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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306001706
Report Date: 12/06/2024
Date Signed: 12/06/2024 02:57:47 PM

Document Has Been Signed on 12/06/2024 02:57 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:BEST ELDERLY CARE IFACILITY NUMBER:
306001706
ADMINISTRATOR/
DIRECTOR:		MARIANA NITAFACILITY TYPE:
740
ADDRESS:17912 LINCOLN STTELEPHONE:
(714) 639-5885
CITY:VILLA PARKSTATE: CAZIP CODE:
92861
CAPACITY: 6CENSUS: 5DATE:
12/06/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:43 PM
MET WITH:Mariana NitaTIME VISIT/
INSPECTION COMPLETED:
04:00 PM
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Licensing Program Analysts (LPA) Samer Haddadin conducted an unannounced visit for the purpose of conducting a required/ annual visit. LPA were greeted and granted entry into the facility by Administrator (AD) Mariana Nita and explained the reason for the visit.

LPAs toured the interior and exterior portions of the facility with AD and observed the following:

Facility is 6 bedrooms, 3.5 resident bathrooms, 3 staff bedroom and 1 staff bathroom, two story home with an attached garage. Facility has 6 residents present during today's visit. LPAs observed residents relaxing in their respective rooms.


Resident rooms were provided with furniture, chair and clean Lenin adequate storage space, and kept free of tripping hazards. Manual smoke detectors, carbon monoxide and exit alarms were tested to be operational. Bathrooms were observed to be in good repair and provided with grab bars and hot water was measured at 108.9 degrees Fahrenheit. Facility met the minimum two-day supply of perishable and seven-day supply of non-perishable food stock requirements.

Fire extinguisher was observed with last inspection date of August 4th, 2024 . For the exterior portion, facility had outside furniture in good repair; and grounds were free of tripping hazards and ample space for activities. facility has 3-car garage and is kept locked and used for storage. Laundry room was equipped with an operational washer and dryer.

Kitchen was in good repair with cleaning supplies and sharp items inaccessible to residents in care. Medications are kept locked separately in hallway. LPAs reviewed two clients’ files and medications no discrepancies observed. (...CONTINUE 809C...)

SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Samer Haddadin
LICENSING EVALUATOR SIGNATURE: DATE: 12/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/06/2024
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME: BEST ELDERLY CARE I
FACILITY NUMBER: 306001706
VISIT DATE: 12/06/2024
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LPAs reviewed two staff files with no discrepancies. All files of staff and clients contained all required documentation. Upon review of records, the facility is up to date with required quarterly fire drill, which was last conducted in September 9th, 2024. LPA observed pub-457 poster posted but not within regulatory required size.

No deficiencies were noted during today's inspection visit. An exit interview was conducted, and a copy of this report was provided the administrator.

SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Samer Haddadin
LICENSING EVALUATOR SIGNATURE:

DATE: 12/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/06/2024
LIC809 (FAS) - (06/04)
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