<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306002986
Report Date: 07/19/2022
Date Signed: 07/19/2022 01:59:59 PM

Document Has Been Signed on 07/19/2022 01:59 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
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME:GILBERT CARE HOME-MARKEVFACILITY NUMBER:
306002986
ADMINISTRATOR:NOEL/ARLYN VILLEGASFACILITY TYPE:
735
ADDRESS:1430 S MARKEV STREETTELEPHONE:
(714) 995-1542
CITY:ANAHEIMSTATE: CAZIP CODE:
92804
CAPACITY: 6CENSUS: 6DATE:
07/19/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:48 PM
MET WITH:Noel Villegas, AdministratorTIME COMPLETED:
02:30 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA) Ruth Martinez conducted an unannounced visit for the purpose of conducting a required annual inspection. LPA was greeted and granted entry into the facility by Administrator. LPA met with Noel Villegas, Administrator and explained the nature of the visit.

LPA Martinez accompanied by Administrator began the tour of the inside and outside of the facility. LPA observed a check in station in the main entry of the facility. Facility staff are taking temperatures daily to all visitors, staff and clients and documenting the results. There are six clients in care and there is no active covid-19 case in the facility. LPA observed two clients in the dining/living room and two clients in their bedrooms. All clients appeared to be clean and well taken care of. LPA observed required department postings, covid-19 precautionary posting in the facility as well as hand washing sign throughout. LPA observed the emergency disaster and evacuation plan. Restrooms were observed to have a supply of soap as well as hand towels. Restrooms appeared to be clean and all equipment to be functional. LPA inspected client’s bedrooms and they appeared to be clean and sanitary. All facility bedrooms are private occupancy with one client per. All bedrooms observed to have required components. LPA inspected the food supply and observed the emergency food and water supply. LPA observe PPE to be stored in living room of facility as well as attached garage. Medication is located in kitchen cabinet and LPA observed facility to have a 30 day supply of medication for clients. LPA toured the outside of the facility and observed a shaded seating area for client’s enjoyment. LPA observed facility to have exercise equipment for clients use.

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

This report was reviewed with the Administrator and a copy of this report was provided to the facility.
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Ruth Martinez
LICENSING EVALUATOR SIGNATURE: DATE: 07/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/19/2022
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 1