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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306001396
Report Date: 04/05/2024
Date Signed: 04/05/2024 04:05:00 PM

Document Has Been Signed on 04/05/2024 04:05 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 COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME:ALEXA'S HOMEFACILITY NUMBER:
306001396
ADMINISTRATOR/
DIRECTOR:		PATRICIA FESTINFACILITY TYPE:
735
ADDRESS:3117 W. CUBBONTELEPHONE:
(657) 245-3165
CITY:SANTA ANASTATE: CAZIP CODE:
92704
CAPACITY: 6CENSUS: 4DATE:
04/05/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:16 PM
MET WITH:Patricia Festin-AdministratorTIME VISIT/
INSPECTION COMPLETED:
04:19 PM
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On this in conjunction with complaint control #22-AS-20231211135300 and citation issued on 03/06/2024 and 03/15/2024. LPA was greeted and granted entry into the facility by Administrator (AD) Patricia Festin and explained the reason for the visit.

On 03/20/2024, AD failed to correct the following:
Deficiency cited under Title 22 Regulation 80026(e) pertaining to Safeguards for Cash Resources, Personal Property, and Valuables of Residents.

As of 04/05/2024, Deficiency cited under Title 22 Regulation 80026(e) pertaining to Safeguards for Cash Resources, Personal Property, and Valuables of Residents has been CLEARED. Licensee provided a written plan on how to ensure the P&I ledger is balanced at all times.

On 03/20/2024, AD failed to correct the following:
Deficiency cited under Title 22 Regulation 80026(h) pertaining to Safeguards for Cash Resources, Personal Property, and Valuables of Residents.

As of 04/05/2024, Deficiency cited under Title 22 Regulation 80026(h) pertaining to Safeguards for Cash Resources, Personal Property, and Valuables of Residents has been CLEARED.

Licensee has read regulation and sign a statement of understanding. Licensee has complied with the terms of the POC.

LPA Ramirez conducted an exit interview with AD Festin and a copy of this report and Letter of Cleared Deficiency has been provided to the facility.
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Alvaro Ramirez Jr.
LICENSING EVALUATOR SIGNATURE: DATE: 04/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/05/2024
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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