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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306005709
Report Date: 08/24/2023
Date Signed: 08/24/2023 11:43:10 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
08/04/2023 and conducted by Evaluator Jessica Cho
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20230804143339
FACILITY NAME:GENERATIONS OF ANAHEIM ASSISTED LIVING, INCFACILITY NUMBER:
306005709
ADMINISTRATOR:MANALAD, JOSELITOFACILITY TYPE:
735
ADDRESS:1941 E. CENTER STREETTELEPHONE:
(714) 533-3640
CITY:ANAHEIMSTATE: CAZIP CODE:
92805
CAPACITY:42CENSUS: 38DATE:
08/24/2023
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Maria Nonato- Officer ManagerTIME COMPLETED:
12:05 PM
ALLEGATION(S):
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Staff are not properly addressing bed bug issue at the facility.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Jessica Cho arrived unannounced for the purpose to deliver the findings into the above allegation. LPA met with Office Manager Maria Nonato and stated the purpose of the visit.

On August 10, 2023, LPA initiated the complaint investigation visit. During the intial visit, LPA inspected a total of six units, interviewed clients and staff, and obtained copies of pertinent facility and client records. The following was revealed during the course of the investigation:

It is alleged that staff are not properly addressing the bed bug issue at the facility. On August 10, 2023, LPA along with Staff #1 (S1) conducted a tour of the clients' living quarters and discovered a dead bed bug in one out of the six units. Staff #2 (S2) indicated that the facility has been treating the bed bugs in-house out of precaution by utilizing Diatomaceous Earth and bed bug glue traps which were observed in the units.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Jessica Cho
LICENSING EVALUATOR SIGNATURE:

DATE: 08/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/24/2023
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-20230804143339
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: GENERATIONS OF ANAHEIM ASSISTED LIVING, INC
FACILITY NUMBER: 306005709
VISIT DATE: 08/24/2023
NARRATIVE
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Two out of the six individuals interviewed confirmed the presence of bed bugs; and most recently, one out of the six individuals stated that bed bugs were discovered the morning of the initial visit was held. LPA determined based on the interviews and observations made that the current plan of action implemented by the facility was inadequate to eradicate the pests.

Therefore, based on LPA's observations, interviews which were conducted, and the records that were reviewed, the preponderance of evidence standard has been met, therefore the allegation: Staff are not properly addressing bed bug issue at the facility is deemed SUBSTANTIATED. California Code of Regulations, Title 22, Division 6, Chapter 1 is being cited on the attached LIC 9099D.

An exit interview was conducted with Office Manager Maria Nonato, and a copy of this report along with the LIC9099-C, LIC9099-D, and LIC811 were provided via email to the office manager at the end of the visit.
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Jessica Cho
LICENSING EVALUATOR SIGNATURE:

DATE: 08/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/24/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 22-AS-20230804143339
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: GENERATIONS OF ANAHEIM ASSISTED LIVING, INC
FACILITY NUMBER: 306005709
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/24/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/01/2023
Section Cited
CCR
80087(a)(1)
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80087 Building and Grounds (a) The facility shall be clean, safe, sanitary…for the safety and well-being of clients, employees and visitors. (1) The licensee shall take measures to keep the facility free of flies and other insects. This requirement was not met as evidenced by:
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Licensee to schedule pest control in the interior portion of the facility within 24 hours and to begin the bed bug treatments within 7 days. Additionally, licensee to provide proof of appointment date and service report(s) indicating that the facility is free of pests to LPA via email by POC due date.
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Based on LPA’s interviews and observations, LPA along with S1 observed a dead bed bug in one out of the six units which poses an immediate Heath, Safety, or Personal Rights risk to persons in care.
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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: 08/24/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/24/2023
LIC9099 (FAS) - (06/04)
Page: 5 of 5