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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306001818
Report Date: 07/27/2021
Date Signed: 07/27/2021 04:37:29 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:D'BEST CAREFACILITY NUMBER:
306001818
ADMINISTRATOR:MA DINAH DELA CRUZFACILITY TYPE:
740
ADDRESS:3608 W. ASH AVENUETELEPHONE:
(714) 278-0528
CITY:FULLERTONSTATE: CAZIP CODE:
92833
CAPACITY:6CENSUS: 2DATE:
07/27/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
04:01 PM
MET WITH:Ma Dinah DeLa CruzTIME COMPLETED:
05:00 PM
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Licensing Program Analyst (LPA) Lydia Martinez conducted an unannounced visit for the purpose of conducting a Required 1 Year inspection. LPA was greeted and granted entry by Administrator Mary Joyce Nora and reason for the visit was explained.

Upon entry LPA was screen per COVID guidelines. LPA began the tour of the facility. The facility currently has 2 residents in care. LPA observed the residents relaxing. Residents appeared happy and well taken care of. Facility appears clean and sanitary. Staff screens all visitors to the facility and LPA observed the screening station in the entrance of the facility. Facility keeps documentation in regard to COVID for all the visitors, staff, and resident. LPA observed hand washing guidelines posted in all bathrooms of facility. LPA observed facility has COVID precautionary posting throughout the facility as well as all required Department postings. Facility has an active COVID-19 prevention plan in place for the safety of residents in care. LPA observed ample of emergency food and water as well as First Aid kit in the facility. Facility has an ample supply of PPE, incontinence, and cleaning supplies. Facility has sanitation precaution in place. LPA observed caregivers cleaning and sanitizing facility. LPA toured the outside and observed a shaded outside space for residents that can be used for outdoor visitation. Facility has a plan for COVID testing residents and staff as needed as well as a plan for isolation as needed. Facility has 6 bedrooms, 3 for residents and 2 staff bedroom. Mitigation Plan was submitted and has been approved.

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

An exit interview was conducted with Administrator and a copy of this report was provided and left at facility.
SUPERVISOR'S NAME: Marina StanicTELEPHONE: (714) 703-2840
LICENSING EVALUATOR NAME: Lydia MartinezTELEPHONE: (714) 703-2840
LICENSING EVALUATOR SIGNATURE:

DATE: 07/27/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2021
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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