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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306003744
Report Date: 07/20/2023
Date Signed: 08/03/2023 10:21:40 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
07/12/2023 and conducted by Evaluator Jessica Cho
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20230712165830
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: 68DATE:
07/20/2023
UNANNOUNCEDTIME BEGAN:
09:42 AM
MET WITH:Marjan Arastoo- AdministratorTIME COMPLETED:
05:30 PM
ALLEGATION(S):
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Faclity staff does not ensure food services perform in compliance with hygiene rules.
Facility staff has inappropriate interactions with clients.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Jessica Cho made an unannounced vist for the purpose to conduct a complaint investigation. LPA met with Administrator (Admin) Marjan Arastoo at 9:45am and stated the purpose of the visit. During the course of the investigation, LPA conducted a tour of the physical plant which includes the kitchen, interviewed clients and staff, and obtained copies of pertinent client records. The following are the findings which involved observations, record review, and interviews:

On the allegation that facility staff does not ensure food services perform in compliance with hygiene rules, it was alleged that Staff #1 (S1) does not wear gloves when serving meals. S1 made an admission indicating that gloves were not worn on occasions when on duty as both the cook and server. One out of three clients interviewed corroborated S1 not wearing gloves.

On the allegation that facility staff has inappropriate interactions with clients, it was alleged that S1 used the middle finger towards Client #1 (C1). ***THIS IS AN AMENDED REPORT.***
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Jessica Cho
LICENSING EVALUATOR SIGNATURE:

DATE: 07/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/20/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 5
Control Number 22-AS-20230712165830
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		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 PLUS
FACILITY NUMBER: 306003744
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/20/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/28/2023
Section Cited
CCR
80076(a)(13)
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80076 Food Services (a) In facilities providing meals to clients, the following shall apply: (13) All persons engaged in food preparation and service shall observe personal hygiene... practices..."
This requirement was not met as evidenced by:
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Administrator to review the said regulation and to submit an Acknowledgement of Understanding and to provide proof of staff training on personal hygiene practices when engaging in food preparation to LPA via email by POC due date.
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Based on Administrator Marjan's admission to not wearing gloves on occassion during food preparation, this poses a potential Health, Safety, or Personal Rights risk to persons in care.
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Type B
07/20/2023
Section Cited
CCR
80072(a)(1)
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80072 Personal Rights (a) Except for children’s residential facilities, each client shall have personal rights which include, but are not limited to, the following: (1) To be accorded dignity in his/her personal relationships with staff and other persons.
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This requirement was not met as evidenced by:

Based on the interviews, three out of three individuals confirmed witnessing Administrator Marjan displaying an inappropriate gesture to C1.
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Administrator to review the said regulation and to submit an Acknowlegement of Understanding to LPA via email by POC due date.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Jessica Cho
LICENSING EVALUATOR SIGNATURE:

DATE: 07/20/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/20/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
07/12/2023 and conducted by Evaluator Jessica Cho
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20230712165830

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: 68DATE:
07/20/2023
UNANNOUNCEDTIME BEGAN:
09:42 AM
MET WITH:Marjan Arastoo- AdministratorTIME COMPLETED:
05:30 PM
ALLEGATION(S):
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Facility staff is asking client to rearrange potentially dangerous furniture.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Jessica Cho made an unannounced vist for the purpose to conduct a complaint investigation. LPA met with Administrator (Admin) Marjan Arastoo at 9:55am and stated the purpose of the visit. During the course of the investigation, LPA interviewed clients and staff and obtained copies of pertinent client records. The following are the findings which involved observations and interviews:

On the allegation that facility staff is asking client to rearrange potentially dangerous furniture, it was alleged that Administrator Abdol Arastoo asked Client #1 (C1) to reposition the bed. C1 clarified during the interview that a staff had relayed the instruction from Administrator Abdol who requested C1 to reposition the bed on their own. The staff who relayed the information denied that Adminstrator Abdol requesting C1 to rearrange their bed.

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Jessica Cho
LICENSING EVALUATOR SIGNATURE:

DATE: 07/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/20/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 22-AS-20230712165830
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		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 PLUS
FACILITY NUMBER: 306003744
VISIT DATE: 07/20/2023
NARRATIVE
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Therefore, based on the observations and interviews which were conducted, although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation: facility staff is asking client to rearrange potentially dangerous furniture is deemed UNSUBSTANTIATED.

An exit interview was conducted with Administrator Marjan Arastoo, and a copy of this report including the LIC9099C was provided during today's visit.
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Jessica Cho
LICENSING EVALUATOR SIGNATURE:

DATE: 07/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/20/2023
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 22-AS-20230712165830
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		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 PLUS
FACILITY NUMBER: 306003744
VISIT DATE: 07/20/2023
NARRATIVE
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Three out of three individuals interviewed witnessed S1 using the middle finger gesture to inappropriately express their attitude towards C1.

Therefore, based on the observations and the interviews which were conducted, the preponderance of evidence standard has been met, therefore the allegations facility staff does not ensure food services perform in compliance with hygiene rules and facility staff has inappropriate interactions with clients are deemed SUBSTANTIATED as per Title 22 of the California Code of Regulations, Division 6, Chapter 1. Citations are being cited on the attached LIC9099-D.

An exit interview was conducted with Administrator Marjan Arastoo, and a copy of this report including the LIC 9099C, LIC9099D, and the appeal rights were provided during today's visit.


***THIS IS AN AMENDED REPORT.***
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Jessica Cho
LICENSING EVALUATOR SIGNATURE:

DATE: 07/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/20/2023
LIC9099 (FAS) - (06/04)
Page: 5 of 5