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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 300603549
Report Date: 12/20/2022
Date Signed: 12/20/2022 04:00:54 PM

Document Has Been Signed on 12/20/2022 04:00 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
SO. REGION AC/RES., 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME:NEW ALTERNATIVES, INC #5FACILITY NUMBER:
300603549
ADMINISTRATOR:MEAGHAN CRITCHLOWFACILITY TYPE:
733
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 20CENSUS: 3DATE:
12/20/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
03:25 PM
MET WITH:Breanna Tucker, Administrator.TIME COMPLETED:
04:10 PM
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On December 20, 2022 at 3:25 PM, Licensing Program Analyst (LPA) Eduardo Barragan conducted an announced Post Licensing inspection at New Alternatives In #5. LPA met with Breanna Tucker, Administrator.

A physical plant inspection was completed of the facility due to recent reservations and included the following checks: Facility grounds are clean. Bedrooms are arranged so that no more than two clients resided in each room. There is adequate shelving and closet space for client’s belongings. The bathrooms were clean. The hot water in the client bathroom's and in the kitchen was measured to be 112 degrees, which is in range (105 degrees and 120 degrees). All hazardous items have been properly made inaccessible to areas where clients will have access. The medications were stored in the medication room and were double locked. Cleansers/chemicals were locked and inaccessible to client and were located in the kitchen. The First Aid Kit is located in the medication room, the kitchen and one in the staff office. The facility's smoke detectors in the hallways/bedrooms were operable. The carbon monoxide detector located in hallways/bedrooms were operable. There are no guns or weapons in the facility as stated by Breanna Tucker, Administrator.

LPA Barragan noted that new flooring was installed, the facility was painted in the interior and new shower and bath tubes were placed as well. LPA Barragan noted that a relatively new kitchen was installed as well.

CONTINUED...

SUPERVISORS NAME: Ann Valenzuela
LICENSING EVALUATOR NAME: Eduardo Barragan
LICENSING EVALUATOR SIGNATURE: DATE: 12/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/20/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SO. REGION AC/RES., 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME: NEW ALTERNATIVES, INC #5
FACILITY NUMBER: 300603549
VISIT DATE: 12/20/2022
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The following required posted items were observed/ accessible to clients: Grievance Procedures, Personal Rights, and ombudsman postings were all posted. Fire extinguisher is properly charged and serviced. The sharps and knifes were kept in a locked cabinet in the kitchen.

Prior to inspection LPA Barragan reviewed a personnel files to ensure they contained all required documentation per Title 22 Regulations. All appropriate personnel who require caregiver background checks have received criminal record and child abuse index check clearances or exemptions. All licensing fees have been paid and are current at this time. LPA Barragan conducted a client file review as well. All files were neatly organized.



Based on the facility inspection and file reviews this date there were no deficiencies found at this time.

A exit interview was conducted. A copy of the report was discussed and provided along with appeal rights to Breanna Tucker, Administrator.
SUPERVISORS NAME: Ann Valenzuela
LICENSING EVALUATOR NAME: Eduardo Barragan
LICENSING EVALUATOR SIGNATURE:

DATE: 12/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2022
LIC809 (FAS) - (06/04)
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