306005186-10-15-2024-22-AS-JHAY-DA3PU2-20241015113649

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 306005186
Report Date: 10/15/2024
Date Signed: 10/15/2024 11:36:58 AM

Document Has Been Signed on 10/15/2024 11:36 AM - 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:	J AND P HOMES ORCHID		FACILITY NUMBER:	306005186
ADMINISTRATOR/ DIRECTOR:	SANTOS, MELBA M		FACILITY TYPE:	735
ADDRESS:	7971 ORCHID DRIVE		TELEPHONE:	(714) 296-5135
CITY:	BUENA PARK	STATE: CA	ZIP CODE:	90620
CAPACITY: 6		CENSUS: 5	DATE:	10/15/2024
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	07:45 AM
MET WITH:	Melba Santos		TIME VISIT/ INSPECTION COMPLETED:	11:45 AM

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Licensing Program Analyst (LPA) Jerome Haley conducted an unannounced visit for the purpose of conducting a required one-year annual inspection. LPA was greeted, granted entry by staff and explained the reason for the visit. Staff contacted Administrators (AD) Melba Santos via telephone who arrived a short time later and was present for the visit.

During the inspection, LPA Haley observed a closet right next to the front door used by staff for their personal items.

Client bedrooms were clean, organized, and had the necessary elements and were in compliance with regulation guidelines. Client bathrooms were clean and organized as well. Hot water temperatures were measured in the range of 109.7 – 116.7 degrees Fahrenheit. Hygiene items are kept locked in the bathrooms due to client behaviors.

The kitchen is clean, organized, and a perishable food supply that meets regulation requirements was observed. A non-perishable food supply that meets regulation requirements was observed as well. Cleaning chemicals are kept locked in a cabinet below the sink. Knives and sharps are kept locked under the countertop next to the locked cabinet with the chemicals. There are additional locked cabinets in the kitchen, above the refrigerator are locked cabinets with clients’ medications and a first aid kit with all the required elements.

A washer and dryer was observed in the laundry area next to the dining room. In hallway closet, additional nonperishable food items were observed. In the locked hallway closet, LPA Haley observed a locked box with clients P&I funds. An emergency supply of water, food items, and emergency bags for clients was observed in the locked closet.

The garage remains locked and inaccessible to clients at all times. The garage was organized, free of clutter and walkways are free of obstruction. An additional refrigerator with an additional food supply, a supply of diapers, additional linens, and an extra wheelchair was observed in the garage.

Continued on LIC809C

SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Jerome Haley
LICENSING EVALUATOR SIGNATURE:	DATE: 10/15/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2024

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

FACILITY NAME: J AND P HOMES ORCHID	FACILITY NUMBER: 306005186
	VISIT DATE: 10/15/2024

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The living room was clean and organized. LPA observed an exercise bike in the living room. There’s a locked filing cabinet in the living room with various different facility binders. Behind the filing cabinet, the fire extinguisher was observed mounted on the wall.

The backyard was clean, organized, and walkways were free of obstruction. A table with a sunshade and chairs was observed. Both side exit gates were self-closing and self-latching.

Smoke detectors, and the carbon monoxide detector tested operational. A fully charged fire extinguisher was observed mounted on the wall in the living room.

Emergency evacuation drills were being conducted monthly until May 2024. The last evacuation drill was conducted May 5, 2024. The house manager was advised evacuation drills need to be conducted at least quarterly for staff on each shift.

During the inspection, 5 client files were reviewed, 4 client medications reviewed, 5 client P&I funds were reviewed, 5 staff files were reviewed, and 2 staff were interviewed.

No deficiencies are being cited as a result of today’s visit.

An exit interview conducted, and a copy of this report was provided to Administrator Melba Santos.

SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Jerome Haley
LICENSING EVALUATOR SIGNATURE:	DATE: 10/15/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2024

LIC809 (FAS) - (06/04)

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