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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306006195
Report Date: 01/17/2025
Date Signed: 01/18/2025 12:54:54 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
11/18/2024 and conducted by Evaluator Alvaro Ramirez Jr.
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20241118130839
FACILITY NAME:WESTMINSTER TERRACEFACILITY NUMBER:
306006195
ADMINISTRATOR:CRISTINA MILLERFACILITY TYPE:
740
ADDRESS:7571 WESTMINSTER BLVDTELEPHONE:
(714) 891-6608
CITY:WESTMINSTERSTATE: CAZIP CODE:
92683
CAPACITY:152CENSUS: 111DATE:
01/17/2025
UNANNOUNCEDTIME BEGAN:
08:19 AM
MET WITH:Carmen Galicia-Executive DirectorTIME COMPLETED:
03:58 PM
ALLEGATION(S):
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Facility mismanaged resident's medication
Facility has bedbugs
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPAs) Alvaro Ramirez, Jr. and Hanna Gough conducted an unannounced visit to deliver findings on the above allegations received on November 18, 2024. LPAs were greeted and granted entry into the facility and met with Executive Director (ED) Carmen Galicia. LPAs explained the reason for the visit.

This Department has investigated the complaint alleging that facility mismanaged resident's medication. Resident 1 (R1) was admitted to the facility on October 24, 2024. Documents reviewed included the Physician Report (LIC602) dated November 18, 2024, for R1. Per Physician report R1’s diagnosis is Type 2 Diabetes. Regarding the allegation that facility mismanaged resident's medication, the following was revealed: During the investigation LPA reviewed documents including the Physician Report (LIC602A) dated September 27, 2024, for R1. Per Physician Report R1 is able to administer own prescribed medications. Per Physician Report (LIC602) dated November 18, 2024, R1 can manage own medications except
CONTINUED ON LIC9099-C...
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Alvaro Ramirez Jr.
LICENSING EVALUATOR SIGNATURE:

DATE: 01/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/17/2025
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 8
Control Number 22-AS-20241118130839
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: 01/17/2025
NARRATIVE
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narcotics. During the course of the interviews with staff, Staff 1 (S1) reported that R1 has not been prescribed narcotics and stated that the resident continues to manage their regular prescribed medications. During the course of the interviews with residents, R2 reported that staff handle his medications. Per R2 staff do not mismanage his medications and reported that he gets his medications on-time.

Regarding the allegation that facility has bedbugs, the following was revealed: One of eight individuals interviewed confirmed the allegation. During the course of the investigation LPA reviewed documents including the Ecolab invoice customer service report dated November 11, 2024. Per Ecolab customer service report, it states that bedroom #305 was inspected and it states that no bedbug activity noted during inspection. During the course of the interviews with residents, R1 reported that they noticed bedbugs within a few days of moving in. Per R2 he has not seen bedbugs. During the course of the interviews with staff, S1 reported that the pest control company did not find bedbugs and stated that no other resident has complained about bedbugs.

Based on the information gathered during the investigation and review of documents obtained, LPA is unable to ascertain if the allegations occurred as reported due to conflicting information. Although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove or refute the alleged violations occurred; therefore, these allegations are deemed UNSUBSTANTIATED.

For today’s visit, there were no citations issued per Title 22, Division 6 of the California Code of Regulations.


LPA conducted an exit interview with ED Galicia, and a copy of this report was provided to the facility.
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Alvaro Ramirez Jr.
LICENSING EVALUATOR SIGNATURE:

DATE: 01/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/17/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 8
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
11/18/2024 and conducted by Evaluator Alvaro Ramirez Jr.
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20241118130839

FACILITY NAME:WESTMINSTER TERRACEFACILITY NUMBER:
306006195
ADMINISTRATOR:CRISTINA MILLERFACILITY TYPE:
740
ADDRESS:7571 WESTMINSTER BLVDTELEPHONE:
(714) 891-6608
CITY:WESTMINSTERSTATE: CAZIP CODE:
92683
CAPACITY:152CENSUS: 111DATE:
01/17/2025
UNANNOUNCEDTIME BEGAN:
08:19 AM
MET WITH:Carmen Galicia-Executive DirectorTIME COMPLETED:
03:58 PM
ALLEGATION(S):
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Facility did not provide resident with a copy of the admission agreement
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPAs) Alvaro Ramirez, Jr. and Hanna Gough conducted an unannounced visit to deliver findings on the above allegations received on November 18, 2024. LPAs were greeted and granted entry into the facility and met with Executive Director (ED) Carmen Galicia. LPAs explained the reason for the visit.

This Department has investigated the complaint alleging that facility did not provide resident with a copy of the admission agreement. Resident 1 (R1) was admitted to the facility on October 24, 2024. Regarding the allegation that facility did not provide resident with a copy of the admission agreement, the following was revealed: One of eight individuals interviewed confirmed the allegation. LPA reviewed documents including the Westminster Terrace Residence and Care Agreement dated October 24, 2024, for R1. Per Residence and Care Agreement for R1 under page 26 it states by signing below, you acknowledge that you have received a signed copy of this Residence and Care Agreement.
CONTINUED ON LIC9099...
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Alvaro Ramirez Jr.
LICENSING EVALUATOR SIGNATURE:

DATE: 01/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/17/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 8
Control Number 22-AS-20241118130839
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: 01/17/2025
NARRATIVE
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During the course of the interviews with residents, R2 reported that she received a copy of her Admission Agreement. R3 reported that he got a copy of the Admission Agreement when he moved in. During the course of the interviews with staff, Staff 1 (S1) reported that R1 got a copy of the Admission Agreement the same day and stated that the residents and family can get a paper copy of the Admission Agreement or receive a copy via email.

Therefore, the allegation is deemed UNFOUNDED, meaning the allegation is false, could not have happened and/or is without a reasonable basis.

LPAs conducted an exit interview with ED Galicia, and a copy of this report was provided to the facility.
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Alvaro Ramirez Jr.
LICENSING EVALUATOR SIGNATURE:

DATE: 01/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/17/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 8
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
11/18/2024 and conducted by Evaluator Alvaro Ramirez Jr.
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20241118130839

FACILITY NAME:WESTMINSTER TERRACEFACILITY NUMBER:
306006195
ADMINISTRATOR:CRISTINA MILLERFACILITY TYPE:
740
ADDRESS:7571 WESTMINSTER BLVDTELEPHONE:
(714) 891-6608
CITY:WESTMINSTERSTATE: CAZIP CODE:
92683
CAPACITY:152CENSUS: 111DATE:
01/17/2025
UNANNOUNCEDTIME BEGAN:
08:19 AM
MET WITH:Carmen Galicia-Executive DirectorTIME COMPLETED:
03:58 PM
ALLEGATION(S):
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Facility's restrooms and sinks do not have hot water
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPAs) Alvaro Ramirez, Jr. and Hanna Gough conducted an unannounced visit to deliver findings on the above allegation received on November 18, 2024. LPAs were greeted and granted entry into the facility and met with Executive Director (ED) Carmen Galicia. LPAs explained the reason for the visit.

This Department has investigated the complaint alleging that facility's restrooms and sinks do not have hot water. Resident 1 (R1) was admitted to the facility on October 24, 2024. Regarding the allegation that facility's restrooms and sinks do not have hot water, the following was revealed: During the initial visit on November 27, 2024, LPA tested the hot water in the following bedrooms #118, #122, #214, #303, #305, and #317. The hot water tested between 91.2 to 102.3 degrees Fahrenheit. During the course of the interviews with the residents, Resident 1 (R1) reported that she does not feel clean because of the lukewarm water and stated that she needs to shower with hot water.
CONTINUED ON LIC9099-C...
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Alvaro Ramirez Jr.
LICENSING EVALUATOR SIGNATURE:

DATE: 01/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/17/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 6 of 8
Control Number 22-AS-20241118130839
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: 01/17/2025
NARRATIVE
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Per R2 some residents complaint that it is lukewarm water.

Based on observations and the interviews which were conducted, the preponderance of evidence standard has been met, therefore the following allegation: facility's restrooms and sinks do not have hot water is deemed SUBSTANTIATED. California Code of Regulations, Title 22, Division 6, Chapter 8 is being cited on the attached LIC 9099D.



An exit interview was conducted with ED Galicia and a copy of this report along with the Appeal Rights were provided at the time of this visit.
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Alvaro Ramirez Jr.
LICENSING EVALUATOR SIGNATURE:

DATE: 01/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/17/2025
LIC9099 (FAS) - (06/04)
Page: 7 of 8
Control Number 22-AS-20241118130839
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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/17/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/21/2025
Section Cited
CCR
87303(e)(2)
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87303 Maintenance and Operation (e)(2) Faucets used by residents for personal care...shall be maintained to automatically regulate the temperature of hot water used by residents to attain a temperature of not less than 105 degree F and not more than 120 degree F. This requirement was not met
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Licensee to regulate the hot water between 105 degrees F and not more than 120 degrees F. Licensee to log in the hot water temperatures and email LPA POC by POC due date.
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 as evidence by: Based on observations and interviews conducted the hot water tested between 91.2 to 102.3 degrees Fahrenheit. This poses a potential health, safety or personal rights risk to persons 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.
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Alvaro Ramirez Jr.
LICENSING EVALUATOR SIGNATURE:

DATE: 01/17/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/17/2025
LIC9099 (FAS) - (06/04)
Page: 8 of 8