Inspection Reports for Westminster Terrace

A case management incident visit was conducted to follow up on an incident report received by Community Care Licensing on October 1, 2025, submitted by the Executive Director Carmen Galicia.

During the inspection, no health or safety issues were observed in the facility or Resident 1's room. No deficiencies were cited at this time.

The inspection was conducted as an unannounced complaint investigation following a complaint received on May 20, 2025, alleging staff interference with the resident council and failure to safeguard residents' personal belongings.

The investigation found the allegations of staff interfering with the resident council and not safeguarding residents' personal belongings to be unsubstantiated. Interviews with residents and staff, observations, and record reviews did not support the claims. No deficiencies were cited.

The complaint alleged that facility staff interfered with the resident council by stealing and copying meeting minutes and retaliating against residents, and that staff did not safeguard residents' personal belongings. The investigation included interviews with residents and staff, document reviews, and observations. The allegations were determined to be unsubstantiated due to lack of sufficient evidence.

The inspection was an unannounced complaint investigation visit conducted in response to a complaint received on May 21, 2025, alleging inadequate medication assistance, untimely response to resident calls, and failure to safeguard residents' personal belongings.

The investigation found that although some residents reported occasional delays in medication administration and response times, and concerns about safeguarding personal belongings, there was insufficient evidence to substantiate the allegations. Staff were observed to respond within adequate timeframes, and protocols for safeguarding belongings were followed. The allegations were determined to be unsubstantiated or unfounded, and no deficiencies were cited.

The complaint investigation was unannounced and conducted by Licensing Program Analyst Michael Tea. Allegations included inadequate medication assistance, untimely response to resident calls, and failure to safeguard personal belongings. The investigation included interviews with residents and staff, review of call logs, and observations. The allegations were determined to be unsubstantiated or unfounded based on evidence and interviews.

An unannounced complaint investigation visit was conducted in response to allegations that staff were mismanaging residents' medications and not ensuring residents' rooms were clean and sanitized.

The investigation found no evidence to substantiate the allegations. Medication administration records and interviews confirmed medications were given as prescribed, and the facility's housekeeping practices were generally satisfactory with no observed cleanliness issues in the resident's room.

The complaint investigation was unsubstantiated based on observations, interviews, and record reviews. Allegations included medication mismanagement and inadequate room sanitation, but evidence did not support these claims.

The inspection was conducted as a case management follow-up visit triggered by a co-complaint report received on April 8, 2025, alleging that the facility was not changing residents' sheets on a regular weekly basis.

Based on observations, interviews with staff and residents, and review of linen supply invoices, the allegation that the facility was not changing residents' sheets weekly was determined to be unsubstantiated. No deficiencies were cited during this visit.

The complaint alleged that the facility was not changing residents' sheets on a regular weekly basis. After investigation, including interviews with the Executive Director, staff, and residents, and review of linen supply invoices, the complaint was determined to be unsubstantiated.

The inspection was an unannounced annual required inspection conducted to evaluate compliance with licensing regulations.

The inspection found no deficiencies in the areas inspected. Resident files, staff files, physical plant, fire safety, medication storage, and resident care were all in compliance with regulations.

An unannounced complaint investigation visit was conducted to investigate allegations of a scabies infestation, improper medication administration, and failure to follow the Infection Control Plan at the facility.

The investigation found that only one resident was diagnosed with scabies and there was no evidence of an infestation. Medication administration was found to be properly managed and documented. The facility followed infection control protocols promptly when scabies was suspected. Overall, the allegations were determined to be unsubstantiated.

The complaint investigation was unsubstantiated, meaning there was insufficient evidence to prove the alleged violations of scabies infestation, medication mismanagement, and infection control plan noncompliance.

A case management visit was conducted to follow up on a co-complaint report received by Community Care Licensing on January 16, 2025, submitted by Orange County Health Agency regarding a scabies outbreak and failure to report to the local health officer/agency.

The facility was cited for failure to report an infection outbreak to the local health officer as required by Title 22 Division 6 of the California Code of Regulations, posing a potential health and safety risk to residents.

The visit was complaint-related based on a report of a scabies outbreak and failure to report infection control issues to the local health officer. The complaint was submitted by Orange County Health Agency and investigated by Community Care Licensing.

The inspection was a case management incident visit conducted to follow up on an incident report received by Community Care Licensing on January 24, 2025.

During the inspection, no health or safety issues were observed, the facility was clean and organized, and no deficiencies were cited at this time.

An unannounced complaint investigation visit was conducted in response to allegations received on October 11, 2024, concerning privacy violations, uncomfortable accommodations due to air fresheners, retaliation against residents, and untimely response to the facility call system.

The investigation found conflicting information regarding the allegations. Some residents and staff confirmed or denied the complaints, and document reviews supported staff training and policies protecting resident rights. Due to insufficient evidence, all allegations were deemed unsubstantiated, and no citations were issued.

The complaint investigation was unsubstantiated due to conflicting information and lack of preponderance of evidence to prove or refute the allegations.

An unannounced complaint investigation visit was conducted to follow up on multiple allegations received on 06/07/2024 regarding resident care and facility conditions at Westminster Terrace.

The investigation substantiated the allegation that residents were not being provided with clean linen, issuing a Type B citation. Other allegations including residents being left soiled, pest infestations, disrespectful treatment, unclean dining areas, and lack of call system access were found to be unsubstantiated.

The complaint investigation was substantiated for the allegation regarding clean linen provision. Other allegations were unsubstantiated based on interviews, observations, and documentation.

An unannounced complaint investigation visit was conducted in response to allegations that residents are afraid to express themselves due to retaliation and that the facility is understaffed.

The investigation included interviews with residents and staff, a tour of the facility, and review of records. The allegations were not substantiated as resident and staff interviews did not corroborate the claims, and staffing levels were verified as adequate through staff schedules and observations.

The complaint investigation was unsubstantiated. Allegations included residents fearing retaliation and understaffing. Interviews with 7 residents and staff did not support these allegations. Staffing schedules confirmed adequate coverage. No preponderance of evidence was found to prove or refute the allegations.

The visit was conducted as a pre-licensing evaluation for an existing facility undergoing a Change of Ownership and applying to operate as a Residential Care For the Elderly (RCFE) with a capacity of 152 residents.

The facility was toured and found to be in compliance with regulatory requirements including adequate supplies, clean and hazard-free common areas, proper food storage, locked medication and toxin storage, and functional call systems. The facility is ready to be licensed.

The visit was an office evaluation conducted on February 9, 2023, involving a telephone interview with the applicant/administrator to verify identification and confirm understanding of California Code Title 22 regulations and facility operation requirements.

The applicant/administrator demonstrated understanding of licensing requirements including facility operation, admission policies, staffing, health conditions, emergency preparedness, complaints, and pre-licensing readiness during the COMP II telephone interview.

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