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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306005257
Report Date: 10/07/2020
Date Signed: 10/07/2020 05:53:24 PM

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:CRESCENDO SENIOR LIVINGFACILITY NUMBER:
306005257
ADMINISTRATOR:DALE WOYTEKFACILITY TYPE:
740
ADDRESS:351 EAST PALM DRIVETELEPHONE:
(714) 528-4990
CITY:PLACENTIASTATE: CAZIP CODE:
92870
CAPACITY:138CENSUS: 95DATE:
10/07/2020
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
03:30 PM
MET WITH:Administrator Dale WoytekTIME COMPLETED:
04:45 PM
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Licensing Program Analyst (LPA) Michelle Reed contacted the facility to commence a case management visit via (facetime) due to COVID-19 and pre-cautionary measures. LPA spoke with Administrator Dale Woytek and discussed the purpose of the call. The visit was conducted to assist with COVID19 protocols as recommended by the Health Department and Community Care Licensing. On 10/6/20, two residents and one staff member tested positive for COVID19. The Orange County Health Department also visited the facility on today's date and assisted with their recommendations.
At approximately 4:00pm LPA Reed and Administrator Dale Woytek conducted a tour of the physical plant in the Assisted Living and Memory Care Building. Policies and procedures are in place for screening staff, residents and essential visitors. Signs are posted throughout the buildings regarding social distancing, handwashing and the covering of cough. Staff temperature as well as residents are taken twice a day. All staff are required to wear surgical masks, shields and gloves as needed. All facility staff encountered during today's Televisit were wearing masks and other PPE as appropriate. Social distancing was also being practiced. Social activities are conducted with less than 10 residents and maintaining a minimum 6-foot social distance. Hand sanitizer was also present throughout the building. All meals are delivered to each resident’s room utilizing disposable plates and cutlery. If residents use the dining room there is a rotation for lunch. Breakfast and dinner are served in resident rooms. Sanitation practices are conducted at least 3x a day and as needed. LPA also discussed the facilities staffing and the supply of PPE.
At the time of visit, the facility had effectively incorporated current COVID-19 guidelines. An exit interview was conducted and a copy of this report was provided to Administrator Dale Woytek via email. An electronic email read receipt, confirms receiving these documents. Ms. Woytek agreed to receive the copy of the report and to return a signed copy.
SUPERVISOR'S NAME: Luz AdamsTELEPHONE: (714) 748-2936
LICENSING EVALUATOR NAME: Michelle ReedTELEPHONE: (714) 743-4958
LICENSING EVALUATOR SIGNATURE:

DATE: 10/07/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2020
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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