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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306002980
Report Date: 09/23/2021
Date Signed: 10/05/2021 10:07:10 AM

Document Has Been Signed on 10/05/2021 10:07 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
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME:ENCORE PROGRAMFACILITY NUMBER:
306002980
ADMINISTRATOR:JULIE MAUNDERSFACILITY TYPE:
775
ADDRESS:15241 SPRINGDALE STREETTELEPHONE:
(714) 898-8184
CITY:HUNTINGTON BEACHSTATE: CAZIP CODE:
92649
CAPACITY: 75CENSUS: 25DATE:
09/23/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Program Director Lisa Crowley.TIME COMPLETED:
01:03 PM
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Licensing Program Analyst (LPA) Shobhana Frank made an unannounced visit for the purpose of conducting an annual inspection. LPA was greeted and met with Administrator/ Director of Programs Lisa Crowley and Executive Director Julie Maunders.
LPA observed COVID - station equipped with hand sanitizer, thermometer, Gloves, visitors log. LPA observed COVID posters throughout the facility.
LPA reviewed five client files. LPA observed the following but not limited to: physician report, TB test, individual program plans, admission agreements, consent forms and personal rights.
LPA reviewed staff files and observed the following but not limited to: criminal record clearance, TB test, health screening, criminal record statement and first aid and CPR training.
LPA tour the interior and exterior of the facility. LPA observed walkways to be free of clutter and/or debris. LPA observed clients were enjoying their lunch and interacting with staff members. LPA observed toxins and sharp objects inaccessible to clients in care. LPA observed fire extinguishers mounted and charged. Hot water temperature in resident bathrooms was measure 113.3 degrees F. LPA observed emergency supplies present. Facility's last fire drill was conducted on 9/21/21.

The facility appears to be operating within compliance of California State Code of Regulations Title 22 Division 6. Based on the observations made during today's visit, no deficiencies were observed in the area inspected.
An exit interview was conducted and a copy of this report was provided.
SUPERVISORS NAME: Marina Stanic
LICENSING EVALUATOR NAME: Shobhana Frank
LICENSING EVALUATOR SIGNATURE: DATE: 09/23/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/23/2021
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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