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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306004311
Report Date: 10/19/2022
Date Signed: 10/19/2022 11:24:04 AM


Document Has Been Signed on 10/19/2022 11:24 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:ROYAL LIVINGFACILITY NUMBER:
306004311
ADMINISTRATOR:ELENA CECILIA MARINESCUFACILITY TYPE:
740
ADDRESS:18601 PATRICIAN DRIVETELEPHONE:
(714) 998-7098
CITY:VILLA PARKSTATE: CAZIP CODE:
92861
CAPACITY:3CENSUS: 0DATE:
10/19/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:50 AM
MET WITH:Mitch and Cecelia MarinescuTIME COMPLETED:
11:45 AM
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Licensing Program Analyst (LPA) Kimberly Lyman conducted an unannounced visit for the purpose of conducting a required annual visit. LPA was greeted and granted entry into the facility and explained the reason for the visit.

At 11:10 AM, LPA toured the facility and observed the following:

Facility has no residents during today's visit and has had no residents since approximately 2020. LPA toured the facility and observed a clean and sanitary facility. Facility to notify LPA should they decide to take residents again. Licensee verbalized intent to close the facility in the near future.






Exit interview conducted and a copy of this report was left at the facility.
SUPERVISOR'S NAME: Alisa OrtizTELEPHONE: (714) 703-2855
LICENSING EVALUATOR NAME: Kimberly LymanTELEPHONE: (714) 795-1497
LICENSING EVALUATOR SIGNATURE:
DATE: 10/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/19/2022
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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