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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306006148
Report Date: 08/04/2022
Date Signed: 08/04/2022 11:38:00 AM

Document Has Been Signed on 08/04/2022 11:38 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
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME:GRAND VIEW VILLAS INC.FACILITY NUMBER:
306006148
ADMINISTRATOR:AMLANI, ROZINAFACILITY TYPE:
740
ADDRESS:25262 VIA DE ANZATELEPHONE:
(714) 348-4793
CITY:LAGUNA NIGUELSTATE: CAZIP CODE:
92677
CAPACITY: 6CENSUS: 6DATE:
08/04/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:58 AM
MET WITH:Patricia Ceno, Celina GarciaTIME COMPLETED:
11:50 AM
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On 8/04/2022 at 11:06am, LPA Jessica Cho conducted an unannounced visit to Valley Residential Elderly Care II. The initial purpose of today's visit was to conduct a Required 1 year visit to Valley Residential Elderly Care II. LPA met with Caregivers Celina Garcia and Patricia Ceno, and it was determined that the facility at 25262 Via De Anza is operating under a new ownership and licensed under Grand View Villas Inc. #306006148. For this reason, LPA conducted a Case Management visit to Grand View Villas Inc. At 11:17am, LPA spoke to Licensee Rozina Amlani via the facility telephone and discussed the purpose of today's visit. Licensee Rozina Amlani authorized Facility Representative/Caregiver Patricia Ceno to sign the report on behalf of the licensee. LPA Cho discussed with Licensee Amlani that the primary LPA, Joseph Alejandre, will conduct the 90 day subsequent visit to Grand View Villas Inc. LPA Cho ended the telephone call with Licensee Rozina Amalani.

An exit interview was conducted with Caregiver Patricia Ceno, and a copy of this report was provided at the time of this visit.


SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Jessica Cho
LICENSING EVALUATOR SIGNATURE: DATE: 08/04/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/04/2022
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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