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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306005709
Report Date: 10/31/2023
Date Signed: 10/31/2023 10:50:29 AM

Unsubstantiated


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
10/27/2023 and conducted by Evaluator Kimberly Lyman
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20231027155336
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: 39DATE:
10/31/2023
UNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Melina AlonzoTIME COMPLETED:
11:15 AM
ALLEGATION(S):
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Staff did not ensure facility was free from bed bugs
INVESTIGATION FINDINGS:
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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 and explained the reason for the visit. LPA observed covid precautions in place and LPA was screened at entry.
During the course of the investigation, LPA toured the facility, interviewed staff and clients as well as reviewed and obtained pertinent documentation such as extermination records. Regarding the allegation that staff did not ensure facility was free from bed bugs, the investigation revealed the following: Documentation provided from Zaver pest control indicated bed bug treatment for four rooms on 08/30/2023. Facility staff indicated using bed bug glue traps in all the mattresses. At first sight of bed bugs on the trap, facility obtained extermination services. Extermination documentation indicates Zaver is on site monthly providing extermination services. Six out of six clients and two out of two staff indicate the problem has been resolved and the last incident of bed bugs was in August 2023. All clients interviewed stated the company came in and sprayed as well as facility removing all items for cleaning and replacing sheets, curtains and all bedding. CONT ON LIC 9099C DATED 10/31/2023
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Kimberly Lyman
LICENSING EVALUATOR SIGNATURE:

DATE: 10/31/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/31/2023
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 2
Control Number 22-AS-20231027155336
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: 10/31/2023
NARRATIVE
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LPA observed mattresses in affected rooms are double wrapped in plastic as well as mattress covers being utilized. LPA did not observe any evidence of bed bugs during the visit and rooms appeared clean and sanitary. Facility had three covid cases in October. All three clients indicated being quarantined in room and receiving meals in the client's room. LPA observed covid precautions in place at the facility. Due to conflicting information, LPA is unable to confirm allegation. Therefore, the allegation is deemed unsubstantiated, meaning that although the allegation may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. Exit interview conducted and a copy of this report was provided to facility representative.
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Kimberly Lyman
LICENSING EVALUATOR SIGNATURE:

DATE: 10/31/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/31/2023
LIC9099 (FAS) - (06/04)
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