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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306005819
Report Date: 07/25/2024
Date Signed: 07/25/2024 02:19:01 PM

Document Has Been Signed on 07/25/2024 02:19 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:ORANGE POINT HOME CAREFACILITY NUMBER:
306005819
ADMINISTRATOR/
DIRECTOR:
LOMEDA, SHIRLEYFACILITY TYPE:
740
ADDRESS:6911 SAN JUAN CIRCLETELEPHONE:
(714) 886-2282
CITY:BUENA PARKSTATE: CAZIP CODE:
90620
CAPACITY: 6CENSUS: 5DATE:
07/25/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
07:45 AM
MET WITH:Shirley LomedaTIME VISIT/
INSPECTION COMPLETED:
02:25 PM
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Licensing Program Analysts (LPA) Jerome Haley conducted an unannounced visit for the purpose of conducting a required one-year annual inspection. LPA Haley was greeted and granted entry by staff and explained the reason for the visit. Staff contacted Administrator Shirley Lomeda who arrived a short time later and was present for the remainder of the of the visit.

During the inspection, LPA Haley observed all resident bedrooms and bathrooms. All resident bedrooms had the necessary elements and were in compliance with regulation guidelines.

Resident bathrooms were clean and organized. Hot water temperatures were measured in the range of 116.6 degrees Fahrenheit and 117.1 degrees Fahrenheit. All grab bars were tightly secured to the wall. No hazardous items were observed.

In the kitchen knives and sharp objects are locked in a drawer next to the dishwasher. The stove was clean and operational. A perishable food supply that meets regulation requirements was observed in the refrigerator and a non-perishable food supply that meets regulation requirements was observed in the cabinets. A fire extinguisher was observed mounted on the wall in the kitchen next the washer and dryer.

The garage was clean, organized, free of clutter, and walkways were free of obstruction. LPA observed a emergency disaster kit prepared and ready to go, and a backup supply of non-perishable food items for the residents.

The backyard was clean, organized, and walkways were free of obstruction. A shaded patio area with a table and chairs was observed. There’s a shed that’s used to store miscellaneous facility items no longer being used, including walkers, a bed frame mattress and other items.

During the visit, a staff record review was completed for 3 staff members including Administrator Lomeda, 5 of 5 resident medications were reviewed, and all 5 resident files were reviewed.

Continued on LIC809C

SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Jerome Haley
LICENSING EVALUATOR SIGNATURE: DATE: 07/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/25/2024
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 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME: ORANGE POINT HOME CARE
FACILITY NUMBER: 306005819
VISIT DATE: 07/25/2024
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Smoke detectors, and carbon monoxide detectors tested operational. A fully charged fire extinguisher was observed mounted on the wall in the kitchen.

An emergency evacuation drill was conducted April 15, 2024, and will continue to be conducted quarterly for staff on each shift.

No deficiencies will be cited during today’s visit. However, Technical Advisories will be issued for observations made during the inspection: Items need to be removed from behind the shed in the backyard and one of the burners on the stove needs to be cleaned or serviced to light properly.

An exit interview was conducted, and a copy of this report was provided to Administrator Shirley Lomeda.

SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Jerome Haley
LICENSING EVALUATOR SIGNATURE:

DATE: 07/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/25/2024
LIC809 (FAS) - (06/04)
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