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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306004823
Report Date: 12/17/2024
Date Signed: 12/17/2024 12:21:35 PM

Document Has Been Signed on 12/17/2024 12:21 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:LEISURE TOWER II RESIDENTIAL CAREFACILITY NUMBER:
306004823
ADMINISTRATOR/
DIRECTOR:		NELSON PEREZFACILITY TYPE:
735
ADDRESS:608 E SYCAMORETELEPHONE:
(714) 321-1656
CITY:ANAHEIMSTATE: CAZIP CODE:
92805
CAPACITY: 32CENSUS: 28DATE:
12/17/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:06 AM
MET WITH:Nelson PerezTIME VISIT/
INSPECTION COMPLETED:
12:36 PM
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Licensing Program Analyst (LPA) Claudia Gutierrez made an unannounced visit for the purpose of conducting a Required/Annual Inspection. LPA met with Administrator (AD) Nelson Perez and explained the purpose of the inspection. During the inspection, LPA and AD conducted a tour of the inside and outside of the facility, common areas, client bedrooms, kitchen, and observed the following:

This is a two-story apartment complex with nine apartments. Eight of the nine apartments are occupied by clients and contain two bedrooms, and one bathroom. One out of nine of the apartments serves as a dining area for clients and as a staff office. All client bedrooms had the required furnishings. LPA observed all client beds had linens and blankets. LPA observed all windows were screened. The courtyard has a shaded sitting area. LPA observed clients socializing in the courtyard and resting in their apartments and respective bedrooms. Bathrooms were observed to be free of debris and mildew, faucets and toilets were operational. LPA tested the water temperature in select client bathrooms, water temperature tested between 106.8-118.2 F degrees. LPA observed emergency disaster plan with means of exiting and emergency phone numbers listed and posted. Food menu was also posted and visible. LPA observed the facility has a 2-day supply of perishables and a 7-day supply of non-perishable food as required by regulations. Smoke detectors and carbon monoxide detectors tested operational. Fire extinguishers were observed mounted on the wall on the first and second story, and were observed to be fully charged with a service tag dated February 13, 2024. Facility appliances were observed to be operable. Sharps, all and any toxic chemicals, cleaning solutions, laundry toxins and disinfectants are inaccessible to clients. Medication cabinet was observed to be locked. LPA reviewed four client files and three staff files. LPA interviewed four clients and two staff.

Based on the observations made during today’s inspection, no deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted and a copy of this report was left at the facility.
SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Claudia Gutierrez
LICENSING EVALUATOR SIGNATURE: DATE: 12/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/17/2024
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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