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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306000377
Report Date: 04/25/2022
Date Signed: 04/25/2022 03:48:29 PM


Document Has Been Signed on 04/25/2022 03:48 PM - 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:TENDER LEISURE CAREFACILITY NUMBER:
306000377
ADMINISTRATOR:STEPHEN G. VENANZIFACILITY TYPE:
740
ADDRESS:25532 ALTHEATELEPHONE:
(949) 243-9214
CITY:MISSION VIEJOSTATE: CAZIP CODE:
92691
CAPACITY:6CENSUS: 5DATE:
04/25/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:50 PM
MET WITH:Stephen Douglas Venanzi, Stephen VenanziTIME COMPLETED:
03:55 PM
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Licensing Program Analyst (LPA) Jessica Cho made an unannounced required annual inspection (mitigation) in this facility. LPA was greeted and granted entry by Stephen Douglas Venanzi, Administrator (AD) after the completing the Coronavirus 2019 (COVID-19) screening procedure. Stephen Venanzi, Licensee joined shortly at 2:15 PM.

The facility is a single level structure and licensed for six non-ambulatory residents with a hospice waiver for one resident. There are no residents in hospice care. For this visit, there are five residents in care and two staff members on duty. LPA toured the interior and exterior portions of the facility. Rooms were provided with furniture in good repair, clean linens, adequate storage space, and kept free of tripping hazards. Smoke detectors, carbon monoxide, and auditory exit alarms were tested to be operational. Bathrooms were observed to be in good repair; and provided with handrails and nonskid - floor mats. Hot water was measured at 134.4 degrees Fahrenheit in Bathroom #1 and 136.4 degrees Fahrenheit in Bathroom #2. Facility met the minimum two day perishable and seven day non-perishable food stock requirements. An inhaler was observed in the kitchen but the inhaler was removed during the visit. Cleaning supplies and sharp items were inaccessible to residents in care. The fire extinguishers were mounted and charged. For the exterior portion, facility had outdoor furniture under ample shading. The grounds were free of tripping hazards. Side exit door was self-latching and self-closing. LPA reviewed the pending COVID-19 Mitigation Plan.

For this visit, there are no deficiencies cited in this review as per Title 22 Division 6 of the California Code of Regulations. An Advisory Note (LIC9102) was issued during the visit and LPA Cho will follow-up with the corrections. An exit interview was conducted with Stephen Venanzi, Licensee and a copy of this report was provided.
SUPERVISOR'S NAME: Sheila SantosTELEPHONE: (714) 334-2064
LICENSING EVALUATOR NAME: Jessica ChoTELEPHONE: 714-703-2840
LICENSING EVALUATOR SIGNATURE:
DATE: 04/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/25/2022
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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