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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306001354
Report Date: 07/24/2024
Date Signed: 07/24/2024 03:53:44 PM

Document Has Been Signed on 07/24/2024 03:53 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:DIAMOND MANORFACILITY NUMBER:
306001354
ADMINISTRATOR/
DIRECTOR:
LOPEZ, CORAZONFACILITY TYPE:
740
ADDRESS:15460 MARLBOROUGH CIRCLETELEPHONE:
(714) 486-2737
CITY:WESTMINSTERSTATE: CAZIP CODE:
92683
CAPACITY: 6CENSUS: 5DATE:
07/24/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:Corazon LopezTIME VISIT/
INSPECTION COMPLETED:
04:00 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) Lydia Martinez made an unannounced visit on this day for the purpose of conducting an Annual Required inspection. LPA met with Licensee/Administrator (AD) Corazon Lopez.

The facility is a single story home with an attached garage, four resident bedrooms, one resident bathroom, one staff bedroom, kitchen, dining room and living room. The facility has a pool which is secured by an iron fence. Of the five resident's in care AD Lopez reports there is one resident receiving hospice services. LPA Martinez, along with Staff conducted a tour of the inside and outside of the facility, and observed the following: LPA observed the facility to be clean and in good repair. The home is maintained at a comfortable temperature. Lighting is sufficient for safety and comfort. LPA observed a table and chairs in back porch area for residents and visitors. Bedrooms were observed to be spacious and easily accommodate furnishings such as lamps, chair, dresser and a bed. Bathroom was observed to be clean, have a supply of soap and paper towels. Hot water temperature was within regulatory requirements. Linen and hygiene supplies were stocked. Emergency Phone Numbers and Exit Plan were reviewed. Food prep area is clean and organized. Food supply meets the requirement of one (1) week supply of non-perishable and two (2) day supply of perishables. Smoke detectors and carbon monoxide detectors were found to be operational. Fire Extinguishers were charged and mounted. Stove burners, dishwasher, microwave, washer, and dryer are operational. Chemicals and sharps are made inaccessible to the residents. Laundry is done in the garage. Medications are centrally stored in a locked medication cart. Medications reviewed appear to have been dispensed accurately. LPA Martinez interviewed 4 of 5 residents and reviewed five resident files. LPA observed the following but not limited to: admission agreements, physician reports, consent forms and personal rights. LPA review staff files and observed the following but not limited to: criminal record clearance, criminal record statement, First Aid, and TB test. LPA confirmed Administrator has a current Administrator's certificate which expires 2/28/2025.

Based on the observations made during today's visit, no deficiency is being cite. An exit interview was conducted with Administrator and a copy of this report was provided at the end of the visit via email.
SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Lydia Martinez
LICENSING EVALUATOR SIGNATURE: DATE: 07/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/24/2024
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