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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306000147
Report Date: 03/11/2022
Date Signed: 03/11/2022 11:11:18 AM

Document Has Been Signed on 03/11/2022 11:11 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
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME:MT OF OLIVES ADULT DAY CARE CENTERFACILITY NUMBER:
306000147
ADMINISTRATOR:ROBIN HORTONFACILITY TYPE:
775
ADDRESS:24772 CHRISANTA DRIVETELEPHONE:
(949) 581-3800
CITY:MISSION VIEJOSTATE: CAZIP CODE:
92691
CAPACITY: 40CENSUS: 22DATE:
03/11/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Matthew Yeakel
Adriana Dobyns, Office Manager
Gaye Satterfield, Program Director		TIME COMPLETED:
11:30 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
Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility in order to conduct a required annual inspection. LPA arrived at facility, was greeted and granted entry by caregiving staff Matthew Yeakel and Office Manager Adriana Dobyns after explaining the purpose of the visit and being asked to sign in and being temperature checked. Director Gaye Satterfield arrived at a later time.

At approximately 10:35am, LPA accompanied by Office Manager began the tour of the facility. There are twenty-two (22) clients expected to participate in the program on the day of the visit, with an weekly average of about 25-26 clients overall. Clients are observed doing chair gym in the activity space and appears well taken care of. Facility appears to be clean, sanitary and free of odors in all areas inspected. Bathrooms observed are equipped with grab bars. Cleaning supplies and other toxic substances are locked.
LPA observed a check-in station next to the entrance of the facility where temperature checks are being documented for visitors. LPA observed the facility has COVID-19 Precautions posters, all required department postings and hand washing signs posted throughout.
LPA observed a sufficient supply of food and water. Facility gets daily meal deliveries from an offsite location, with active temperature controls being performed at time of delivery. Medication is centrally stored under lock. Facility has an adequate supply of PPE. LPA toured the outside of the facility. Outdoor seating is present for the clients' enjoyment. Outside space is free of clutter and debris and is accessed through two unlocked self-latching gates. There are no bodies of water on the premises.

Based on the observations made during today’s visit, no deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. This report was reviewed with facility representative and a copy of this report was provided and left at facility.
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Kevin Saborit-Guasch
LICENSING EVALUATOR SIGNATURE: DATE: 03/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/11/2022
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 1