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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197604989
Report Date: 02/24/2024
Date Signed: 02/24/2024 02:12:19 PM

Document Has Been Signed on 02/24/2024 02:12 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME:DURANDO HOME IIFACILITY NUMBER:
197604989
ADMINISTRATOR:JAMES DURANDOFACILITY TYPE:
740
ADDRESS:38757 37TH STREET EASTTELEPHONE:
(661) 266-0551
CITY:PALMDALESTATE: CAZIP CODE:
93552
CAPACITY: 4CENSUS: 3DATE:
02/24/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:35 AM
MET WITH:James DurandoTIME COMPLETED:
02:15 PM
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
Licensing Program Analyst (LPA) Tihesha Smith conducted an unannounced Required 1-year inspection at this facility at approximately 10:35 am and observed surroundings before exiting vehicle. The administrator was present at the facility and LPA Smith disclosed the purpose of the visit.

LPA conducted a tour of the physical plant at approximately 11:03 am to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations.

Common areas were observed for the ability to safely serve the needs residents. These included the kitchen, dining room area and living room. The common areas were checked for cleanliness and furniture was checked for functionality. Common areas observed to be furnished.

LPA reviewed the food service areas, food storage and supply (perishable and nonperishable foods). The
kitchen food supply was observed and sufficient for the three (3) residents currently residing there. Two (2) days of perishable food observed. The freezer is stocked with meats and frozen vegetables. The medication, sharps and first aid kit are stored in single cabinet near sink. The medications and sharps were observed to be inaccessible to residents. There is one (1) fire extinguisher attached to family room wall. Fire extinguisher observed to be charged.

Laundry room is in hallway behind accordion doors. The appliances observed to be functional.

Due to time constraints this required annual will be completed at a later time.

Exit interview conducted/Copy of report given.
SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Tihesha Smith
LICENSING EVALUATOR SIGNATURE: DATE: 02/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/23/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1