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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197607729
Report Date: 10/15/2023
Date Signed: 10/15/2023 03:30:22 PM

Document Has Been Signed on 10/15/2023 03:30 PM - 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, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME:ALL SEASONS HOMES, INC.FACILITY NUMBER:
197607729
ADMINISTRATOR:ANN LIZA CALDERON-MACIASFACILITY TYPE:
735
ADDRESS:3202 WEST ALBRET STREETTELEPHONE:
(661) 522-7473
CITY:LANCASTERSTATE: CAZIP CODE:
93536
CAPACITY: 4CENSUS: 4DATE:
10/15/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:13 PM
MET WITH:Jamela EnerioTIME COMPLETED:
03:45 PM
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Licensing Program Analyst (LPA) Michael Cava conducted an Annual Required visit and inspection of the facility. LPA met with staff, Jamela Enrio, and explained the reason for the visit.

At approximately 12:13pm, with the assistance of staff, LPA took a tour of the physical plant. Required postings were observed in the entry area. The smoke alarms are battery operated. The carbon monoxide detector is located by the front entrance, at the living room, that functions properly. The fire extinguisher is located in the kitchen. It was purchased on 10/09/23. Both fire and earthquake drills were conducted on 10/03/23.

Kitchen: The kitchen appliances and fixtures were functional. LPA found a sufficient amount of perishable and non-perishable food at the facility; properly stored.

Bedrooms: There were five (5) bedrooms. Four bedrooms are designated for residents' use. Three rooms are private and one is shared. There is also a staff room. The four bedrooms, in use by residents were were properly furnished with appropriate beddings and linens with sufficient lighting.

Bathrooms: There are three (3) bathrooms designated for residents' use. Bathrooms were properly supplied and had functional fixtures. Hot water temperature was measured at 105 degrees Fahrenheit. There were no cleaning supplies kept in the bathrooms.

Common Areas: These included the living room, family room, and dining area. The common areas were properly furnished. The dining room has a table large enough to seat four (4), but can seat six if needed. There is a common computer area for the resident use, with internet access, located by the kitchen. Indoor activities and exercise equipment, including treadmill was observed. There is a fireplace, that is functional. A screen and glass door was observed. No tools or lighting equipment (lighter, matches) were present.
SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Michael Cava
LICENSING EVALUATOR SIGNATURE: DATE: 10/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/15/2023
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: ALL SEASONS HOMES, INC.
FACILITY NUMBER: 197607729
VISIT DATE: 10/15/2023
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Surrounding Grounds: Entry/exits were free of obstruction. There was furniture appropriate for outdoor
use. LPA observed a pool table, ping pong table, and miniature basketball court for outdoor activities. Furthermore, there was sufficient space in the backyard to hold outdoor exercise and activities. The outdoor area was free of hazards. The laundry area is located in the hallway, in between resident rooms #3, #4 and the garage. Cleaning supplies and detergents were observed locked. The garage is used for storage for supplies and extra food. A key is required to gain access into the garage.

OFFICE/STAFF WORKSTATION: Facility has both an office and work station for staff. The work station is located by the dining room. Medications and medication records kept at this location. Staff and resident records also maintained at this location. These items were locked. The staff office, is located by the front entry. Staff meetings held in this room. PPE supplies were also maintained there.

Resident Files: LPA conducted a file review of resident records to insure compliance of licensing forms.

Staff Files: LPA also conducted a file review of staff records to insure forms and training are up to date and compliance with licensing forms.

Medications: Medication and Medication Records were review for proper documentation.

Pursuant to Title 22 Division 6 of the CA Code of Regulations, there were no deficiencies observed during the day's visit. Exit Interview Conducted and a Copy of the Report Issued.
SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Michael Cava
LICENSING EVALUATOR SIGNATURE:

DATE: 10/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2023
LIC809 (FAS) - (06/04)
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