<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306006195
Report Date: 02/19/2026
Date Signed: 02/19/2026 12:04:23 PM

Substantiated


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
08/26/2024 and conducted by Evaluator Jerome Haley
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20240826141418
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: 115DATE:
02/19/2026
UNANNOUNCEDTIME BEGAN:
10:38 AM
MET WITH:Carmen GaliciaTIME COMPLETED:
12:10 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility lacks staffing in which resident needs are not being met
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Regarding the allegation: Facility lacks staffing in which resident needs are not being met.

During the investigation 5 of 6 individuals were able to provide information that supports the complaint allegation. Further, LPA Haley documented observations during the initial complaint visit that was consistent with information discovered during the complaint investigation.

During an interview with a staff member, the staff member acknowledged there was an incident where a resident did not get their breakfast, and the resident's family member had to email the facility regarding the situation. The resident eventually got their breakfast; however, the resident received breakfast about two hours late. During an interview with Resident 1 (R1), they explained after a recent injury, they were left without assistance for at least two hours. R1 says their leg was hanging off the bed and they could not move it due to their recent injury. The resident pulled the pull-cord for assistance and explained it took about two hours before a caregiver came to “save me.”
Continued on LIC9099C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Jerome Haley
LICENSING EVALUATOR SIGNATURE:

DATE: 02/19/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/19/2026
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 3
Control Number 22-AS-20240826141418
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: 02/19/2026
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
R1 also observed that another resident is always brought down to the dining room late for their meals.

Resident 2 (R2) also had concerns about staff responding to calls for assistance. R2 says when you use the call button the staff don’t respond.

During the initial visit August 30, 2024, LPA Haley pulled a pull cord in the men’s restroom on the third floor. No staff member ever responded. LPA Haley set a timer and after about 16 or 17 minutes LPA Haley showed S1 and S2 the timer and explained the pulled cord was pulled over 15 minutes ago. Both staff members acknowledged no one responded to the call. S1 explained that staff was scolded and were told they were not responding to the one’s in the bathroom. S2 said they did not receive the notification, but it goes to the caregivers that have the phone. S2 said they're not sure if the pull cord was working or the staff just forgot to respond.

Although it’s unclear if the failure to respond to pull cords/call buttons is related to a lack of staffing or caregivers forgetting to respond, it is clear that on more than one occasion calls for assistance have been answered late or not responded to at all.

Based on the evidence gathered through interviews and LPA observations, the preponderance of evidence standard has been met, therefore, the allegation above is found to be SUBSTANTIATED. A violation is being cited per California Code of Regulations Title 22.

An exit interview was conducted, and a copy of this report and appeal rights was provided.
SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Jerome Haley
LICENSING EVALUATOR SIGNATURE:

DATE: 02/19/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/19/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 22-AS-20240826141418
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: 02/19/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/25/2026
Section Cited
CCR
87464(f)(1)
1
2
3
4
5
6
7
Basic Services
(f) Basic services shall at a minimum include:

(1) Care and supervision as defined in Section 87101(c)(3) and Health and Safety Code section 1569.2(c).

Health and Safety Code section 1569.2(c) provides:

(c) "Care and supervision" means the facility assumes responsibility for, or provides or promises to provide in the future, ongoing assistance with activities of daily living without which the resident’s physical health, mental health, safety, or welfare would be endangered. Assistance includes assistance with taking medications, money management, or personal care.
This requirement was not met as evidenced by:
1
2
3
4
5
6
7
Executive Director (ED) Galicia states she will conduct an in-service training on response to pull cords and call buttons for all staff.
ED Galicia will email LPA Haley a description of the training, the duration of the training, and a sign in sheet for all in attendance by 12:00 noon on the POC due date.
8
9
10
11
12
13
14
On more than one occasion facility staff has failed to respond to request for assistance. Including a request made by LPA Haley during the initial visit when a pull cord was pulled to see how long it would take for a caregiver to respond. There was no response and around the 16 or 17 minute mark LPA Haley contacted facility staff regarding the issue. This poses a potential health and safety risk to persons in care.
8
9
10
11
12
13
14
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
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: Lourdes Montoya
LICENSING EVALUATOR NAME: Jerome Haley
LICENSING EVALUATOR SIGNATURE:

DATE: 02/19/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/19/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3