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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306005709
Report Date: 04/04/2025
Date Signed: 04/04/2025 04:02:53 PM

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
03/28/2025 and conducted by Evaluator Claudia Gutierrez
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20250328115850
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: 36DATE:
04/04/2025
UNANNOUNCEDTIME BEGAN:
10:40 AM
MET WITH:Jordan NgyuenTIME COMPLETED:
04:15 PM
ALLEGATION(S):
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Facility failed to issue an eviction notice.
Resident was denied access to the facility.
INVESTIGATION FINDINGS:
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An unannounced Complaint Investigation was conducted on this day by Licensing Program Analyst (LPA) Claudia Gutierrez regarding the allegations mentioned above. LPA met with Administrator (AD) Jordan Nguyen.

It is alleged facility failed to issue an eviction notice to Client 1 (C1) and that C1 was denied access to the facility. Interviews were conducted with C1, C1’s responsible party, Witness 1 (W1), and two facility staff. During their interviews, C1 and W1 denied being served with a 30-day eviction notice and stated the facility did not provide alternative placement options and refused to assist with placement all together. Two of two staff interviewed stated C1 was served with an eviction notice and provided LPA with a copy of a notice to vacate dated September 18, 2024. The notice to vacate stated C1 had admitted to staff that they smoked methamphetamine on multiple occasions with the most recent being on September 15, 2024. Notice lists mutual agreement date to vacate as October 1, 2024. Placement however was not sought by either client or the facility. (Cont. LIC9099-C)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Claudia Gutierrez
LICENSING EVALUATOR SIGNATURE:

DATE: 04/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/04/2025
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-20250328115850
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: 04/04/2025
NARRATIVE
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On April 1, 2025, Community Care Licensing (CCL) received an incident report which indicated that on March 25, 2025, staff observed a hole in C1’s bedroom wall, when asked about the hole, C1 became angry, yelled obscenities, and attempted to strike staff. Psychiatric evaluation team was called and C1 was transported to the hospital for a psychiatric evaluation. On March 26, 2025, C1 was discharged from the hospital and returned to the facility from the hospital by ambulance, however, was not allowed entry into the facility and effectively evicted. On March 27, 2025, W1 picked up C1’s personal belongings from the facility.

Based on record review and interviews conducted, the preponderance of evidence standard has been met; therefore, the above allegations are found to be SUBSTANTIATED. Two deficiencies are being cited per Title 22, Division 6 of the California Code of Regulations. An exit interview was conducted, and a copy of this report and appeal rights was provided at the end the inspection.
SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Claudia Gutierrez
LICENSING EVALUATOR SIGNATURE:

DATE: 04/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/04/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 5
Control Number 22-AS-20250328115850
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: 04/04/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
04/05/2025
Section Cited
CCR
85068.5(a)(3)
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(a)... licensee shall be permitted to evict a client by serving the client with a 30-day written notice to quit for any of the following... (3) Failure of the client to comply with the general facility policies...

This requirement is not met a evidenced by:
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AD stated a 30-day written eviction notice will be served to any future client being evicted and a copy of lawful 30-day eviction notice to be served will be provided to LPA via email.
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Based on interviews and record review, the licensee did not comply with the section cited above as C1 was not served with a 30-day written notice to quit after they did not comply with general facility policies, which poses an immediate safety and personal rights risks to persons in care.
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Type A
04/05/2025
Section Cited
CCR
80072(a)(2)
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(a)... each client shall have personal rights which include... (2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs.

This requirement is not met as evidenced by:
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AD stated staff training will be conducted on personal rights and a statement of understanding pertaining to regulation provided to LPA via email by POC date.
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Based on interviews, the licensee did not comply with the section cited above as C1 was denied access to the facility, which poses an immediate health, safety, and personal rights risk to perons 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: Armando J Lucero
LICENSING EVALUATOR NAME: Claudia Gutierrez
LICENSING EVALUATOR SIGNATURE:

DATE: 04/04/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/04/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 5