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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197607729
Report Date: 06/04/2025
Date Signed: 06/04/2025 04:45:30 PM

Document Has Been Signed on 06/04/2025 04:45 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
N LA & CEN COA AC/SC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME:ALL SEASONS HOMES, INC.FACILITY NUMBER:
197607729
ADMINISTRATOR/
DIRECTOR:		ANN LIZA CALDERON-MACIASFACILITY TYPE:
735
ADDRESS:3202 WEST ALBRET STREETTELEPHONE:
(661) 522-7473
CITY:LANCASTERSTATE: CAZIP CODE:
93536
CAPACITY: 4CENSUS: 4DATE:
06/04/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:30 PM
MET WITH:Ann Liza Calderon-Macias -AdministratorTIME VISIT/
INSPECTION COMPLETED:
05:00 PM
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On 06/04/2025 at 1:30 p.m., Licensing Program Analyst (LPA) Evelin Rios arrived at the facility listed above to conduct an unannounced annual inspection using the Inspection Tool. LPA rang the door bell and was greeted by staff #1 (S1) who granted access. S1 contacted the administrator, Ann Liza Calderon-Macias. Administrator met LPA shortly after and LPA explained the reason for the visit.

At approximately 1:47 p.m., with the assistance of the administrator and S1, LPA conducted a physical plant tour. LPA observed appropriate postings by the entry and on the hallway to the clients bedrooms.

Kitchen: The kitchen appliances and fixtures were functional. LPA observed a sufficient amount of 7-day non-perishable and a 2-day perishable supply of food at the facility, properly stored. The fire extinguisher is located in the kitchen and was purchased on 10/03/24.

Bedrooms: There are five (05) bedrooms available for clients, with one designated as a shared bedroom. Each bedroom is well-furnished, with appropriate bedding, sufficient lighting, and storage

Bathrooms: There are three (3) bathrooms designated for clients. All bathrooms were properly supplied and had functional fixtures. Hot water temperature was measured at 105 degrees Fahrenheit. Bathrooms are supplied with hand soap, toilet paper and paper towels but clients have the option to use a bidet and hand dryer.

(Continue to LIC809-C)
NAME OF LICENSING PROGRAM MANAGER: Eva Miller
NAME OF LICENSING PROGRAM ANALYST: Evelin Rios
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 06/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/04/2025
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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
N LA & CEN COA AC/SC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: ALL SEASONS HOMES, INC.
FACILITY NUMBER: 197607729
VISIT DATE: 06/04/2025
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(Continue from LIC809)Common Areas: These included the formal living room, family room and dining areas. The common areas were properly furnished. The dining areas have tables and chairs that sit the capacity of the facility. All furniture was observed in good repair. In the family room there is a television and games for clients. There is fire place in the family room secured with a screen. Sharps and clients' medication and facility records were observed stored locked in cabinets in the formal living room.

Laundry/Garage: Laundry room is accessible to clients located by client bedrooms. Detergents and cleaning supplies were observed locked in a cabinet in the laundry room. The garage was observed looked. In the garage the facility keeps extra facility supplies and an overflow of food supplies.

Surrounding Grounds: Entry/exits were free of obstruction. There was shade and furniture appropriate for outdoor use. The backyard was sufficient in space for outdoor activities. The outdoor area was free of hazards.

Resident Files: At 2:35 p.m., LPA reviewed four (04) of four (04) client records. Records were observed complete and up-to-date. Medications and centrally stored medication records were also reviewed.

Staff Files: LPA conducted a file review of two (02) staff records to insure forms and training are up-to-date and in compliance with licensing forms. Files were observed complete and up-to-date.

The smoke detectors are hardwired and interconnected located through out the facility. LPA observed the administrator test the detectors at 4:11 p.m. Detectors were observed to be functioning properly. LPA tested the carbon monoxide detector by the entry and it was functioning properly.

Pursuant to Title 22 Division 6 of the CA Code of Regulations, there were no deficiencies observed during the visit. Exit interview conducted and a copy of the report provided.
NAME OF LICENSING PROGRAM MANAGER: Eva Miller
NAME OF LICENSING PROGRAM ANALYST: Evelin Rios
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2025
LIC809 (FAS) - (06/04)
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