306005901-6-3-2025-22-AS-APAO-DHPL8A-20250616083138

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306005901
Report Date: 06/03/2025
Date Signed: 06/03/2025 03:05:27 PM

Unsubstantiated

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
02/19/2025 and conducted by Evaluator Jessica Cho

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20250219144336

FACILITY NAME:	BEACH TERRACE ASSISTED LIVING AND MEMORY CARE		FACILITY NUMBER:	306005901
ADMINISTRATOR:	CHON, CHRISTINE		FACILITY TYPE:	740
ADDRESS:	12282 BEACH BOULEVARD		TELEPHONE:	(714) 694-3205
CITY:	STANTON	STATE: CA	ZIP CODE:	90680
CAPACITY:	120	CENSUS: 48	DATE:	06/03/2025
		UNANNOUNCED	TIME BEGAN:	02:05 PM
MET WITH:	Christine Chon- Executive Director		TIME COMPLETED:	03:20 PM

ALLEGATION(S):

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Facility staff are not meeting residents' dietary needs.
Facility staff do not provide residents snacks between meals.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Jessica Cho arrived unannounced for the purpose of delivering the findings into the above allegations. LPA met with Executive Director (ED) Christine Chon and explained the reason for the visit.

During the course of the investigation, LPA inspected the food supply in the kitchen, a meal service, snack area, successfully interviewed five out of seven residents and one out of two staff, and obtained the following pertinent documentation: Resident Roster, Personnel Report, Face Sheets, Physician’s Reports (LIC602s), Resident Dietary Preferences/Orders, Narrative Charting, and February 2025 Dining/Snack Menus.

It is alleged that the facility staff are not meeting the resident’s dietary needs. On February 24, 2025, LPA inspected the food supply in the main kitchen and observed ample food supply exceeding the two-day perishables and seven-day supply of non-perishable food requirement.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Lourdes Montoya	TELEPHONE: (714) -70-2870
LICENSING EVALUATOR NAME: Jessica Cho	TELEPHONE: 714-703-2853
LICENSING EVALUATOR SIGNATURE:	DATE: 06/03/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/03/2025

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 22-AS-20250219144336

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: BEACH TERRACE ASSISTED LIVING AND MEMORY CARE	FACILITY NUMBER: 306005901
	VISIT DATE: 06/03/2025

NARRATIVE

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LPA observed a posting of the meal of the day framed by the third floor elevator. Breakfast was egg and ham scramble, fresh fruit, 100% juice, and whole grain toast with lunch as soup du jour, buttermilk baked chicken, fresh cooked yams, seasoned cabbage, baked roll, and cherry cobbler, and soup du jour, broccoli cheese casserole, peach fruit cup, herb roasted tomatoes, herb pull apart roll, and pumpkin chocolate chip cookie for dinner. LPA observed lunch was served according to the menu and residents having food from the alternate menu as well. Food serving was observed sufficient and well-balanced. Facility was following the dietary orders for all residents on file. Four out of five residents and one staff interviewed did not corroborate with the allegation and having no concerns with the meals.

It is alleged that the facility staff do not provide residents snacks between meals. LPA observed facility having an assortment of snacks such as chips and fruits with water/juice in the snack area. Also observed on the bulletin board of the third floor dining room, a posting showing snacks such as strawberry banana yogurt, 24 hour fruit salad, peanut butter jam sandwich, ham sandwich, cheese quesadilla, and classic turkey sandwich are "always available." Five of five residents and one staff interviewed did not corroborate with the allegation indicating that snacks are available upon request.

Based on the observations made, interviews which were conducted, and the records that were reviewed, although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the following allegations: Facility staff are not meeting residents' dietary needs and Facility staff do not provide residents snacks between meals are deemed UNSUBSTANTIATED.

An exit interview was conducted with Executive Director Christine Chon, and a copy of this report was provided at exit.

SUPERVISOR'S NAME: Lourdes Montoya	TELEPHONE: (714) -70-2870
LICENSING EVALUATOR NAME: Jessica Cho	TELEPHONE: 714-703-2853
LICENSING EVALUATOR SIGNATURE:	DATE: 06/03/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/03/2025

LIC9099 (FAS) - (06/04)

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