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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306000347
Report Date: 06/01/2021
Date Signed: 06/01/2021 04:04:20 PM

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:ATRIA SAN JUANFACILITY NUMBER:
306000347
ADMINISTRATOR:JAMES CRADDOCKFACILITY TYPE:
740
ADDRESS:32353 SAN JUAN CREEK RDTELEPHONE:
(949) 661-1220
CITY:SAN JUAN CAPISTANOSTATE: CAZIP CODE:
92675
CAPACITY:140CENSUS: 101DATE:
06/01/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:44 PM
MET WITH:James CraddockTIME COMPLETED:
04:21 PM
NARRATIVE
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Licensing Program Analyst (LPA) Joseph Alejandre made an unannounced visit to conduct the annual visit for mitigation control. LPA was greeted and granted entry by Executive Director (ED) James Craddock. LPA Alejandre and ED James Craddock toured the facility. Facility is a 3 story building with an interior courtyard with a fountain. LPA inspected the common areas including the kitchen, dining room, front lobby, courtyard with fountain and activity room with screened fireplace. LPA and ED also toured the memory care area which is the second floor. LPA toured the medication room on the first floor. All medications were secured in the medication carts. LPA observed all fire extinguishers are fully charged. LPA did not observe any obstacles or hazards. LPA toured the outside of the building and parking area, LPA did not observe any obstacles or hazards. LPA has reviewed the facility's Covid-19 mitigation plan. Mitigation plan is in accordance with CCL guidelines. LPA discussed mitigation plan and procedures with Executive Director. LPA reviewed activity calendar with activity director Denise Appleby. LPA reviewed/discussed menu with restaurant director Kevin Zahnter. LPA observed the facility is organized and clean. Based on Title 22 Division 6 of the California Code of Regulations, no deficiencies are being cited as a result of this visit. Exit interview conducted with Executive Director James Craddock and a copy of this report provided.
SUPERVISOR'S NAME: Luz AdamsTELEPHONE: (714) 703-2855
LICENSING EVALUATOR NAME: Joseph AlejandreTELEPHONE: (951) 473-7041
LICENSING EVALUATOR SIGNATURE:

DATE: 06/01/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/01/2021
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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