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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306005730
Report Date: 08/23/2022
Date Signed: 08/23/2022 12:23:10 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
08/18/2022 and conducted by Evaluator Michelle Reed
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20220818154418
FACILITY NAME:MERIDIAN AT ANAHEIM HILLS, THEFACILITY NUMBER:
306005730
ADMINISTRATOR:BOTTINELLI, SHEILAFACILITY TYPE:
740
ADDRESS:525 S ANAHEIM HILLS ROADTELEPHONE:
(714) 974-2226
CITY:ANAHEIMSTATE: CAZIP CODE:
92807
CAPACITY:120CENSUS: 75DATE:
08/23/2022
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Executive Director Sheila BotinelliTIME COMPLETED:
12:30 PM
ALLEGATION(S):
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Food is not of good quality and not stored in a safe and healthful manner
INVESTIGATION FINDINGS:
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Licensing Program Analyst Michelle Reed arrived at the facility to discuss the complaint allegation. Upon arrival, LPA met with Sales Director Jessica Jensen. LPA explained the purpose of the visit and a tour of the Main Kitchen was conducted at approximately 9:15 am with Ms. Jensen. Larry Andrews, Food Service Director joined the tour at approximately 9:30am. During the tour LPA, Jessica Jensen and Larry Andrews observed the following in the kitchen refrigerator: Food was observed stored in covered containers with saran wrap but not all dated. Cabbage, celery and lettuce were observed wilted and stored in boxes. Shredded lettuce was observed in a metal pan filled with water with a date of 8/8/22. The lettuce was soggy

Mr. Andrews stated that food is delivered to the facility on Tuesday and Thursday's by Cisco Foods. LPA observed a delivery had just been made. Executive Director Sheila Botinelli arrived shortly after 9:30 am and she also observed the food in the kitchen refrigerator. A menu for the week was provided at the time of visit. Today Chicken Enchilada's, Beef Taco Salad and rice and beans were being served. There was also a Citrus slaw salad.

Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Sheila SantosTELEPHONE: (714) 703-2857
LICENSING EVALUATOR NAME: Michelle ReedTELEPHONE: (714) 743-4958
LICENSING EVALUATOR SIGNATURE:

DATE: 08/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2022
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-20220818154418
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: MERIDIAN AT ANAHEIM HILLS, THE
FACILITY NUMBER: 306005730
VISIT DATE: 08/23/2022
NARRATIVE
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LPA and Ms. Botinelli toured the Assisted Living kitchen and dining room at approximately 9:45am and also noted food stored in containers in the refrigerator that were not dated, partially covered cheese in saran wrap, ice cream in the freezer with no lid and mushy banana's on a shelf.

Based upon LPAs observations, the preponderance of evidence standard has been met and the allegation is substantiated.

See LIC9099D for cited deficiencies.

An exit interview was conducted with Executive Director Sheila Botinelli and a copy of this report and appeal rights were provided.
SUPERVISOR'S NAME: Sheila SantosTELEPHONE: (714) 703-2857
LICENSING EVALUATOR NAME: Michelle ReedTELEPHONE: (714) 743-4958
LICENSING EVALUATOR SIGNATURE:

DATE: 08/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 22-AS-20220818154418
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: MERIDIAN AT ANAHEIM HILLS, THE
FACILITY NUMBER: 306005730
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/23/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/26/2022
Section Cited
CCR
87555(a)
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General Food Service Requirements-All food shall be selected, stored, prepared and served in a safe and healthful manner.


This requirement was not met as evidenced by:
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Executive Director agrees to have all kitchen staff, including the Food Service Director, retrained in the proper storage, preparation and service of food. Training will also include the storage of cleaning agents and personal food in the kitchen and dining room, An agenda and staff in attendance will be provided by 8/26/22.
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LPA, Food Service Director and Executive Director observed wilted vegetables stored in cardboard boxes as well as undated and uncovered food in the kitchen refrigerators and freezer (See 9099)

This poses a potential health and safety risk to residents 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.
SUPERVISOR'S NAME: Sheila SantosTELEPHONE: (714) 703-2857
LICENSING EVALUATOR NAME: Michelle ReedTELEPHONE: (714) 743-4958
LICENSING EVALUATOR SIGNATURE:

DATE: 08/23/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 3