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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306004781
Report Date: 03/24/2023
Date Signed: 03/24/2023 01:55:51 PM


Document Has Been Signed on 03/24/2023 01:55 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:YORBA LINDA SENIOR CARE IIFACILITY NUMBER:
306004781
ADMINISTRATOR:CHRIS CURTISFACILITY TYPE:
740
ADDRESS:4442 ACORN COURTTELEPHONE:
(714) 928-6550
CITY:YORBA LINDASTATE: CAZIP CODE:
92886
CAPACITY:6CENSUS: 0DATE:
03/24/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:10 PM
MET WITH:Chris CurtisTIME COMPLETED:
02:25 PM
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Licensing Program Analyst (LPA) Ruth Martinez conducted an unannounced Case Management visit for the purpose to verify facility closure. LPA arrived at facility was greeted by Chris Curtis, Administrator and granted entry.

On February 13, 2023 Administrator Chris Curtis notified CCLD of the intent of facility closure. On March 22, 2023 Administrator notified LPA Velazquez that facility was officially closed and no longer operating as a licensed facility. Administrator indicated that facility had only one resident and they were moved out of the facility on November 01, 2022 to another licensed facility held by the Administrator.

The reason for today’s inspection is to confirm the closure of the licensed facility. LPA accompanied by Administrator toured the facility and observed no residents in care. LPA observed the home to be empty and found no evidence the home is operating as a licensed facility. Based on observation the facility is no longer operating as a licensed facility and is closed.

This report was reviewed with Administrator and a copy of this report was provided.
SUPERVISOR'S NAME: Armando J LuceroTELEPHONE: (949) 430-1222
LICENSING EVALUATOR NAME: Ruth MartinezTELEPHONE: (657) 285-1397
LICENSING EVALUATOR SIGNATURE:
DATE: 03/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/24/2023
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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