<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306006165
Report Date: 07/15/2022
Date Signed: 07/15/2022 09:57:11 AM

Document Has Been Signed on 07/15/2022 09:57 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:ABLELIGHT, INC. -- OSPREYFACILITY NUMBER:
306006165
ADMINISTRATOR:KUM, JENNIFERFACILITY TYPE:
740
ADDRESS:24411 OSPREY STREETTELEPHONE:
(949) 837-5385
CITY:LAKE FORESTSTATE: CAZIP CODE:
92630
CAPACITY: 4CENSUS: 5DATE:
07/15/2022
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
08:59 AM
MET WITH:Administrator - Jennifer Kum
Program Manager - Maria Amedo 		TIME COMPLETED:
10:15 AM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA) Celine De Perio conducted a continuation prelicensing visit to follow up on the needed updates discussed on 7/8/22. LPA De Perio was greeted and granted entry by facility administrator (AD) Jennifer Kum. Program Manager (PM) Maria Amedo toured LPA De Perio around facility.

For this visit, the following updates were reviewed:
  • Hand-washing signs posted in restrooms: COMPLETED- posted in each restroom and kitchen.
  • Ombudsman poster posted: COMPLETED- posted at the main entrance and staff office.
  • Auditory exit alarms: COMPLETED- placed in each bedroom, and doors.
  • Backyard gates to be self-latching and self-closing: COMPLETED- both gates are self-latching and self-closing.
  • Stabilize outside wooden railing: COMPLETED- backyard wooden railing is stabilized.

As of this time, the Licensee does not plan to advertise for special dementia care program.
The prelicensing and Component III have been completed.

LPA De Perio will provide a copy of this report to Centralized Applications Bureau (CAB) for review, and final determination of the application.
LPA De Perio conducted an exit interview with AD Kum and PM Amedo, and a copy of this report was provided to the facility.
SUPERVISORS NAME: Luz Adams
LICENSING EVALUATOR NAME: Celine DePerio
LICENSING EVALUATOR SIGNATURE: DATE: 07/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/15/2022
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 1