306004796-2-24-2025-22-AS-JTIE-DE825D-20250224160522

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 306004796
Report Date: 02/24/2025
Date Signed: 02/24/2025 04:06:17 PM

Document Has Been Signed on 02/24/2025 04:06 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
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

FACILITY NAME:	HUNTINGTON TERRACE		FACILITY NUMBER:	306004796
ADMINISTRATOR/ DIRECTOR:	GREGORY CASE		FACILITY TYPE:	740
ADDRESS:	18800 FLORIDA ST		TELEPHONE:	(714) 848-8811
CITY:	HUNTINGTON BEACH	STATE: CA	ZIP CODE:	92648
CAPACITY: 185	TOTAL ENROLLED CHILDREN: 0	CENSUS: 165	DATE:	02/24/2025
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	08:00 AM
MET WITH:	Administrator Mike Marion		TIME VISIT/ INSPECTION COMPLETED:	04:15 PM

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On February 24, 2025 Licensing Program Analyst’s (LPAs) Jenifer Tirre and Edward Kim conducted an unannounced visit for the purpose of conducting a required annual visit using the CARE Inspection Tool. LPA’s were greeted by staff and granted entry after stating the purpose of the visit. Administrator (AD) Mike Marion was present to assist with the facility inspection on today's date.

The facility is licensed for thirty (30) Ambulatory residents, One hundred fifty five (155) Non Ambulatory which 15 bedridden with approved hospice waiver for thirty (30) residents. Currently, there are twelve (12) Hospice residents present during today’s visit. Facility is a three story building with 155 units combined in both Assisted Living and Memory Care.

At around 8:15 AM, LPA’s Tirre and Kim conducted a tour of the physical plant accompanied by Director of sales Susan Peterson, and the following was observed: Facility has an enclosed pool located in outside patio area. Rooms which were inspected observed to be furnished Beds and bedding supplies were in operational condition, lighting was provided, and storage for the Resident’s personal belongings was observed. Bed linens, comforters, and bath towels were available during the visit. Bathrooms were operational with water temperature measured between 108.5 to 115.5 degrees F. A comfortable temperature of 70 degrees F. was maintained in the facility. Residents were observed relaxing in common areas, eating on the dining room, and relaxing in bistro as well as relaxing in bedrooms. Memory care residents were observed engaged in group exercise activities.

The kitchen was inspected, and facility has sufficient perishable and non-perishable foods as well as supply of emergency food and water. Storage areas for sharps objects and cleaning supplies were stored and not accessible to residents. Facility has multiple fire extinguishers. During today’s visit Ten (10) fire extinguishers were observed to be fully charged and mounted.

A review of the Medication Records Administration (MAR) was conducted, and LPA’s observed the records are in compliance. CONTINUED ON 809C

Lourdes Montoya	TELEPHONE: (714) 703-2870
Jenifer Tirre	TELEPHONE: (714) 401-6844
	DATE: 02/24/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/24/2025

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

FACILITY NAME: HUNTINGTON TERRACE	FACILITY NUMBER: 306004796
	VISIT DATE: 02/24/2025

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During the visit, LPA’s observed the facility's infection control practices. LPA’s observed screening protocols for visitors, staff, and residents, and sanitizing stations in common areas and restrooms. All mandated inspection control posters were posted.

LPA observed First Aid Kit was maintained. A working landline phone was operational. Facility has operating smoke detectors and audible alarms which LPA's observed Last fire inspection paperwork was completed by Fire Safety Service, The last fire drill was conducted on January 28, 2025. The facility has current liability insurance on file effective 7/1/2024 – 7/1/2025. LPA’s observed four evacuation chairs located on top of third story stairwells.

During today’s visit a review of Seventeen (17) residents (R1-R17) service files and Ten staff (S1-S10) personnel files revealed to be complete. The facility has the current administrator's certification on file for Michael Marion Expiration 9/12/2025.

No deficiencies during this inspection visit.

An exit interview was conducted with Executive Director Mike Marion, and a copy of the report was provided.

SUPERVISOR'S NAME: Lourdes Montoya	TELEPHONE: (714) 703-2870
LICENSING EVALUATOR NAME: Jenifer Tirre	TELEPHONE: (714) 401-6844
LICENSING EVALUATOR SIGNATURE:	DATE: 02/24/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/24/2025

LIC809 (FAS) - (06/04)

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