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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306006195
Report Date: 02/22/2023
Date Signed: 02/24/2023 09:13:55 AM


Document Has Been Signed on 02/24/2023 09:13 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868



FACILITY NAME:WESTMINSTER TERRACEFACILITY NUMBER:
306006195
ADMINISTRATOR:MAHONEY, ERINFACILITY TYPE:
740
ADDRESS:7571 WESTMINSTER BLVDTELEPHONE:
(714) 891-6608
CITY:WESTMINSTERSTATE: CAZIP CODE:
92683
CAPACITY:152CENSUS: 55DATE:
02/22/2023
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Erin Mahoney & Christine MillerTIME COMPLETED:
01:00 PM
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Licensing Program Analyst (LPA), Lydia Martinez conducted an announced visit at this facility for the purpose of completing a Pre-Licensing evaluation. Facility is an existing facility and undergoing a Change of Ownership. There are 55 residents in care under the current license. An initial Application to operate a Residential Care For the Elderly (RCFE) was submitted to the Central Applications Unit (CAU) on 06/02/2022 for a capacity of 152 residents. LPA met with Applicant Erin Mahoney and Christine Miller.

Facility is a three story building with 76 individual apartments. A Fire Clearance was granted for 56 ambulatory and 96 non-Ambulatory, of which 30 can be Bedridden on 01/23/2023. Non-ambulatory residents may only live on the first and second floors. Bedridden may occupy any resident room located on the first and second floor. LPA toured the entire premises, including the kitchen, dining room, activity rooms, laundry, patios, storage areas and a sampling of resident rooms. Hot water in random bathrooms was tested and is within regulatory requirements. Bath towels, toiletries and personal hygiene supplies were adequately stocked. An adequate supply of linen was available. Common areas were clean and clear of hazards, doorways were free of obstructions. Perishable and non-perishable food supply was checked and adequately stocked at time of visit. There was a locked room for centrally stored medications and several locked areas for toxins and cleaning supplies. Call system was in place.



Outside grounds were toured and no bodies of water were observed. First Aid kits contained all required items including tweezers, thermometer, and scissors. LPA viewed the required postings as well as COVID-19 postings, hand sanitizer and screening equipment.

The Component III was completed during today's visit. The facility is ready to be licensed. An exit interview was conducted and a copy of this report will be sent to email on file.
SUPERVISOR'S NAME: Armando J LuceroTELEPHONE: (714) 703-2840
LICENSING EVALUATOR NAME: Lydia MartinezTELEPHONE: (714) 703-2840
LICENSING EVALUATOR SIGNATURE:
DATE: 02/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/22/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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