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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306005798
Report Date: 10/10/2024
Date Signed: 10/10/2024 08:10:45 AM

Document Has Been Signed on 10/10/2024 08:10 AM - 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:PARK VIEW ESTATESFACILITY NUMBER:
306005798
ADMINISTRATOR/
DIRECTOR:		MARIA ARRIAGAFACILITY TYPE:
740
ADDRESS:11360 WARNER AVE.TELEPHONE:
(949) 333-3486
CITY:FOUNTAIN VALLEYSTATE: CAZIP CODE:
92708
CAPACITY: 150CENSUS: 118DATE:
10/10/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
07:35 AM
MET WITH:Tina Tanus- Life Enrichment DirectorTIME VISIT/
INSPECTION COMPLETED:
08:25 AM
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Licensing Program Analyst (LPA) Jessica Cho arrived unannounced for the purpose to clear the deficiency cited during the 10-day complaint investigation conducted on September 25, 2024 from 7:32am to 12:30pm. LPA was greeted and allowed entry by Concierge Paige Pheng and notified the lead management staff on duty. LPA met with Life Enrichment Director Tina Tanus and explained the purpose of the visit.
  • 87303 Maintenance and Operation(a) The facility shall be... in good repair at all times. - The elevator was tested at 7:47am. Malfunctioning issue resolved on September 26, 2024.


Facility has complied with the terms of the plan of correction. The deficiency is now cleared.

An exit interview was conducted with Life Enrichment Director Tina Tanus and Executive Director Peggy Ulland by telephone, and a copy of this report including the Letter of Deficiency Citations Cleared were provided at the end of the visit.
SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Jessica Cho
LICENSING EVALUATOR SIGNATURE: DATE: 10/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/10/2024
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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