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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306000049
Report Date: 03/22/2024
Date Signed: 03/22/2024 09:41:15 AM

Document Has Been Signed on 03/22/2024 09:41 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:
03/22/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
08:47 AM
MET WITH:Diane Hall-LicenseeTIME COMPLETED:
09:56 AM
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On this day Licensing Program Analyst (LPA) Alvaro Ramirez, Jr. made an unannounced Plan of Correction (POC) visit in conjunction with complaint control #22-AS-20230828081438 and citation issued on 03/08/2024. LPA was greeted and granted entry into the facility by Licensee Diane Hall and explained the reason for the
visit.

During today's visit LPA toured the inside and outside of the facility with Licensee Hall. During the tour LPA observed two clients in care. LPA observed the two clients relaxing in their bed.

As of 03/22/2024, Deficiency cited under Title 22 Regulation 85079(c) pertaining to Activities has been CLEARED.

Licensee provided an updated Activities calendar. Licensee has complied with the terms of the POC.

LPA Ramirez conducted an exit interview with Licensee Hall and a copy of this report and Letter of Cleared Deficiency has been provided to the facility.
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Alvaro Ramirez Jr.
LICENSING EVALUATOR SIGNATURE: DATE: 03/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/22/2024
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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