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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197607393
Report Date: 02/16/2022
Date Signed: 02/16/2022 12:13:07 PM

Document Has Been Signed on 02/16/2022 12:13 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 INC.IIIFACILITY NUMBER:
197607393
ADMINISTRATOR:JAMES DURANDOFACILITY TYPE:
740
ADDRESS:36235 43RD STREET EASTTELEPHONE:
(661) 917-4380
CITY:PALMDALESTATE: CAZIP CODE:
93552
CAPACITY: 4CENSUS: 3DATE:
02/16/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:20 AM
MET WITH:Rebecca Dinges, StaffTIME COMPLETED:
12:30 PM
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At 10:20am Licensing Program Analyst (LPA), Angela Panushkina, conducted an unannounced annual inspection at the facility mentioned above. LPA was greeted by Rebecca Dinges (staff), who granted access to the facility. The Administrator was contacted over the phone and LPA explained the reason for the visit.

At 10:30am, LPA conducted a tour of the facility with staff and the following was observed:

Infection control: Upon arrival, LPA was screened and asked to sign-in the visitors’ log. In addition, LPA was asked all infection control questions. Proper signage was observed inside along the hallway and in the restrooms. Hand sanitizer was also observed. Staff stated they have sufficient PPE supplies for residents and staff. LPA observed all trash cans throughout the facility have fitted lids.

Kitchen: LPA toured the kitchen area and observed enough supplies of staple non-perishable for minimum 1 week and perishable for 2 days at the facility. All knives and sharps are observed to be locked in a kitchen drawer and inaccessible to residents. The fire extinguisher was last serviced on 04/15/21.

Smoke detectors/carbon monoxide. Dual smoke and carbon monoxide detectors were located throughout the facility, and at 11:15am they were tested and observed to be operational.

Bedrooms: There are four (4) bedrooms designated for residents use and have sufficient lighting. All bedrooms are properly furnished, clean and have appropriate bedding and linens.

Bathrooms: At 10:45am LPA observed all bathrooms are clean and in good repair. Properly supplied with toilet papers, soap and paper towels. The hot water temperature measured at 105°F. LPA observed


appropriate grab bar and non-skid mat. LPA observed appropriate hand washing signs posted in each bathroom. All trash cans in bathrooms had fitted lids to protect from cross contamination.
Continue on LIC809-C
SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Angela Panushkina
LICENSING EVALUATOR SIGNATURE: DATE: 02/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/16/2022
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		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 INC.III
FACILITY NUMBER: 197607393
VISIT DATE: 02/16/2022
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Common Areas: The facility maintains a comfortable temperature at 72°F. The living room and dining area appeared clean and were properly furnished and the fireplace is adequately screened. No obstructions and or tripping hazards throughout the facility.

Outside areas: At approximately, 11:00am LPA toured the outside area of the facility. LPA observed appropriate outdoor furniture, with a covered shaded area for residents. The facility has an in ground pool in the backyard that has fencing and a lock on the gate and is inaccessible to residents. There is an empty one acre lot in a back yard that has fencing and a lock on the gate. LPA discussed the importance of maintaining the care and supervision to meet the needs of residents.

The garage: Laundry area is located in an attached garage and kept locked and inaccessible to residents. Extra PPE supplies and food storage was also observed.



Medications: At approximately, 10:35am LPA observed medications are centrally stored and locked in a kitchen cabinet, area and inaccessible to residents in care.

Administrative: LPA collected Certificate of Liability Insurance and LIC.500.

No citations issued during this visit. Exit interview conducted. Copy of report emailed to Licensee.

SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Angela Panushkina
LICENSING EVALUATOR SIGNATURE:

DATE: 02/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/16/2022
LIC809 (FAS) - (06/04)
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