306005211-7-10-2023-22-AS-SSAS-D2X7CE-20240229203230

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306005211
Report Date: 07/10/2023
Date Signed: 07/10/2023 03:39:51 PM

Unfounded

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE & INLAND A/SC, 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
06/30/2023 and conducted by Evaluator Alvaro Ramirez Jr.

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20230630160447

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: 25	DATE:	07/10/2023
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Alexandra Blancarte-Assistant Administrator, Melinda Flores-Administrator		TIME COMPLETED:	03:55 PM

ALLEGATION(S):

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Staff speak inappropriately to the residents.
Facility is not kept clean.
Facility is malodorous.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Alvaro Ramirez, Jr. conducted an unannounced initial 10-Day complaint visit to initiate the investigation into the above allegations and to deliver the findings of the investigation. LPA was greeted and granted entry into the facility and met with Assistant Administrator Alexandra Blancarte. LPA explained the reason for the visit. Administrator (AD) Melinda Flores arrived shortly after.

On today’s visit LPA Ramirez conducted file reviews and interviews and obtained copies of pertinent documents. Regarding the allegations, the following was revealed: One of eight individuals interviewed corroborated the allegations. Seven of eight individuals interviewed denied the allegations. Per AD she has not witness staff speaking innapropriately to the residents and that all staff are mandated reporters. Per interviews conducted residents reported that staff do not speak inappropriately to the residents and that staff are good people. Residents appeared to be comfortable and at ease as evidence by smiling, laughing and by conversating with staff. At 9:08 AM LPA tour the facility and observed that staff had just finished mopping the floors.
CONTINUED on LI9099-C...

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Alisa Ortiz	TELEPHONE: (714) 703-2855
LICENSING EVALUATOR NAME: Alvaro Ramirez Jr.	TELEPHONE: 714-703-2840
LICENSING EVALUATOR SIGNATURE:	DATE: 07/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2023

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 6

Control Number 22-AS-20230630160447

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE & INLAND A/SC, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

FACILITY NAME: ARDENT CARE	FACILITY NUMBER: 306005211
	VISIT DATE: 07/10/2023

NARRATIVE

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LPA also observe that the dining room was being disinfected. At 9:10 AM LPA observed residents watching television and/or participating in exercises and stretching activities. LPA did not notice malodorous throughout the facility and/or the resident rooms. It was reported via interviews by residents that staff clean daily and/or that staff do their best to clean after the residents.

Therefore, based on interviews conducted and documents reviewed the allegations are deemed UNFOUNDED, meaning the allegations are false, could not have happened and/or is without a reasonable basis.

LPA Ramirez conducted an exit interview with AD Flores, and a copy of this report was provided to the facility.

SUPERVISOR'S NAME: Alisa Ortiz	TELEPHONE: (714) 703-2855
LICENSING EVALUATOR NAME: Alvaro Ramirez Jr.	TELEPHONE: 714-703-2840
LICENSING EVALUATOR SIGNATURE:	DATE: 07/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 6

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE & INLAND A/SC, 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
06/30/2023 and conducted by Evaluator Alvaro Ramirez Jr.

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20230630160447

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: 25	DATE:	07/10/2023
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Alexandra Blancarte-Assistant Administrator, Melinda Flores-Administrator		TIME COMPLETED:	03:55 PM

ALLEGATION(S):

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Uncleared staff allowed to work.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Alvaro Ramirez, Jr. conducted an unannounced initial 10-Day complaint visit to initiate the investigation into the above allegation and to deliver the findings of the investigation. LPA was greeted and granted entry into the facility and met with Administrator (AD) Melinda Flores. LPA explained the reason for the visit.

On today’s visit LPA Ramirez conducted file reviews and interviews and obtained copies of pertinent
documents. Regarding the allegation, the following was revealed: Three of eight individuals interviewed corroborated the allegation. Three of eight individuals interviewed denied the allegation. As for the remaining two individuals, they reported not knowing if staff go through a background clearance prior to their first day working at the facility. During the investigation LPA reviewed documents including the Guardian Employee Roster dated 07/07/23. Per Guardian Employee Roster Staff 1 (S1), S2 and S3 have an association status either as Not Eligible Determination Closed and/or In Process.
CONTINUED on LI9099-C...

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Alisa Ortiz	TELEPHONE: (714) 703-2855
LICENSING EVALUATOR NAME: Alvaro Ramirez Jr.	TELEPHONE: 714-703-2840
LICENSING EVALUATOR SIGNATURE:	DATE: 07/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2023

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 6

Control Number 22-AS-20230630160447

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE & INLAND A/SC, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

FACILITY NAME: ARDENT CARE	FACILITY NUMBER: 306005211
	VISIT DATE: 07/10/2023

NARRATIVE

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During the course of the interviews AD stated that staff can start working at the facility when the Live Scan and Background Clearance is in process. During today's visit LPA observed that S1 was working at the facility and S1 identified themselves as the Assistant Administrator.

Based on the interviews which were conducted and the records that were reviewed, the preponderance of evidence standard has been met, therefore the following allegation: uncleared staff allowed to work is deemed SUBSTANTIATED. California Code of Regulations, Title 22, Division 6, Chapter 8 is being cited on the attached LIC 9099D.

Three $500 Civil Penalties Assessed on LIC421BG.

An exit interview was conducted with AD Flores and a copy of this report along with the Appeal Rights were provided at the time of this visit.

SUPERVISOR'S NAME: Alisa Ortiz	TELEPHONE: (714) 703-2855
LICENSING EVALUATOR NAME: Alvaro Ramirez Jr.	TELEPHONE: 714-703-2840
LICENSING EVALUATOR SIGNATURE:	DATE: 07/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2023

LIC9099 (FAS) - (06/04)

Page: 4 of 6

Control Number 22-AS-20230630160447

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE & INLAND A/SC, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

FACILITY NAME: ARDENT CARE	FACILITY NUMBER: 306005211
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/10/2023

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 07/11/2023 Section Cited CCR 87355(e)(1)	1 2 3 4 5 6 7	87355 Criminal Record Clearance (3)All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1569.17(b) shall prior to working, residing or volunteering in a licensed facility: (1)Obtain a California clearance or a criminal record exemption as required by the Department.	1 2 3 4 5 6 7	AD asked S1 to leave the facility premises. LPA observed as S1 left the facility. AD will not allow staff to began working until they have been background clear.
	8 9 10 11 12 13 14	This requirement is not met as evidende by: Based on observation and AD admission staff began working at the facility prior to having a Background Clearance.	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: Alvaro Ramirez Jr.	TELEPHONE: 714-703-2840
LICENSING EVALUATOR SIGNATURE:	DATE: 07/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2023

LIC9099 (FAS) - (06/04)

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