306006452-9-9-2024-22-AS-AORZ-D945ZF-20240913202353

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306006452
Report Date: 09/09/2024
Date Signed: 09/09/2024 04:56:54 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
06/18/2024 and conducted by Evaluator Kevin Saborit-Guasch

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20240618165757

FACILITY NAME:	ANAHEIM PALACE		FACILITY NUMBER:	306006452
ADMINISTRATOR:	CHON, CHRISTINE M		FACILITY TYPE:	740
ADDRESS:	525 W. LA PALMA AVE		TELEPHONE:	(626) 252-7287
CITY:	ANAHEIM	STATE: CA	ZIP CODE:	92801
CAPACITY:	199	CENSUS: 193	DATE:	09/09/2024
		UNANNOUNCED	TIME BEGAN:	03:15 PM
MET WITH:	Susan Lee, Executive Director		TIME COMPLETED:	05:00 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Facility is not ensuring the facility is kept at a comfortable temperature.

Food portions are insufficient for the residents' nutritional needs

Facility is not sufficiently staffed for residents with special needs

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility for the purpose of following up on the investigation into the three allegations listed above. LPA was greeted and granted entry by facility staff after introducing himself and explaining the purpose of the visit. Executive Director Susan Lee was present and assisted with the visit after being presented with the allegations.
The initial complaint investigation visit was conducted on June 20, 2024. During the visit, LPA requested and obtained the facility's resident census, room assignments and Resident Care schedule for June 2024. LPA accompanied by facility staff conducted a tour of the physical plant. Staff and resident interviews were conducted during the visit.
During the follow up visit, LPA toured the premises again. Temperatures were measured in common areas, hallways and a total of thirteen shared units. Five resident interviews were attempted or conducted. September schedule and records of employee clock-ins were requested and obtained.
CONTINUED ON FORM LIC9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Sheila Santos	TELEPHONE: (714) 334-2062
LICENSING EVALUATOR NAME: Kevin Saborit-Guasch	TELEPHONE: (714) 497-8754
LICENSING EVALUATOR SIGNATURE:	DATE: 09/09/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2024

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 2

Control Number 22-AS-20240618165757

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: ANAHEIM PALACE	FACILITY NUMBER: 306006452
	VISIT DATE: 09/09/2024

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

CONTINUED FROM LIC9099
Regarding the allegation that Facility is not ensuring the facility is kept at a comfortable temperature, the following has been concluded: On the day of the visit, outside temperatures in Anaheim had reached a high of 105F. Throughout the facility, hallways, common areas, dining halls and living units were all verified to be served by functional air conditioning units. Administrator stated A/C unit filters had been replaced on the day of the follow-up visit. Room temperature measured throughout ranged from 72F to 82F in some units were residents had opted to temporarily inactivate the air conditioning. Similar observations had been conducted during the initial visit on a day with lower outside temperatures. Two of the residents interviewed were able to corroborate that their units had functioning air conditioning and that they individually were able to set the room temperature comfortably for themselves. Additionally, a similar allegation was investigated as part of complaint investigation 22-AS-20240610155726 and found to be Unsubstantiated.

Regarding the allegation that Food portions are insufficient for the residents' nutritional needs, the following has been concluded: A total of six resident interviews were conducted. None of the residents interviewed stated that the portions were insufficient. Two residents stated that on occasion they requested for a second serving but also confirmed they received that additional portion whenever requested. Staff interviews conducted confirmed that the food supply on hand is sufficient.

Regarding the allegation that Facility is not sufficiently staffed for residents with special needs, the following has been concluded: The morning shift was confirmed to have 8 to 9 caregivers on hand every day scheduled. The afternoon shift also had a usual full staffing of 8 caregivers each day while there are three caregivers actively assigned to the night shift in the memory care. The wide majority of caregivers during the two daytime shifts are assigned to the memory care, with usually 4 caregivers present on the second floor of the unit and two present on the ground floor. Staffing levels were verified through the facility's payroll records as well as observation conducted during the first visit which both concluded that the actual staffing levels observed corresponded to the schedule provided.

As a result, all three allegations are found to be Unsubstantiated, meaning that although the allegations may have happened or are valid, there is not a preponderance of evidence to prove or refute that the alleged violations occurred. An exit interview was conducted and a copy of this report was provided to a facility representative.

SUPERVISOR'S NAME: Sheila Santos	TELEPHONE: (714) 334-2062
LICENSING EVALUATOR NAME: Kevin Saborit-Guasch	TELEPHONE: (714) 497-8754
LICENSING EVALUATOR SIGNATURE:	DATE: 09/09/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2024

LIC9099 (FAS) - (06/04)

Page: 2 of 2