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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306006412
Report Date: 10/28/2024
Date Signed: 10/28/2024 10:18:25 AM

Document Has Been Signed on 10/28/2024 10:18 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:ABSOLUTE ELDERLY CARE,CORP.FACILITY NUMBER:
306006412
ADMINISTRATOR/
DIRECTOR:		SANCHEZ, ISRAELFACILITY TYPE:
740
ADDRESS:13432 WINTHROPE STREETTELEPHONE:
(714) 538-0050
CITY:SANTA ANASTATE: CAZIP CODE:
92705
CAPACITY: 6CENSUS: 0DATE:
10/28/2024
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Isarael SanchezTIME VISIT/
INSPECTION COMPLETED:
10:30 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) Jerome Haley made an announced visit to conduct the second pre-licensing inspection. LPA Haley was greeted and granted entry and explained the reason for the visit.

During a tour of the facility, LPA Haley observed that the following items have been corrected:

1) Repair or replace the stove. The top right burner on the stove is not working and the light above the stove needs to be replaced or repaired. The part needed to replace the stove has been ordered and will arrive Friday, November 1, 2024.


2) Remove all personal items from the resident bedrooms. Personal Items have been removed from the bedrooms.
3) Adjust the hot water temperature to meet regulation requirements. Hot water was measured in the range of 110.1 – 113.3 degrees F.
4) Post a sample menu on the refrigerator – A sample menu has been posted on the refrigerator.
5) Place a lock on the cold (ice/water) therapy tank – Two locks have been placed on the therapy tank in the backyard.
6) Wires – Secure cover on phone jack in room #1 – Phone jack cover has been installed and the wires are no longer exposed.
7) Get bedframes for rooms without beds. Beds have been ordered and have been set up in resident bedrooms. Applicants are waiting on the arrival of 2 more beds for bedroom #4.
8) Non-skid matts for showers. – Non-skid matts have been placed in the showers.
9) Facility Postings board for required items: personal rights, house rules, infection control plan, etc. – Facility postings board has been posted on the wall near the entrance of the facility.
10) Emergency items (food, water, flashlights, batteries). – Disaster supplies, an emergency food supply, and an emergency water supply was observed in the garage.

Continued on LIC809C
SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Jerome Haley
LICENSING EVALUATOR SIGNATURE: DATE: 10/28/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/28/2024
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 2
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: ABSOLUTE ELDERLY CARE,CORP.
FACILITY NUMBER: 306006412
VISIT DATE: 10/28/2024
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
26
27
28
29
30
31
32
Applicant has 2 corrections still pending before being recommended for licensure:

1) Stove – Repairs need to be completed.

2) Resident beds – 2 resident beds need to be delivered and installed in bedroom #4.

Component III was not presented at this time as the facility still has 2 corrections needed.

An exit interview was conducted and a copy of this report was provided to Applicant Isarael Sanchez.

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

DATE: 10/28/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2024
LIC809 (FAS) - (06/04)
Page: 2 of 2