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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306003744
Report Date: 12/20/2021
Date Signed: 12/20/2021 05:23:57 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME:QUALITY CARE PLUSFACILITY NUMBER:
306003744
ADMINISTRATOR:MARJAN ARASTOOFACILITY TYPE:
735
ADDRESS:1652 W. BROADWAYTELEPHONE:
(714) 635-6561
CITY:ANAHEIMSTATE: CAZIP CODE:
92802
CAPACITY:80CENSUS: 73DATE:
12/20/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Marjan Arastoo, Abdul ArastooTIME COMPLETED:
05:40 PM
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Licensing Program Analyst (LPA) Joseph Alejandre made an unannounced case management inspection to check on the Health and Safety of the clients and the plan of corrections for violations cited during previous visits. LPA was greeted and granted entry by staff. LPA met with Marjan Arastoo and Abdul Arastoo and explained the reason for the visit. LPA observed 6 staff including the Administrator. LPA and Administrator toured the facility. LPA observed new mattresses in rooms, 202, 202A, 205, 206, 207, 219, 223 and 101. LPA observed that the toilet in room 220 has been repaired and is operational and the window screen has been replaced. LPA observed the bathroom door in room 207 has been repaired and is operational. LPA observed that the window screens in room 204 and 223 have been replaced with new window screens. LPA observed the tile in the hallway on the first floor by the second set of stairs is being repaired. LPA toured the kitchen. LPA observed the kitchen has a 2 day perishable and 7 day non-perishable food supply on hand. LPA observed the kitchen stove and oven were clean along with all of the work areas. While the LPA and Administrator toured the facility LPA observed housekeeping staff cleaning resident rooms. LPA observed all fire extinguishers are fully charged. Administrator provided LPA with a copy of the updated LIC 500. LPA consulted with the Administrator concerning facility maintenance, evictions and record keeping. Previous 2 citations from 12/16/21 and 12/13/21 have been cleared and the Administrator was provided with proof of correction letter. No deficiencies are being cited as a result of this visit. An exit interview was conducted and a copy of the report provided.
SUPERVISOR'S NAME: Luz AdamsTELEPHONE: (714) 703-2855
LICENSING EVALUATOR NAME: Joseph AlejandreTELEPHONE: (951) 473-7041
LICENSING EVALUATOR SIGNATURE:

DATE: 12/20/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2021
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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