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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306004566
Report Date: 02/14/2023
Date Signed: 02/14/2023 01:50:26 PM

Document Has Been Signed on 02/14/2023 01:50 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 & INLAND A/SC, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME:NEW HOPE CARE HOMESFACILITY NUMBER:
306004566
ADMINISTRATOR:ASUNCION JACINTOFACILITY TYPE:
735
ADDRESS:7284 CHEROKEE CIRCLETELEPHONE:
(714) 588-3112
CITY:BUENA PARKSTATE: CAZIP CODE:
90620
CAPACITY: 6CENSUS: 5DATE:
02/14/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Asuncion Jacinto, Administrator
Anil Suresh Licensee		TIME COMPLETED:
02:15 PM
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Licensing Program Analyst (LPA) Ruth Martinez conducted an unannounced visit for the purpose of conducting a required annual inspection. LPA was greeted and granted entry into the facility by staff and explained the nature of the visit. Asuncion Jacinto, Administrator and Anil Suresh, Licensee arrived shortly after and met with LPA.

LPA Martinez began the tour of the physical plant of the facility. There are five clients in care and there are no active Covid cases in the facility. During facility tour LPA observed one client in dinning room, three in the TV room watching a movie and one client in their bedroom. All clients appeared to be clean and well taken care of. Facility has a sign in/sign out procedure in place. LPA observed required department postings, Covid precautionary postings, and hand washing posting in the facility. The facility has an approved Mitigation Plan on file and has the required Emergency Disaster Plan. There is a minimum of one week of non-perishable foods and two days of perishable foods available. Facility has an emergency food and water supply on hand for use. LPA observed the facility to have a supply of PPE for use. The facility has a supply of hygiene, cleaning, and disinfecting products. All facility bathrooms observed to be functioning and have a supply of soap, toilet paper and hand towels. LPA toured the client’s bedrooms, all bedrooms observed to have all required components. Facility has a secure location for client’s medication, and it was observed that facility has a 30 day supply on hand. LPA toured the outside of the facility and observed a shaded seating area for clients use.

Based on the observation made during today’s visit, no deficiencies were noted today in the areas inspected per Title 22 Division 6 of the California Code of Regulations.

This report was reviewed with the facility representative and a copy of this report was provided to the facility.
SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Ruth Martinez
LICENSING EVALUATOR SIGNATURE: DATE: 02/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/14/2023
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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