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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306005591
Report Date: 06/18/2021
Date Signed: 06/18/2021 02:03:27 PM

Document Has Been Signed on 06/18/2021 02:03 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:LIVING THE DREAM CARE HOMEFACILITY NUMBER:
306005591
ADMINISTRATOR:RADU, CRISTINA SFACILITY TYPE:
740
ADDRESS:17391 BONNER DRTELEPHONE:
(714) 734-6501
CITY:TUSTINSTATE: CAZIP CODE:
92780
CAPACITY: 6CENSUS: 5DATE:
06/18/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:10 PM
MET WITH:Cristina Radu, AdministratorTIME COMPLETED:
02:22 PM
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Licensing Program Analyst (LPA) Ruth Martinez conducted an unannounced visit for the purpose of conducting a required inspection visit. LPA was greeted at the door by caregiver and granted entry. LPA advised caregiver the reason for the visit. Administrator arrived shortly after.

LPA began the tour of the facility accompanied by caregiver. The facility currently has 5 residents in care. LPA observed residents in dinning room having lunch upon entry. All residents appeared happy and well taken care of. Facility appears clean and sanitary. Facility staff screens all visitors to the facility and LPA observed the screening station in the entrance of the facility. Facility keeps documentation in regard to covid for all the staff and resident. At 12:34pm LPA tested the hot water temperature in bathrooms which are used by the residents. The hot water temperature was measured at 116.8 Fahrenheit degrees. LPA observed facility has covid precautionary posting through out the facility as well as all required department postings. Facility has an active coid-19 prevention plan in place for the safety of residents in care. LPA observed ample of emergency food and water as well as first aid kits in the facility. Facility has an ample supply of PPE, incontinence, and cleaning supplies. Facility has sanitation precaution in place through out the facility and all common spaces. LPA toured the outside and observed a shaded outside space for resident, area is used for outdoor visitation as well. Facility has a plan for covid testing residents and staff as needed as well as a plan for isolation as needed. Facility bedrooms are currently single occupancy and plans to remain that way until further notice.

Based on the observations made during today’s visit, no deficiencies were noted today per Title 22 Division 6 of the California Code of Regulations.

An exit interview was conducted, this report was reviewed with Administrator and a copy of this report was provided and left at facility.
SUPERVISORS NAME: Marina Stanic
LICENSING EVALUATOR NAME: Ruth Martinez
LICENSING EVALUATOR SIGNATURE: DATE: 06/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/18/2021
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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