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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306003935
Report Date: 09/30/2024
Date Signed: 09/30/2024 11:57:08 AM

Document Has Been Signed on 09/30/2024 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 ASC, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME:CHATEAU ST. MARK HOMES 4FACILITY NUMBER:
306003935
ADMINISTRATOR/
DIRECTOR:		ANICIA LOPEZFACILITY TYPE:
735
ADDRESS:2002 W. CHATEAU AVENUETELEPHONE:
(714) 563-0617
CITY:ANAHEIMSTATE: CAZIP CODE:
92804
CAPACITY: 6CENSUS: 0DATE:
09/30/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:39 AM
MET WITH:Early Maglaya - QA ManagerTIME VISIT/
INSPECTION COMPLETED:
12:12 PM
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On 09/30/2024, Licensing Program Analyst (LPA) Dwayne Mason Jr. conducted an unannounced visit to Chateau St. Mark Homes 4. LPA was greeted and granted entry by Early Maglaya, QA Manager. LPA explained the purpose of the visit.

The facility is a one-story home with four client bedrooms, two bathrooms, living room, dining room, kitchen, attached two-car garage and backyard with pool.

The facility closed approximately 01/2022 due to a lack of clients and has not accepted any clients since. Admin indicated that the facility has been renovating the interior of the facility. Admin indicated that there are no dates on accepting new clients.

As of today, there are no clients living in the facility. LPA conducted a tour along with QA Manager Maglaya. LPA observed the electricity, gas and water are operational. Admin was advised to inform the LPA when the facility is ready to accept new clients and was reminded to pay the annual licensing fees to keep the license active.

Based on the observations made during today's visit, no deficiency is cited in this review as per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted with facility staff, and a copy of this report was provided.
SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Dwayne L Mason
LICENSING EVALUATOR SIGNATURE: DATE: 09/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/30/2024
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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