306006195-12-18-2025-22-AS-AORZ-DPW2W3-20251231164452

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306006195
Report Date: 12/18/2025
Date Signed: 12/18/2025 03:23:37 PM

Unfounded

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
12/16/2025 and conducted by Evaluator RoseMarie Ruppert

COMPLAINT CONTROL NUMBER: 22-AS-20251216155721

FACILITY NAME:	WESTMINSTER TERRACE		FACILITY NUMBER:	306006195
ADMINISTRATOR:	CARMEN GALICIA		FACILITY TYPE:	740
ADDRESS:	7571 WESTMINSTER BLVD		TELEPHONE:	(714) 891-6608
CITY:	WESTMINSTER	STATE: CA	ZIP CODE:	92683
CAPACITY:	152	CENSUS: 116	DATE:	12/18/2025
		UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Carmen Galicia, Executive Director (ED)		TIME COMPLETED:	03:45 PM

ALLEGATION(S):

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Facility staff failed to address a resident's prohibited health condition adequately

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Rose Ruppert made an unannounced visit to investigate a complaint filed with the Regional Office. LPA was greeted and granted entry by the Concierge at 1pm. LPA met with Carmen Galicia, Executive Director (ED) and explained the purpose of the visit.

LPA obtained documentation for Resident #1 (R1) which include: Unusual Incident Reports, Hospital discharge paperwork, Face Sheet and Emergency Info, Physician's Report dated 10/24/2024, Service Plan dated 04/02/2024 and a copy of the Assisted Living Waiver.

It was alleged that Facility staff failed to address a resident's prohibited health condition adequately. LPA reviewed the Unusual Incident Reports submitted to the Department on 12/10/2025. On 12/05/2025 R1 was sent out of the community at 3pm due to continuous nose bleed. R1 was assessed at Emergency Room and returned to the facility on the same day with no new orders.
(Continued on LIC 9099-C)

Unfounded

Estimated Days of Completion:

SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: RoseMarie Ruppert
LICENSING EVALUATOR SIGNATURE:	DATE: 12/18/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2025

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-20251216155721

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: WESTMINSTER TERRACE	FACILITY NUMBER: 306006195
	VISIT DATE: 12/18/2025

NARRATIVE

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(Continued from LIC 9099)

On 12/07/2025 at 7:30am, R1 had an unwitnessed fall and was sent out to the hospital for assessment. R1 returned to the community at 2:30pm on 12/07/2025. Staff reviewed discharge paperwork and noted there were tests done at the hospital for an infectious disease. Staff immediately contacted the Wellness Director (WD) and WD instructed staff to set up Personal Protective Equipment in front of R1's apartment and to send R1 back out to the hospital. It was not confirmed if R1 had an infectious disease but the discharge paperwork noted that R1 was tested for infectious disease and was being treated with medication for infectious disease. R1 was sent out by non-emergency ambulance on 12/7/2025 at 5pm per Incident Report. R1 was in the community for two-and-a-half hours and remained in a shared room with a roommate.
Per staff interviews, facility was not informed of any infectious disease for R1's return to the community. On 12/11/2025 the hospital social worker spoke with WD regarding R1's return and was told infectious disease test for R1 was pending. WD stated R1 could not return until the results of the testing were done. If R1's test confirmed positive for infectious disease, R1 would need to go to a Skilled Nursing Facility (SNF). If R1's test was negative, WD would go to the hospital for assessment and R1 would be able to return to the community. As of December 18, 2025 neither ED or WD received confirmation for test results but R1 has not returned to the community and currently resides in a SNF.

WD provided LPA with documentation that R1's roommate's family were notified of possible exposure to infectious disease and will test resident to confirm. A staff in-service regarding Infectious Disease Protocol will be conducted on Tuesday, December 23, 2025 and will be submitted to the Department. Currently there are no cases of infectious disease reported and facility did not receive confirmation of diagnosis from hospital.
LPA interviewed two of two staff who denied the allegation that Facility staff failed to address a resident's prohibited health condition adequately. When facility staff realized possible exposure to infectious disease, staff members initiated infection control protocol and sent resident back to the hospital for possible treatment. LPA interviewed three of three residents. Three of three residents did not have any knowledge of an infectious disease going around the community.

(Continued on LIC 9099-C1)

SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: RoseMarie Ruppert
LICENSING EVALUATOR SIGNATURE:	DATE: 12/18/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2025

LIC9099 (FAS) - (06/04)

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Control Number 22-AS-20251216155721

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: WESTMINSTER TERRACE	FACILITY NUMBER: 306006195
	VISIT DATE: 12/18/2025

NARRATIVE

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(Continued from LIC 9099-C)

LPA toured the community and observed residents watching television in the downstairs communal room, residents playing Bingo on the 2nd floor Activities Room and residents in the Library on the third floor. LPA did not observe any PPE stations in front of apartments, which would indicate a resident in isolation due to an infectious disease.

Based on LPA's observations, record review and interviews the allegation that Facility staff failed to address a resident's prohibited health condition adequately is Unfounded. The allegation is false, could not have happened, and/or is without a reasonable basis. An exit interview was conducted with Executive Director Carmen Galicia and a copy of this report was provided to the facility.

SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: RoseMarie Ruppert
LICENSING EVALUATOR SIGNATURE:	DATE: 12/18/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2025

LIC9099 (FAS) - (06/04)

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