306006419-3-6-2024-22-AS-AORZ-D5PSJS-20240528135537

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306006419
Report Date: 03/06/2024
Date Signed: 03/06/2024 02:56:33 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
02/27/2024 and conducted by Evaluator Alvaro Ramirez Jr.

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20240227161530

FACILITY NAME:	GOLDEN YEARS GROUP1		FACILITY NUMBER:	306006419
ADMINISTRATOR:	ATTRAH, AHMED		FACILITY TYPE:	740
ADDRESS:	2324 E. PURITAN LANE		TELEPHONE:	(949) 994-2900
CITY:	ANAHEIM	STATE: CA	ZIP CODE:	92806
CAPACITY:	6	CENSUS: 6	DATE:	03/06/2024
		UNANNOUNCED	TIME BEGAN:	01:20 PM
MET WITH:	Ameer Attrah-Administrator Assistant		TIME COMPLETED:	02:50 PM

ALLEGATION(S):

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Staff did not seek medical attention in a timely manner.
Staff did not communicate with resident's responsible party in a timely manner of incident.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Alvaro Ramirez, Jr. conducted an unannounced initial 10-Day complaint visit to initiate the investigation into the above allegation and to deliver the findings of the investigation. LPA was greeted and granted entry into the facility and met with Administrator Assistant Ameer Attrah. LPA explained the reason for the visit.

This agency has investigated the complaint alleging that staff did not seek medical attention in a timely manner and staff did not communicate with resident's responsible party in a timely manner of incident. Regarding the allegations, the following was revealed: Four of four individuals interviewed denied the allegations. During the initial visit on 03/06/24 LPA observed that the facility Golden Years Group1 has not been licensed.
Therefore, the allegations are deemed UNFOUNDED, meaning the allegations are false, could not have happened and/or are without a reasonable basis.
LPA Ramirez conducted an exit interview with Administrator Assistant, and a copy of this report was provided to the facility.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Sheila Santos	TELEPHONE: (714) 334-2062
LICENSING EVALUATOR NAME: Alvaro Ramirez Jr.	TELEPHONE: 714-705-6007
LICENSING EVALUATOR SIGNATURE:	DATE: 03/06/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2024

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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