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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306002309
Report Date: 05/19/2021
Date Signed: 05/19/2021 03:13:16 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:EUROPEAN LOVING CARE IFACILITY NUMBER:
306002309
ADMINISTRATOR:COTILIA DAHABREHFACILITY TYPE:
740
ADDRESS:6561 DOHRN CIRCLETELEPHONE:
(714) 848-5544
CITY:HUNTINGTON BEACHSTATE: CAZIP CODE:
92647
CAPACITY:6CENSUS: 4DATE:
05/19/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:05 PM
MET WITH:Administrator, Cotilia DahabrehTIME COMPLETED:
03:25 PM
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Licensing Program Analysts (LPA's) Jenifer Tirre and Kimberly Lyman made an unannounced visit to facility to conduct an Annual visit. LPA's introduced themselves and discussed the purpose of visit.

During the visit LPA's toured the facility. Facility is a 7 bedroom and 4 bathroom single story home. There are 4 Residents in care. LPA's observed proper covid signage at front entrance of facility as well as sanitization station. Facility has required Department postings. LPA's observed copy of Administrators Certificate expiring 01/27/23. LPA's toured all residents rooms, all rooms appeared clean and sanitary. All restrooms observed contained ample supplies of hand sanitizer, soap, wipes, gloves and paper towels. LPA's observed two outside visitation areas with ample shading. Residents were observed relaxing in the Living room. Facility has required Mitigation plan and Emergency Disaster Plan posted. LPA's observed ample supply of Emergency food and water supply. Facility has a secured location for resident medication and files.

During the visit, LPAs consulted with Administrator regarding the importance of maintaining a thirty day supply of PPE onsite. Additionally, LPAs discussed sign in and screening procedures with Administrator. LPAs advised the importance of mask wearing for staff at all times.

No deficiencies noted during todays visit. An exit interview was conducted with Administrator Cotilia Dahabreh and a copy of this report was left at facility.
SUPERVISOR'S NAME: Alisa OrtizTELEPHONE: (714) 703-2855
LICENSING EVALUATOR NAME: Jenifer TirreTELEPHONE: (714) 703-2840
LICENSING EVALUATOR SIGNATURE:

DATE: 05/19/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/19/2021
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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