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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306003744
Report Date: 12/22/2021
Date Signed: 12/22/2021 01:18:23 PM

Document Has Been Signed on 12/22/2021 01:18 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: 73DATE:
12/22/2021
TYPE OF VISIT:Case Management - Health ChecksUNANNOUNCEDTIME BEGAN:
10:10 AM
MET WITH:Marjan Arastoo, Abdul ArastooTIME COMPLETED:
01:30 PM
NARRATIVE
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Licensing Program Analyst (LPA) Ruth Martinez is conducting this case management visit for the purpose of a health and safety check. LPA arrived at the facility was greeted and granted entry by Administrator. LPA explained the nature of the visit to Administrator.

Upon entry LPA observed clients in care throughout the facility in the exterior and interior of the physical plant. During the case management visit LPA met with staff from County of Orange Health Care Agency to discuss the served eviction notices and the client’s evaluation of care plans. LPA obtained an up to date list of names for clients that were served an eviction notice. LPA observed 8 staff including both Administrator and assistant Administrator. LPA accompanied by Marjan Arastoo, Administrator toured the physical plant of the facility. LPA toured the kitchen; it was observed that kitchen has a 2 day supply of perishables and 7 day non-perishable food available. LPA observed the kitchen work areas were clean and dishes were being washed, staff was prepping food for dinner. During the tour LPA observed staff in medication room, kitchen, caregivers on the floor and housekeeping in the facility. LPA observed all fire extinguishers are fully charged. LPA observed hallways and walkways were free of obstruction. Administrator provided LPA with a copy of the updated LIC 500.

No deficiencies are being cited as a result of this visit. An exit interview was conducted, and a copy of the report provided.
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Ruth Martinez
LICENSING EVALUATOR SIGNATURE: DATE: 12/22/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/22/2021
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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