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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306002440
Report Date: 08/23/2023
Date Signed: 08/23/2023 01:41:47 PM

Document Has Been Signed on 08/23/2023 01:41 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:ALPINE BFACILITY NUMBER:
306002440
ADMINISTRATOR:MALACA, ROCHELFACILITY TYPE:
740
ADDRESS:24606 SATURNATELEPHONE:
(949) 533-5938
CITY:MISSION VIEJOSTATE: CAZIP CODE:
92691
CAPACITY: 6CENSUS: 0DATE:
08/23/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Rochele Malaca, Administrator (via phone)
Kim Walters
Michelle Nesbitt		TIME COMPLETED:
01:30 PM
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On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility for the purpose of confirming the implementation of the plan of corrections determined after a type B citation issued on August 1, 2023 as well as confirming the facility's closure.

LPA rang the bell and observed the facility was empty. LPA then called Administrator Rochele Malaca to notify her of the visit. LPA was later greeted and granted entry by Maintenance Supervisor Matthew Montgomery before facility staff Kim Walters and Michelle Nesbitt arrived to assist.

The pool treatment was confirmed to have been performed and the insect infestation resolved. Contracted pool maintenance staff was observed to be present and adding water treatment to the swimming pool. A clearance letter was thus provided to facility staff.

Additionally, all residents were confirmed to have moved out by August 17, 2023 and the facility is therefore considered closed and not operating for the time being. The closure will be finalized once the change of ownership is confirmed with the issuance of a new license to Wellpointe Inc.

At this time no deficiencies are observed per Title 22 of the California Code of Regulations. An exit interview was conducted and a copy of this report was provided to a facility representative.
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Kevin Saborit-Guasch
LICENSING EVALUATOR SIGNATURE: DATE: 08/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/23/2023
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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