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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306004502
Report Date: 03/17/2025
Date Signed: 03/17/2025 04:35:58 PM

Document Has Been Signed on 03/17/2025 04:35 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:L & D BOARD AND CAREFACILITY NUMBER:
306004502
ADMINISTRATOR/
DIRECTOR:		LILIA DUELASFACILITY TYPE:
735
ADDRESS:10361 16TH STREETTELEPHONE:
(714) 867-6028
CITY:GARDEN GROVESTATE: CAZIP CODE:
92843
CAPACITY: 6CENSUS: 4DATE:
03/17/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:35 AM
MET WITH:Lu IbeTIME VISIT/
INSPECTION COMPLETED:
01:15 PM
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Licensing Program Analyst (LPA) Kimberly Lyman conducted an unannounced visit to L & D Board and Care. The purpose of today’s visit was to conduct the Annual Required inspection. LPA was allowed entry into the home and met with Caregiver Lu Ibe. Facility is licensed for 6 ambulatory clients and the facility currently has 4 clients. Delfin Duelas has an Administrator Certificate expiring on 06/03/2026.

LPA Lyman along with Caregiver Ibe toured the facility at 10:55 AM. Administrator Delfin Duelas arrived during the visit. LPA toured the physical plant, checked food service, and the first aid kit. The home consists of four client bedrooms, two staff rooms, one shared hall bathroom, living room, dining room, and kitchen. Client bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. Client bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure and shower was free of mold/mildew. Water temperature measured 107.9 degrees F in facility bathroom. Client bath towels, toiletries and personal hygiene supplies were adequately stocked at time of visit. Common areas were clean and clear of hazards, doorways were free of obstructions. First aid kit had all the required elements including tweezers, thermometer, and scissors. LPA observed a locked storage area for cleaning supplies under the kitchen sink. Kitchen was inspected. Perishable and non-perishable food supply was checked and adequately stocked at time of visit. LPA observed sharps locked in a kitchen drawer. Smoke detectors and Carbon Monoxide detectors tested operational during today's visit. Fire extinguishers are fully charged. Kitchen appliances are operational during today's visit. LPA toured the outside grounds and there is ample shaded seating for clients. LPA observed emergency food and water supply. LPA reviewed the emergency disaster plan during the visit. Plan is thorough and complete. Facility provided documentation of last fire drill conducted on 10/05/2024. Facility provides activities in the form of exercise and outings in the community. At 11:20 AM, LPA reviewed four client files and two staff files. Client files contained required documents including admission agreements, current physician reports and client appraisals. CONT ON LIC 809C DATED 03/17/2025

SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Kimberly Lyman
LICENSING EVALUATOR SIGNATURE: DATE: 03/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/17/2025
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME: L & D BOARD AND CARE
FACILITY NUMBER: 306004502
VISIT DATE: 03/17/2025
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Staff files reviewed contained required documentation of training and criminal record clearance. LPA reviewed medication storage and administration. Medications are stored in a locked cabinet and are being administered per physician order.














Based on the observations made during today’s inspection, No deficiencies are being cited. An exit interview was conducted and a copy of this report was discussed with and provided to facility representative.
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Kimberly Lyman
LICENSING EVALUATOR SIGNATURE:

DATE: 03/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2025
LIC809 (FAS) - (06/04)
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