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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306006195
Report Date: 02/26/2025
Date Signed: 02/26/2025 05:29:05 PM

Document Has Been Signed on 02/26/2025 05:29 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME:WESTMINSTER TERRACEFACILITY NUMBER:
306006195
ADMINISTRATOR/
DIRECTOR:		CRISTINA MILLERFACILITY TYPE:
740
ADDRESS:7571 WESTMINSTER BLVDTELEPHONE:
(714) 891-6608
CITY:WESTMINSTERSTATE: CAZIP CODE:
92683
CAPACITY: 152CENSUS: 108DATE:
02/26/2025
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:00 AM
MET WITH:Carmen GaliciaTIME VISIT/
INSPECTION COMPLETED:
10:00 AM
NARRATIVE
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Licensing Program Analyst (LPA) Michael Tea conducted a case management visit to follow up on a co-complaint report received by Community Care Licensing (CCL) on January 16, 2025, submitted by Orange County Health Agency (OCHCA). LPA was greeted and allowed entrance into the facility by the Business Office Manager (BOM), Lakhena Lor and explained the reason for the visit. Executive Director (ED) Carmen Galicia arrived shortly to assist during the visit.

The OCHCA received a complaint about a scabies outbreak. Public Health attempted to follow up about infection control and did not hear anything from the facility or any reports about an infection. This is in violation of failure to report to the local health officer/agency.

Based on the report received the following deficiency is being cited per Title 22 Division 6 of the California Code of Regulations.



An exit interview was conducted with Executive Director, Carmen Galicia and a copy of this report and appeal rights were provided to the facility.
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Michael Tea
LICENSING EVALUATOR SIGNATURE: DATE: 02/26/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/26/2025
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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Document Has Been Signed on 02/26/2025 05:29 PM - It Cannot Be Edited


Created By: Michael Tea On 02/26/2025 at 09:39 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

FACILITY NAME: WESTMINSTER TERRACE
FACILITY NUMBER: 306006195

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/26/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/12/2025
Section Cited
CCR
87211(a)(2)

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Reporting requirements ... Each licensee shall furnish to the licensing agency such reports as the Department may require, including, but not limited to, the following: Occurrences, such as epidemic outbreaks, poisonings, catastrophes or major accidents which threaten the welfare, safety or health of residents, personnel or visitors, shall be reported within 24 hours ... the local health officer when appropriate.
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Facility will provide a written statement of understanding of the regulation, signed by all facility staff and personnel and forward to LPA by POC due date.
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This requirement is not met as evidenced by:

Based on a report received by CCLD from Orange Public Health Care Agency in regards to infection control of an outbreak. This could pose as 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:Alisa Ortiz
LICENSING EVALUATOR NAME:Michael Tea
LICENSING EVALUATOR SIGNATURE:
DATE: 02/26/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/26/2025


LIC809 (FAS) - (06/04)
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