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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306002874
Report Date: 11/06/2024
Date Signed: 11/06/2024 11:57:12 AM

Document Has Been Signed on 11/06/2024 11:57 AM - 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:WESTWOOD FAMILY HOMEFACILITY NUMBER:
306002874
ADMINISTRATOR/
DIRECTOR:		MANSUETO T. CONANAN, JR.FACILITY TYPE:
735
ADDRESS:910 N. WESTWOOD AVENUETELEPHONE:
(714) 973-0755
CITY:SANTA ANASTATE: CAZIP CODE:
92703
CAPACITY: 6CENSUS: 3DATE:
11/06/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:16 AM
MET WITH:Jesus Koh-CaregiverTIME VISIT/
INSPECTION COMPLETED:
12:11 PM
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Licensing Program Analysts (LPAs) Alvaro Ramirez, Jr. and Brandon Lopez conducted an unannounced visit for the Required 1 Year Inspection. LPAs explained the purpose of today’s visit, and were greeted and granted entry by Caregiver Jesus Koh. Administrator (AD) Mansueto Conanan Jr was notified by staff via telephone.

For today’s visit, LPAs observed a total of one client in care and two staff members on duty.

LPAs observed the Administrator's Certificate for facility AD Mansueto Conanan Jr. which expired on March 11, 2024. AD showed proof that the AD certificate renewal has been received by the Administrator Certification Section (ACS).

LPAs toured the interior and exterior portions of the facility with caregiver Koh. The facility is a one-story home and is licensed for six ambulatory clients. There are a total of four bedrooms of which three are for clients and one for staff. LPAs toured each bedroom in the facility and observed that bedrooms were provided with furniture in good repair, clean linens, adequate storage space, and kept free of tripping hazards. LPAs observed all windows were screened. Smoke and carbon monoxide detectors were tested and operational. There are a total of three restrooms of which two are for clients and one for staff. Restrooms were observed to be in good repair and toilets were operational. Water temperature tested between 105.8-106.7 degrees Fahrenheit.

Food menu was also posted and visible. LPAs observed the facility has a 2-day supply of perishables and a 7-day supply of non-perishable food as required by regulations. Fire extinguisher was observed to be fully charged and mounted with service tag dated September 17, 2024. Fire extinguisher is located by the laundry room. Gas stove, microwave, washer, and dryer were all inspected and observed to be operable.

CONTINUED ON LIC809-C..

SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Alvaro Ramirez Jr.
LICENSING EVALUATOR SIGNATURE: DATE: 11/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/06/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
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: WESTWOOD FAMILY HOME
FACILITY NUMBER: 306002874
VISIT DATE: 11/06/2024
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LPAs observed the emergency disaster and evacuation plan, which is located by dining room. Facility had back-up emergency food and water supply. LPAs observed that First Aid Kit had all the required components. LPAs observed that medications and toxins were locked and inaccessible to clients in care.

For the exterior portion, LPAs observed a shaded area, patio furniture, and the grounds were free of any hazards. There is one gate in the backyard. No bodies of water were observed.

LPAs reviewed three of three client files and three staff files. LPAs also reviewed client money and ledger for three of three clients. LPAs interviewed two staff.

For today's visit no deficiencies were issued per Title 22 Division 6 of the California Code of Regulations.

An exit interview was conducted with caregiver Koh.

A copy of this report was provided at the time of exit.

SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Alvaro Ramirez Jr.
LICENSING EVALUATOR SIGNATURE:

DATE: 11/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2024
LIC809 (FAS) - (06/04)
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