random Client rooms, common bathrooms, kitchen and food service and spoke to random clients who stated they had no complaints and/or concerns. LPA 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 1 Administrator, 2 Housekeepers, and 1 Handyman. Staff Abdul Arastoo is preparing meals until the Cook returns on 12/14/2021.



There are currently has 73 clients residing at the facility. AD was advised that she cannot admit any new clients until the facility is fully staffed. LPA reviewed 24 of 73 Client files.

Due to time constraints, LPA will return at a later date to complete Case Management. LPA Martinez conducted an exit interview with AD Marjan, and copy of this report and list of Confidential Names (LIC811) will be emailed.
SUPERVISORS NAME: Marina Stanic
LICENSING EVALUATOR NAME: Lydia Martinez
LICENSING EVALUATOR SIGNATURE: DATE: 12/08/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/08/2021
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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