<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 300605409
Report Date: 12/27/2023
Date Signed: 12/27/2023 03:38:40 PM

Document Has Been Signed on 12/27/2023 03:38 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
ORANGE COUNTY ASC, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME:SUTTON FOUNDATIONFACILITY NUMBER:
300605409
ADMINISTRATOR:JORGE G. MONROYFACILITY TYPE:
735
ADDRESS:4101 BELVEDERETELEPHONE:
(949) 651-0778
CITY:IRVINESTATE: CAZIP CODE:
92604
CAPACITY: 6CENSUS: 4DATE:
12/27/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Jorge Monroy - AdministrationTIME COMPLETED:
04:00 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
LPA Dwayne Mason Jr. arrived at the facility for the purpose of conducting an unannounced Plan of Corrections inspection. LPA was greeted and granted entry by DSP John Alamonte. Administrator (AD) Jorge Monroy joined the inspection ten minutes after LPA's arrival. LPA stated the purpose of the visit. LPA is following up on deficiencies issued at the 12/18/2023 inspection.

LPA received, via email on 12/22/2023, the posting created by the AD to notify staff and visitors to not use the bathroom in the shared bedroom. Based on record review, observations and staff interviews, LPA has determined that staff no longer use the shared bedroom's bathroom.

LPA also received, via email on 12/22/2023, a document outlining the procedures the facility is to follow regarding PNI documentation, storage and access. LPA reviewed PNI with AD. LPA determined that the PNI ledger is accurate with receipts and cash stored.

Based on today's inspection, LPA has determined the facility has fulfilled their Plan of Corrections for both deficiencies issued on 12/18/2023. A copy of this report and the generated clear letters were provided.
SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Dwayne L Mason
LICENSING EVALUATOR SIGNATURE: DATE: 12/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/27/2023
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 1