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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306004799
Report Date: 01/21/2025
Date Signed: 01/21/2025 04:03:39 PM

Document Has Been Signed on 01/21/2025 04:03 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:VERDI HOMEFACILITY NUMBER:
306004799
ADMINISTRATOR/
DIRECTOR:		CRISTINA SANTOSFACILITY TYPE:
735
ADDRESS:6471 VERDI DRIVETELEPHONE:
(714) 994-6471
CITY:BUENA PARKSTATE: CAZIP CODE:
90621
CAPACITY: 6CENSUS: 6DATE:
01/21/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:19 PM
MET WITH:Jessie NazarenoTIME VISIT/
INSPECTION COMPLETED:
04:15 PM
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On January 21st, 2025 Licensing Program Analyst (LPA) William Vanegas made an unannounced visit for the purposes of conducting an annual visit. Upon arrival LPA Vanegas was greeted and granted entry into the facility by Direct Support Staff (DSP) Jessie Nazareno. LPA Vanegas explained the purpose of the visit and began to tour the facility and observed the following.

This is a one storied home with six bedrooms four of which are client rooms and two of which are staff rooms, with two restrooms, and a two car attached garage. LPA Vanegas observed the kitchen to be in clean and sanitary condition. LPA Vanegas observed for there to be a gas stove, microwave, and refrigerator to all be in good repair and operational. LPA Vanegas observed there to be a two day supply of perishable food and a seven day supply of non-perishable food, and a sufficient amount of emergency water.

LPA Vanegas observed bathrooms to be clean and in good repair. Water faucet and toilet tested operational and water tested to be between. 128.3 and 131.5 degrees. LPA Vanegas observed all client rooms to be missing a chair and advised DSP Jessie Nazareno, that all individuals require a chair to be placed in their rooms. LPA Vanegas observed client rooms to have a bed, chest drawers, closet space, and clean linens in good repair meaning no strains or tears.

LPA Vanegas toured the outside of the facility and observed there to be no obstructions along the emergency exits and door were unlocked and self latching. LPA Vanegas advised that due to time constraints the visit would have to end and LPA Vanegas would come back to the facility to complete the annual visit. No deficiencies were issued at this time and an exit interview was conducted and a copy of this report was left at the facility.
SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: William Vanegas
LICENSING EVALUATOR SIGNATURE: DATE: 01/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/21/2025
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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