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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306002535
Report Date: 08/08/2023
Date Signed: 08/08/2023 03:13:48 PM

Document Has Been Signed on 08/08/2023 03:13 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, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME:PARADISE RESIDENTIAL HOMEFACILITY NUMBER:
306002535
ADMINISTRATOR:NOEMI FIGUEROAFACILITY TYPE:
740
ADDRESS:546 N. WRIGHTWOOD DRIVETELEPHONE:
(714) 516-2750
CITY:ORANGESTATE: CAZIP CODE:
92869
CAPACITY: 6CENSUS: 5DATE:
08/08/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:19 PM
MET WITH:Noemi Figueroa, AdministratorTIME COMPLETED:
03:18 PM
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A case management was conducted on this date in conjunction with delivery of findings for complaint control #22-AS-20200701110909.
On today's date, LPA Quiroz along with Administrator (AD) Noemi Figueroa conducted a tour of interior and exterior of facility premises. On or about 2:25pm, while LPA Quiroz along with (AD) Figueroa were conducting facility tour and inspecting Resident 1 and Resident 2's bedroom area, LPA Quiroz observed Resident 3 inside Resident 1 and Resident 2's bathroom area. This was verified with Administrator Noemi Figueroa and 2 of 2 caregivers present in the facility.
LPA Quiroz provided consultation on 87468.1(a(1)(2)(3):Personal Rights of Residents in All Facilities.


Based on today's facility inspection, an Advisory Note Technical violation (LIC 9102 TV) was conducted on today's date. No citations were issued during today's visit.
An exit interview was conducted with (AD) Noemi Figueroa, and a copy of this report along with LIC-811 Confidential Names and LIC 9102 TV were provided at exit.
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Rosie Quiroz
LICENSING EVALUATOR SIGNATURE: DATE: 08/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/08/2023
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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