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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306005257
Report Date: 01/23/2024
Date Signed: 01/23/2024 01:46:06 PM


Document Has Been Signed on 01/23/2024 01:46 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:CRESCENDO SENIOR LIVINGFACILITY NUMBER:
306005257
ADMINISTRATOR:VIVIAN VILLEGASFACILITY TYPE:
740
ADDRESS:351 EAST PALM DRIVETELEPHONE:
(714) 528-4990
CITY:PLACENTIASTATE: CAZIP CODE:
92870
CAPACITY:138CENSUS: DATE:
01/23/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
12:20 PM
MET WITH:Laurie GalalTIME COMPLETED:
02:00 PM
NARRATIVE
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Licensing Program Analyst (LPA) Claudia Gutierrez conducted an unannounced case management inspection for the purpose of following-up on Resident 1's (R1's) death report submitted to Community Care Licensing (CCL) on 1/17/24. LPA met with Executive Director (ED) Laurie Galal and explained the purpose of the inspection.

LPA obtained copies of staff schedule, R1's narrative charting, incident charting, and LIC602.

During the inspection, LPA, AD, and Wellness Director (WD) Kim Mims conducted a tour of the physical plant. The facility is a two-level structure with an adjacent two-story building used for memory care. LPA observed resident bedrooms had the required furnishings. LPA observed resident beds had linens and blankets. Water temperature tested at 111.7 degrees Fahrenheit; faucets and toilets were operational. Facility has two separate stairwells, and each contains its own evacuation chair. 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. Sharps, all and any toxic chemicals were observed to be inaccessible to residents. Fire extinguishers were charged, mounted, and located in multiple areas of the facility with service tags dated 11/15/23. Facility has a shaded seating area in the front entrance and in the courtyard, no obstacles or hazards were observed.

LPA did not observe any immediate threats to the health or safety of residents in care. Based on 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 provided to the facility.

SUPERVISOR'S NAME: Armando J LuceroTELEPHONE: (714) 703-2840
LICENSING EVALUATOR NAME: Claudia GutierrezTELEPHONE: 714-703-2840
LICENSING EVALUATOR SIGNATURE:
DATE: 01/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/23/2024
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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