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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306006572
Report Date: 12/20/2024
Date Signed: 12/20/2024 09:27:47 AM

Document Has Been Signed on 12/20/2024 09:27 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:FLOWERS FAMILY CARE 2FACILITY NUMBER:
306006572
ADMINISTRATOR/
DIRECTOR:		MARTINEZ, JONATHANFACILITY TYPE:
740
ADDRESS:2126 E MONROE AVETELEPHONE:
(714) 714-0851
CITY:ORANGESTATE: CAZIP CODE:
92867
CAPACITY: 6CENSUS: DATE:
12/20/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:25 AM
MET WITH:Jonathan Martinez TIME VISIT/
INSPECTION COMPLETED:
09:40 AM
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On 12/20/2024 Licensing Program Analyst (LPA's) William Vanegas, Alvaro Ramirez, and Brandon Lopez made an announced visit for the purposes of a follow up pre licensing visit, Upon arrival LPA's were greeted by Licensee and were granted entrance into the facility. At 8:35AM LPA's began a tour of the home and observed the following corrections were made.

Licensee fixed broken wood panel in the backyard, fixed broken window in dining room, screened fire place, corrected water temperature, and the water tested to be at 112.3 Degrees F. Licensee also fixed sliding door in resident room #2. Licensee also obtained trash cans that have a sealed covering over them. Licensee also screened all windows in dining rooms and in common areas, resident rooms now have screens on them as well.

Component III was completed with Licensee and they were advised that component II will be done by centralized application's bureau (CAB). An exit interview was completed and a copy of this report was left at the facility.
SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: William Vanegas
LICENSING EVALUATOR SIGNATURE: DATE: 12/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/20/2024
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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