306005211-3-2-2022-22-AS-AORZ-CCXUK2-20220328153823

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306005211
Report Date: 03/02/2022
Date Signed: 03/02/2022 01:02:50 PM

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
02/22/2022 and conducted by Evaluator Kimberly Lyman

COMPLAINT CONTROL NUMBER: 22-AS-20220222090137

FACILITY NAME:	ARDENT CARE		FACILITY NUMBER:	306005211
ADMINISTRATOR:	MELINDA FLORES		FACILITY TYPE:	740
ADDRESS:	1665 SOUTH BROOKHURST STREET		TELEPHONE:	(714) 991-0991
CITY:	ANAHEIM	STATE: CA	ZIP CODE:	92804
CAPACITY:	27	CENSUS: 23	DATE:	03/02/2022
		UNANNOUNCED	TIME BEGAN:	11:55 AM
MET WITH:	Alex Blancarte		TIME COMPLETED:	01:20 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Facility is not allowing residents to leave their rooms.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA) Kimberly Lyman conducted an unannounced complaint visit to initiate an investigation into the above allegation. LPA was greeted and granted entry into the facility Lead Medication Technician Alex Blancarte and explained the reason for the visit.

During the visit, LPA toured the facility and interviewed staff. Regarding the allegation that facility is not allowing residents to leave their rooms, the investigation revealed the following: Facility had a covid outbreak from the beginning of February with active cases to date. Facility was following department guidelines as well as public health and ensuring residents are quarantined for 14 days. Residents were quarantined in rooms and provided medications, meals and activities in their rooms. Once the quarantine period was over, residents were allowed to leave their rooms. Therefore the allegation is deemed UNFOUNDED, meaning the allegation was false, could not have happened and/or is without a reasonable basis.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Alisa Ortiz	TELEPHONE: (714) 703-2855
LICENSING EVALUATOR NAME: Kimberly Lyman	TELEPHONE: (714) 795-1497
LICENSING EVALUATOR SIGNATURE:	DATE: 03/02/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2022

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 3

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
02/22/2022 and conducted by Evaluator Kimberly Lyman

COMPLAINT CONTROL NUMBER: 22-AS-20220222090137

FACILITY NAME:	ARDENT CARE		FACILITY NUMBER:	306005211
ADMINISTRATOR:	MELINDA FLORES		FACILITY TYPE:	740
ADDRESS:	1665 SOUTH BROOKHURST STREET		TELEPHONE:	(714) 991-0991
CITY:	ANAHEIM	STATE: CA	ZIP CODE:	92804
CAPACITY:	27	CENSUS: 23	DATE:	03/02/2022
		UNANNOUNCED	TIME BEGAN:	11:55 AM
MET WITH:	Alex Blancarte		TIME COMPLETED:	01:20 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Facility is not allowing residents to have visitors.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA) Kimberly Lyman conducted an unnanounced complaint visit to initiate an investigation into the above allegation. LPA was greeted and granted entry into the facility Lead Medication Technician Alex Blancarte and explained the reason for the visit.
During the visit, LPA toured the facility and interviewed staff. Regarding the allegation that facility is not allowing residents to have visitors, the investigation revealed the following: Facility had a covid outbreak from the beginning of February with active cases to date. Per interview conducted, facility has been denying visitation due to the covid outbreak. Per department guidelines, visitors are allowed inside the facility with proof of vaccination or a negative covid test. Outside visitation is allowed in lieu of inside visitation requirements. The only caveat regarding residents in quarantine is that visitors must be provided, and wear, proper personal protective equipment (PPE) during visitation. The preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, (Title 22, Division 6, Chapter 8), are being cited on the attached LIC 9099D. An exit interview was conducted and a copy of this report was provided as well as appeal rights.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Alisa Ortiz	TELEPHONE: (714) 703-2855
LICENSING EVALUATOR NAME: Kimberly Lyman	TELEPHONE: (714) 795-1497
LICENSING EVALUATOR SIGNATURE:	DATE: 03/02/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2022

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 22-AS-20220222090137

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: ARDENT CARE	FACILITY NUMBER: 306005211
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/02/2022

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 03/03/2022 Section Cited CCR 87468.1(a)(11)	1 2 3 4 5 6 7	Residents in all residential care facilities... shall have all of the following personal rights: To have their visitors...., permitted to visit privately during reasonable hours and without prior notice... This req is not being met as evidenced by:	1 2 3 4 5 6 7	Licensee to read PIN 22-07-ASC and forward a written statement of understanding to LPA by POC due date.
	8 9 10 11 12 13 14	Based on interview conducted, facility failed to ensure facility residents were allowed visitation. Public health and department guidelines allow for visitation at the facility. This poses an immediate health and safety risk for residents in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Alisa Ortiz	TELEPHONE: (714) 703-2855
LICENSING EVALUATOR NAME: Kimberly Lyman	TELEPHONE: (714) 795-1497
LICENSING EVALUATOR SIGNATURE:	DATE: 03/02/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2022

LIC9099 (FAS) - (06/04)

Page: 3 of 3