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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198602971
Report Date: 10/01/2024
Date Signed: 10/01/2024 03:31:23 PM

Document Has Been Signed on 10/01/2024 03:31 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, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME:YEARLING ARF INCORPORATEDFACILITY NUMBER:
198602971
ADMINISTRATOR/
DIRECTOR:		MACHADO, MARYFACILITY TYPE:
735
ADDRESS:11309 YEARLING STTELEPHONE:
(714) 875-8388
CITY:CERRITOSSTATE: CAZIP CODE:
90703
CAPACITY: 4CENSUS: 4DATE:
10/01/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:28 PM
MET WITH:Administrator Julie MachadoTIME VISIT/
INSPECTION COMPLETED:
03:45 PM
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On 10/01/24, Licensing Program Analyst (LPA) Jewel Baptiste conducted an unannounced Annual/Required inspection to Yearling ARF incorporated. Upon arrival LPA was greeted by Administrator Julie Machado and explained the reason for the visit. This home is licensed to serve (4) Developmentally Disabled Ambulatory Adults, (3) non-Ambulatory and (1) Ambulatory Adults ages 18 through 59. There are three (3) age exception waivers in place. The home is vendored through Harbor Regional Center. There were (1) nonverbal client in care during the time of this visit. The last emergency disaster/fire drill was conducted on 9/15/2024. The Administrator Certificate expires on 05/02/2024 #6068595735. During today's visit LPA inspected the physical plant inside and outside, reviewed the food supply, tested the smoke/carbon monoxide detectors, reviewed (4) client files, medications, and medication administration records for (4) clients and P&I.

This home contains 4 bedrooms, 1 vacant bedroom, 1 bathroom, 1 staff bathroom, living room/office with fireplace, kitchen, living room/ dining room and an attached garage. LPA toured the physical plant with DSP Noelia Vidales, and observed all (4) client bedrooms, contained required furniture, lamps, dresser, chair, and closet space. The bathrooms contain a working toilet, basin, and water faucet, walk in shower with grab bar, shower chair, and bath strips. The temperature measured at 108.5*F-108.6*F respectively. The smoke detectors were battery operated and individually tested and observed to be working properly. The carbon monoxide detector was located throughout the facility, tested, and functioning properly. There were (2) fire extinguishers located in kitchen and garage fully charged and up to date. The kitchen was toured and contained working appliances; refrigerator, stove, oven and contained dishware, cups, plates, utensils, pots, and pans. The knives were secured and locked in a kitchen draw. The cleaning agents and toxins was locked and secured underneath kitchen sink. The pantry was well stocked with canned goods, pasta, cereals, and the food supply contained a sufficient supply with a two-day supply of perishables and a seven-day supply of non-perishables that met title 22 guidelines. Walls and floors, cabinets and counters were clean and sanitary throughout the home. (Report continued on LIC809C.)
SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Jewel Baptiste
LICENSING EVALUATOR SIGNATURE: DATE: 10/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/01/2024
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: YEARLING ARF INCORPORATED
FACILITY NUMBER: 198602971
VISIT DATE: 10/01/2024
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The outdoor grounds were toured and inspected, and the patio was well maintained with a shaded seating area accessible for client use. The garage contained a working washer and dryer, with cabinetry that contained emergency supply kits, bottled water, toiletries, personal care supplies, and toxins and cleaning agents stored locked and inaccessible to the clients.

Exit interview conducted with Administrator Julie Machado, a copy of this report was provided.
SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Jewel Baptiste
LICENSING EVALUATOR SIGNATURE:

DATE: 10/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/01/2024
LIC809 (FAS) - (06/04)
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