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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306000049
Report Date: 03/08/2024
Date Signed: 03/08/2024 11:34:15 AM

Document Has Been Signed on 03/08/2024 11:34 AM - 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 RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME:HALL FAMILY HOMEFACILITY NUMBER:
306000049
ADMINISTRATOR:RON SALDAFACILITY TYPE:
735
ADDRESS:1922 WEST FLORA STREETTELEPHONE:
(714) 434-0100
CITY:SANTA ANASTATE: CAZIP CODE:
92704
CAPACITY: 6CENSUS: 2DATE:
03/08/2024
TYPE OF VISIT:Case Management - OtherANNOUNCEDTIME BEGAN:
11:01 AM
MET WITH:Diane Hall-LicenseeTIME COMPLETED:
11:40 AM
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Licensing Program Analyst (LPA) Alvaro Ramirez, Jr. conducted a office meeting to deliver findings on an investigation completed by the Department. LPA greeted and met with Licensee Diane Hall and explained the reason for the meeting.

After two failed attempted visits on 02/12/24 and 02/22/24 to deliver findings for complaint # 22-AS-20230828081438, Licensee agreed to come into the office today to received the findings.

An exit interview was conducted with Licensee Hall and a copy was provided at the time of exit.
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Alvaro Ramirez Jr.
LICENSING EVALUATOR SIGNATURE: DATE: 03/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/08/2024
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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