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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306000959
Report Date: 07/14/2023
Date Signed: 07/14/2023 02:04:08 PM

Document Has Been Signed on 07/14/2023 02:04 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
ORANGE & INLAND A/SC, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME:HIGH HOPES HEAD INJURY PROGRAMFACILITY NUMBER:
306000959
ADMINISTRATOR:DESMOND, MARK J.FACILITY TYPE:
775
ADDRESS:2953 & 2961 EDINGER AVE.TELEPHONE:
(949) 733-0044
CITY:TUSTINSTATE: CAZIP CODE:
92780
CAPACITY: 120CENSUS: 25DATE:
07/14/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:22 PM
MET WITH:Tracy DesmondTIME COMPLETED:
02:25 PM
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Licensing Program Analyst (LPA) Ruth Martinez made an unannounced visit for the purpose of conducting an annual required visit. LPA arrived at facility was greeted at the front desk by staff and granted entry. LPA met with Tracy Desmond, Case Manager and explained the reason of the visit. Mark Desmond, Director arrived shortly after and met with LPA.

LPA accompanied by case manager began the tour of the day program. The day program consists of OT room, cognitive classroom, computer lab, lounge/dining area, conditioning room, restrooms, office spaces and staff break room. LPA observe that the facility fire clearance is maintained in conformity with the State Fire Marshall regulatory standards. Fire Extinguishers were last serviced March 15, 2023, and observed to be mounted on the wall throughout the facility. Smoke detectors and sprinkler systems are serviced annually by a contracted vendor. Fire drills are conducted quarterly. There are no pools, bodies of water at this location. Disinfectants cleaning solutions and poisons are inaccessible to clients and stored in locked cabinet. The day program is maintained in a clean, safe, and sanitary condition. The premises and furnishings are in good repair. There are no food preparation areas at this site. Clients provide their own lunches and are stored in facility refrigerator. Students are required to bring their own meals and snacks. LPA was informed there was no clients at program today since facility does not have sessions on Fridays. LPA was informed facility does not handle client’s medication. First aid supplies are adequate, and LPA observed a first aid kit stored in front office and throughout the facility. LPA inspected restrooms and LPA measured the hot water temperature which measured 111.9 Fahrenheit degrees. All restrooms observed to have a supply of soap, toilet paper and towels. LPA began review of records. LPA reviewed four clients’ records. All the required



Continued on LIC809-C
SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Ruth Martinez
LICENSING EVALUATOR SIGNATURE: DATE: 07/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/14/2023
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE & INLAND A/SC, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME: HIGH HOPES HEAD INJURY PROGRAM
FACILITY NUMBER: 306000959
VISIT DATE: 07/14/2023
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documentation was present and current in client’s files reviewed. LPA reviewed three employee records. All employees present have a criminal record clearance and are associated to the facility. LPA observed records reviewed have a current First Aid certificate.

Based on the observation made during today’s visit, no deficiencies were noted today in the areas inspected per Title 22 Division 6 of the California Code of Regulations.

This report was reviewed with the Director and a copy of this report was provided to the facility.
SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Ruth Martinez
LICENSING EVALUATOR SIGNATURE:

DATE: 07/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/14/2023
LIC809 (FAS) - (06/04)
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