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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306004443
Report Date: 03/21/2024
Date Signed: 03/21/2024 03:29:53 PM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 03/21/2024 03:29 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
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME:D & D HOMESFACILITY NUMBER:
306004443
ADMINISTRATOR:LYNETTE DIZONFACILITY TYPE:
735
ADDRESS:1543 BEACON STREETTELEPHONE:
(714) 860-4463
CITY:ANAHEIMSTATE: CAZIP CODE:
92802
CAPACITY: 6CENSUS: 3DATE:
03/21/2024
TYPE OF VISIT:Case Management - Annual ContinuationUNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Don Enriquez, Lead staffTIME COMPLETED:
03:45 PM
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On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility for the purpose of conducting a continuation visit to the annual inspection which took place on March 8, 2024. Licensing staff had been unable to review the Personal & Incidental Funds for the clients in care as Lead Staff Don Enriquez was absent from the facility at the time.

During the visit, LPA requested, obtained and reviewed the individual pouches and ledgers for the P&I funds for the three clients in care. All receipts are being kept adequately. No discrepancies were found between the ledgers and the funds kept at the facility.

No deficiencies are being cited per Title 22 Regulations at this time. An exit interview was conducted and a copy of this report was provided to a facility representative.
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Kevin Saborit-Guasch
LICENSING EVALUATOR SIGNATURE: DATE: 03/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/21/2024
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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