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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 300603257
Report Date: 03/07/2022
Date Signed: 03/07/2022 04:24:26 PM


Document Has Been Signed on 03/07/2022 04:24 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, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868



FACILITY NAME:REGENTS POINTFACILITY NUMBER:
300603257
ADMINISTRATOR:FORNEY, MELINDA MFACILITY TYPE:
741
ADDRESS:19191 HARVARD AVENUETELEPHONE:
(949) 854-9500
CITY:IRVINESTATE: CAZIP CODE:
92612
CAPACITY:399CENSUS: 287DATE:
03/07/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:20 AM
MET WITH:Melinda Forney and Ashley CroslinTIME COMPLETED:
12:20 PM
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Licensing Program Analyst (LPA) Kimberly Lyman conducted an unannounced visit to Regents Point. The purpose of today’s visit was to conduct the Required 1 Year inspection. LPA was allowed entry into the facility and met with Executive Director Melinda Forney. Facility is licensed for a capacity of 399 residents including 60 non-ambulatory residents. Facility also has an approved hospice waiver for 12 residents as well as approval for delayed egress. There are 7 residents in the memory care unit, 37 in assisted living and 243 in the independent living. There are 4 residents on hospice care during today's visit. Nurse Manager Sheila Weathers and Director of Wellness Ashley Croslin were present as well. Executive Director Melinda Forney has an administrator certificate expiring on 07/22/2023.

At 10:25 AM, LPA toured the facility with Executive Director and Director of Wellness. Facility consists of Assisted Living, Independent Living and Memory Care units. LPA observed multiple outside shaded visitation areas, dining room, bistro, library, hair salon, gym, and Wellness Center. LPA observed residents relaxing in the facility. All residents appeared happy and well taken care of. Facility appears clean and sanitary. All resident rooms had the required elements as well as restrooms stocked with soap/ sanitizer. All rooms observed are single occupancy. Facility screens all visitors to the facility and LPA observed the screening/ sanitizing station in the facility. Facility utilizes an electronic visitor sign in sheet/ questionnaire. Facility takes resident and staff temperatures daily and documents. Facility has all required department postings. LPA observed the first aid kit has all required items. Facility mitigation plan has been approved. Facility has emergency evacuation chairs at the top of stairwells. LPA observed an ample supply of emergency food and water. Facility has a generator on-site for emergencies. Facility has an outside agency, Phoenix Fire, come into the facility quarterly for fire inspection. Facility maintenance tests smoke and carbon monoxide detectors. LPA toured the outside grounds and observed a secured pool, putting green, and lawn bowling. LPA observed the medication room and facility uses electronic medical records for medication management. Facility has a plan for covid testing residents and staff as needed as well as a plan for isolation and quarantine. CONTINUED ON LIC 809C DATED 03/07/2021.

SUPERVISOR'S NAME: Alisa OrtizTELEPHONE: (714) 703-2855
LICENSING EVALUATOR NAME: Kimberly LymanTELEPHONE: (714) 795-1497
LICENSING EVALUATOR SIGNATURE:
DATE: 03/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/07/2022
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, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME: REGENTS POINT
FACILITY NUMBER: 300603257
VISIT DATE: 03/07/2022
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LPA reviewed select resident files during the visit and all files are up to date including emergency information. Most residents and staff are vaccinated for Covid-19. LPA consulted with Executive Director regarding the importance of hand washing signs in all public restrooms.

No deficiencies noted during today's visit. An exit interview was conducted and a copy of this report was left at the facility.
SUPERVISOR'S NAME: Alisa OrtizTELEPHONE: (714) 703-2855
LICENSING EVALUATOR NAME: Kimberly LymanTELEPHONE: (714) 795-1497
LICENSING EVALUATOR SIGNATURE:

DATE: 03/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2022
LIC809 (FAS) - (06/04)
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