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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306001252
Report Date: 12/18/2024
Date Signed: 12/18/2024 05:57:18 PM

Document Has Been Signed on 12/18/2024 05:57 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
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME:BUBBE & ZAYDE'S PLACE IIFACILITY NUMBER:
306001252
ADMINISTRATOR/
DIRECTOR:
CURKIN, BONNIEFACILITY TYPE:
740
ADDRESS:1533 E. 20TH ST.TELEPHONE:
(714) 542-3939
CITY:SANTA ANASTATE: CAZIP CODE:
92705
CAPACITY: 6CENSUS: 4DATE:
12/18/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
04:15 PM
MET WITH:Juana GonzalezTIME VISIT/
INSPECTION COMPLETED:
06:15 PM
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Licensing Program Analyst (LPA) Lydia Martinez made an unannounced visit to the facility to conduct a Required - 1 year inspection. LPA identified herself and was granted entry into the facility by Caregiver (CG) Lampaida "Aida" Casciano. Supervisor Juana Gonzalez and Administrator (AD) Bonnie Curkin arrived shortly after and reason for the visit was explained. AD Curkin's Administrator certificate expires on 10/12/2026.

There are 4 Residents present and one staff during the visit. One resident is receiving Hospice care. LPA, along with Supervisor Gonzalez toured the physical plant. LPA observed the facility to be clean, sanitary and in good repair. The home is maintained at a comfortable temperature. Resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each Resident comfortably. Bathrooms were checked, toilets/water faucets worked properly and shower was free of mold/mildew. Hot water temperature was within regulatory requirements. Bath towels, toiletries and personal hygiene supplies were adequately stocked. Common areas were clean and clear of hazards, doorways were free of obstructions. Kitchen is clean and organized. Perishable and non-perishable food supply was checked and adequately stocked. LPA observed sharps and cleaning supplies are inaccessible to the Residents. Smoke detectors and carbon monoxide detector tested operational; Fire extinguisher was fully charged and mounted. No bodies of water were observed outside. Walkways around the home were clear of hazards. Exit gates are unlocked and self-latching. Outside activities are conducted at the Main home which has sufficient seating for Residents and visitors. Emergency/Fire Drills are conducted last one being 07/19/2024. LPA observed emergency supplies including food and water. LPA reviewed four Resident files. All the required documentation was present and current. LPA reviewed one staff file. Staff has a criminal record clearance and is associated to the facility. LPA observed staff file reviewed has a current First Aid/CPR certificate. Medication was observed to be in a centrally stored location and medication reviewed appeared to have been dispensed accurately.

Based on the observations made during today’s visit, no deficiency is being cited. This report was discussed with the Supervisor Gonzalez and a copy of the report and LIC9102 Advisory were sent to email on file.

SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Lydia Martinez
LICENSING EVALUATOR SIGNATURE: DATE: 12/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/18/2024
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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