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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306001939
Report Date: 09/18/2024
Date Signed: 09/18/2024 02:40:55 PM

Document Has Been Signed on 09/18/2024 02:40 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:A.C.E. ADVANCED CARE FOR ELDERLYFACILITY NUMBER:
306001939
ADMINISTRATOR/
DIRECTOR:
GEORGETA FIRUTAFACILITY TYPE:
740
ADDRESS:2400 TRYON AVE.TELEPHONE:
(714) 926-4902
CITY:ANAHEIMSTATE: CAZIP CODE:
92806
CAPACITY: 6CENSUS: 4DATE:
09/18/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:00 PM
MET WITH:Georgeta FirutaTIME VISIT/
INSPECTION COMPLETED:
03:00 PM
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Licensing Program Analyst (LPA) Lydia Martinez made an unannounced visit for the purpose of conducting a Required 1 Year inspection. LPA met with Caregivers Yocelin Verastica Meza and Francis Montiel Mata and purpose of visit was shared. Administrator (AD) Georgeta Firuta arrived shortly after. AD's Certificate expired on 08/21/2024. AD stated she has submitted required documentation to renew certificate.

LPA Martinez, along with staff toured the inside and outside of the facility. Facility currently has four residents, of which one resident is in the hospital. There are no residents receiving Hospice care. LPA observed residents were having lunch. Residents were observed clean, content and well taken care of. 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. Backyard has a covered patio for outdoor activities and sufficient seating for residents and visitors. Bedrooms were observed to be spacious and easily accommodate furnishings such as lamps, chair, dresser and a bed. Bathrooms were observed to be clean and 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. Medication was observed locked in a kitchen cabinet. Medications reviewed appear to have been dispensed accurately.
LPA observed the Emergency Disaster Plan posted. LPA reviewed 4 resident files and 2 staff files; and interviewed residents and staff. No documentation of Emergency Drills conducted.

Based on observations made during today's visit, no deficiencies are being cited. LIC9102 Advisories were issued. An exit interview was conducted with Administrator and a copy of this report was sent to email on file
SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Lydia Martinez
LICENSING EVALUATOR SIGNATURE: DATE: 09/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/18/2024
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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