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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306000147
Report Date: 03/20/2024
Date Signed: 04/04/2024 09:17:46 AM

Document Has Been Signed on 04/04/2024 09:17 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:MT OF OLIVES ADULT DAY CARE CENTERFACILITY NUMBER:
306000147
ADMINISTRATOR:GAYE SATTERFIELDFACILITY TYPE:
775
ADDRESS:24772 CHRISANTA DRIVETELEPHONE:
(949) 581-3800
CITY:MISSION VIEJOSTATE: CAZIP CODE:
92691
CAPACITY: 40CENSUS: 27DATE:
03/20/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:01 PM
MET WITH:Corina Oxford, Office ManagerTIME COMPLETED:
03:45 PM
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Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility in order to conduct the required annual inspection. LPA arrived at facility, was greeted and granted entry by caregiving staff Matthew Yeakel and Office Manager Corina Oxford after explaining the purpose of the visit.

LPA accompanied by Office Manager began the tour of the facility. There are twenty-seven (27) clients present in the building on the day of the visit, with daily attendance stated to fluctuate between 19 and 32 clients. A musical activity is observed to be in progress during the visit.

LPA reviewed the Disaster and Emergency Plan, Infection Control document, as well as staff records for the staff members present during the visit, and a sample of client records maintained at the facility.

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. Water temperature was measured to be 108F.

LPA observed a sufficient supply of food and water. Facility gets daily meal deliveries from an offsite location, with occasional substitutions being performed when a wide number of clients do not tolerate the provided meals. Medication is centrally stored under lock for one client only.

LPA and office manager toured the outside of the facility. Outdoor seating is present and the 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. Sound alarms are observed to be in operation on exit doors.

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: Sheila Santos
LICENSING EVALUATOR NAME: Kevin Saborit-Guasch
LICENSING EVALUATOR SIGNATURE: DATE: 03/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/20/2024
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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