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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306006418
Report Date: 01/03/2025
Date Signed: 01/03/2025 09:40:40 AM

Document Has Been Signed on 01/03/2025 09:40 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:CHERISH SENIOR LIVINGFACILITY NUMBER:
306006418
ADMINISTRATOR/
DIRECTOR:
PAUL, VICTORIAFACILITY TYPE:
740
ADDRESS:907 N. CHIPPEWA AVENUETELEPHONE:
(657) 253-2396
CITY:ANAHEIMSTATE: CAZIP CODE:
92801
CAPACITY: 6CENSUS: 4DATE:
01/03/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:14 AM
MET WITH:Victroia Paul TIME VISIT/
INSPECTION COMPLETED:
12:00 PM
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Licensing Program Analyst (LPA) Samer Haddadin is conducting this unannounced visit for the purpose of completing an annual required inspection. LPA arrived at the facility was greeted and granted entry by Administrator (AD) Victoria Paul.
LPA toured the interior and exterior facility and observed the following:
this is a one-story home. Facility is a 5-bedroom, 3-bathroom, 1 story house with an attached garage that is being used for storage. At time of visit the facility had 4 residents in care.

LPA and AD tested smoke detectors/carbon monoxide in common areas and bedrooms; all were operational. Resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably.



LPAs observed fire extinguisher mounted in kitchen and garage areas with last inspection date of on September 8th, 2024. Upon review of record, emergency drill log indicated that the last drill was conducted on October 23rd, 2023.
LPA observed sharps sand knives locked in the kitchen and are inaccessible to residents in care
Restrooms toilets and water faucets were also observed to be operational. Grab bars were secure, and showers were observed to be free of mold/mildew. Water temperature measured between at 105.6 degrees Fahrenheit and 107. degrees Fahrenheit. LPAs and AD toured the backyard of the facility and observed a shaded seating area for residents’ enjoyment. LPA checked emergency exits to be free of obstacles.

LPAs reviewed two residents’ and two staff files and observed they all had the required documentation.



Based on the observations made during today’s inspection, deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted, and a copy of this report and appeal rights were provided to staff at end of inspection.
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Samer Haddadin
LICENSING EVALUATOR SIGNATURE: DATE: 01/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/03/2025
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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