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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306003529
Report Date: 12/15/2023
Date Signed: 12/15/2023 03:09:50 PM


Document Has Been Signed on 12/15/2023 03:09 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:GUARDIAN ANGELS HOMES IFACILITY NUMBER:
306003529
ADMINISTRATOR:SONIA GARCIAFACILITY TYPE:
740
ADDRESS:18021 E. SANTA CLARA AVENUETELEPHONE:
(714) 269-7307
CITY:SANTA ANASTATE: CAZIP CODE:
92705
CAPACITY:6CENSUS: 5DATE:
12/15/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
02:35 PM
MET WITH:Stephanie MaganaTIME COMPLETED:
03:25 PM
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Licensing Program Analyst (LPA) Claudia Gutierrez made an unannounced visit for the purpose of conducting a Plan of Correction (POC) inspection. LPA was greeted and granted entry by Staff Stephanie Magana and explained the purpose of the inspection. Administrator (AD) Sonia Garcia was contacted by phone and arrived at 2:48 p.m.

LPA is following up on deficiencies cited during facility’s annual inspection on 11/06/23. Deficiency 87202(a) was cited due to lounge room being used as staff bedroom. During today’s visit, LPA confirmed lounge room is no longer being used a staff bedroom and is free of personal belongings. Deficiency under health and safety code 1569.695(c) was cited because disaster drills were not being conducted. AD provided LPA with a copy of disaster drill log, which indicated facility conducted a fire drill on 11/26/23.

AD has met both POCs and deficiencies previously cited are being cleared.

Based on today’s observations no deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted and a copy of this report was left at the facility.

SUPERVISOR'S NAME: Armando J LuceroTELEPHONE: (714) 703-2840
LICENSING EVALUATOR NAME: Claudia GutierrezTELEPHONE: 714-703-2840
LICENSING EVALUATOR SIGNATURE:
DATE: 12/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/15/2023
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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