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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 300605585
Report Date: 06/21/2022
Date Signed: 06/21/2022 04:23:32 PM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 06/21/2022 04:23 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:LEARNING LIGHT FOUNDATION ADULT DEVEL. PROGRA, THEFACILITY NUMBER:
300605585
ADMINISTRATOR:PABLO GARAYFACILITY TYPE:
775
ADDRESS:1212 E. LINCOLN AVENUETELEPHONE:
(714) 533-2314
CITY:ANAHEIMSTATE: CAZIP CODE:
92805
CAPACITY: 40CENSUS: 38DATE:
06/21/2022
TYPE OF VISIT:Case Management - Annual ContinuationUNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Edward YorbaTIME COMPLETED:
04:30 PM
NARRATIVE
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Licensing Program Analyst (LPA) Claudia Gutierrez made an unannounced visit for the purpose of conducting a Required/Annual Inspection. LPA met with staff Edward Yorba and discussed the purpose of the inspection. During the inspection LPA Gutierrez and staff Yorba conducted a tour of the inside and outside of the facility, common areas, offices, kitchen, activity rooms and observed the following:

This is a two-story complex that consists of various rooms used for storage, activities, as offices, and one changing room. There are two staff restrooms and one client restroom with six toilets. During the inspection LPA observed four staff and no clients in care due to day program having concluded.

During the inspection of the courtyard toxic substances and other dangerous objects were observed; a Deficiency was cited on today's date. Lunch is not provided since client's bring their own lunch and the program provides snacks. Random selection of client files were reviewed. There is no medication handling for any of the clients. Program is providing the following activities: social skills, advocacy class, music, arts and crafts, socialization and communication.

Based on the observations made during today’s inspection, one deficiency is being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted, and a copy of this report was left at the facility.
SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Claudia Gutierrez
LICENSING EVALUATOR SIGNATURE: DATE: 06/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/21/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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Document Has Been Signed on 06/21/2022 04:23 PM - It Cannot Be Edited


Created By: Claudia Gutierrez On 06/21/2022 at 03:55 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

FACILITY NAME: LEARNING LIGHT FOUNDATION ADULT DEVEL. PROGRA, THE
FACILITY NUMBER: 300605585

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/21/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/01/2022
Section Cited
HSC
82087.2(a)(1)

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Outdoor Activity Space
If outdoor activity space is provided, it shall:
Be free of hazards.

This requirement is not being met as evidence by LPA observed buckets of paint and bleach outside in the
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General Manager (GM) Hannah Tayfour stated the items would be removed and place in a locked storage room. GM will email LPA Gutierrez a photo of the courtyard free of hazards and a picture of where the hazardous items are now kept by 7/01/22.
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courtyard of the facility. This poses an immediate health and safety risk to clients in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Armando J Lucero
LICENSING EVALUATOR NAME:Claudia Gutierrez
LICENSING EVALUATOR SIGNATURE:
DATE: 06/21/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/21/2022


LIC809 (FAS) - (06/04)
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