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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306000622
Report Date: 09/20/2024
Date Signed: 09/20/2024 10:53:03 AM

Document Has Been Signed on 09/20/2024 10:53 AM - 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, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME:ARCENE GUEST HOME IIFACILITY NUMBER:
306000622
ADMINISTRATOR/
DIRECTOR:		MAILA ENRIQUEZFACILITY TYPE:
740
ADDRESS:508 MICHEL PLACETELEPHONE:
(714) 996-4717
CITY:PLACENTIASTATE: CAZIP CODE:
92870
CAPACITY: 6CENSUS: 3DATE:
09/20/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Maila Enriquez SolivenTIME VISIT/
INSPECTION COMPLETED:
11:05 AM
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Licensing Program Analyst (LPA) Claudia Gutierrez made an unannounced Plan of Correction (POC) inspection. LPA was greeted and granted entry by. Administrator (AD) Maila Enriquez Soliven and LPA explained the purpose of the inspection.

Deficiencies 1569.605, 1569.625(b)(1), 1569.313, 1569.695(c), and 87468(c)(2)(A) were previously cited on August 6, 2024, during facility's annual/required inspection. During POC visit conducted on September 13, 2024, POCs for citations were extended to close of business Monday, September 16, 2024.

During today's visit, LPA verified four of five POCs have been met. POC for citation 1569.625(b)(1) has been extended to close of business, September 27, 2024.

Based on observations made during today's inspection, no deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted and a copy of this report was left at the facility.

SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Claudia Gutierrez
LICENSING EVALUATOR SIGNATURE: DATE: 09/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/20/2024
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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