<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306005362
Report Date: 10/01/2024
Date Signed: 10/01/2024 10:08:18 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 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
09/25/2024 and conducted by Evaluator Jenifer Tirre
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20240925155824
FACILITY NAME:LP CARE HOMEFACILITY NUMBER:
306005362
ADMINISTRATOR:TRAN, LINDAFACILITY TYPE:
735
ADDRESS:8791 MONTEREY CIRCLETELEPHONE:
(714) 622-5764
CITY:WESTMINSTERSTATE: CAZIP CODE:
92683
CAPACITY:6CENSUS: 5DATE:
10/01/2024
UNANNOUNCEDTIME BEGAN:
08:10 AM
MET WITH:Administrator, Phil TranTIME COMPLETED:
10:20 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Licensee did not ensure that facility is free of flies and other insects
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Jenifer Tirre conducted an unannounced inspection visit to initiate complaint investigation into the above allegations. LPA explained the reason for the visit with Administrator Phil Tran.

During investigation visit, LPA met with Administrator Tran to discuss investigation allegations. Administrator Tran confirmed that two clients were at day program and others were out on a day outing during visit. Upon arrival LPA observed a worker from Tru Heat Solutions preparing for a treatment to facility. Administrator informed LPA that Tru Heat Solutions was conducting a heat treatment regarding recent Bed bug outbreak at facility. Administrator stated that they learned of bed bugs on 9/19/2024 and notified Regional Center Agency on 9/26/24 and Licensing on 9/27/24.

CONTINUED ON 9099C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Jenifer Tirre
LICENSING EVALUATOR SIGNATURE:

DATE: 10/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/01/2024
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
Control Number 22-AS-20240925155824
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: LP CARE HOME
FACILITY NUMBER: 306005362
VISIT DATE: 10/01/2024
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Based on Investigation interviews and Observations, the allegation Licensee did not ensure that facility is free of flies and other insects is deemed SUBSTANTIATED.

The following is being cited per California Code of Regulations Title 22.

An exit interview was conducted with Administrator, and a copy of this report, 809-D Page, and appeal rights was provided.
SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Jenifer Tirre
LICENSING EVALUATOR SIGNATURE:

DATE: 10/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/01/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 22-AS-20240925155824
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: LP CARE HOME
FACILITY NUMBER: 306005362
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/01/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/04/2024
Section Cited
CCR
87303(a)
1
2
3
4
5
6
7
87303(a) Maintenance and Operation. The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors.
1
2
3
4
5
6
7
AD Tran stated facility conducting heat treatment today 10/1/24 and on 10/2/24 carpet cleaning company providing cleaning of carpets and furniture. AD providing copy of exterminator agreement along with a letter of understanding of regulation by POC date.
8
9
10
11
12
13
14
This requiremnet was not met as evidence by, facility had bed bugs outbreak inside client bedroom. This poses a potential health and safety threat to clients 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.
SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Jenifer Tirre
LICENSING EVALUATOR SIGNATURE:

DATE: 10/01/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/01/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3