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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306005334
Report Date: 08/03/2022
Date Signed: 08/03/2022 02:40:38 PM


Document Has Been Signed on 08/03/2022 02:40 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:WONDER'S YEARSFACILITY NUMBER:
306005334
ADMINISTRATOR:JUAN M. GARCIA TRUJILLOFACILITY TYPE:
740
ADDRESS:24301 BARK STREETTELEPHONE:
(949) 215-4087
CITY:LAKE FORESTSTATE: CAZIP CODE:
92630
CAPACITY:6CENSUS: 4DATE:
08/03/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:50 PM
MET WITH:Administrator (AD) Juan Trujillo TIME COMPLETED:
03:00 PM
NARRATIVE
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Licensing Program Analysts (LPAs) Albert Marin and Celine De Perio made an unannounced case management visit to this facility. LPAs met with AD Juan Trujillo and stated the purpose of the visit.

LPAs Marin and De Perio conducted a tour in the interior and exterior portions of the facility, LPAs observed that smoke alarm in each shared resident's room was low on battery; and AD replaced the batteries and were tested to be operational. LPAs also observed video surveillance unit installed in each resident's room. LPA conducted interviews and review of capability of the camera. Per AD and verified by LPA Marin, cameras located in resident's room was off and did not have recording or playback capability at this time. Cameras were used only at night as an alert system in event there are movements inside the resident's rooms. Per advice, AD Trujillo removed the cameras located in the resident's rooms. LPA provided AD with guidance on the requirements of maintaining video surveillance system in the common areas of the facility. LPA Marin also discussed California Code of Regulations Section (CCR) 87355 Criminal Record Clearance, CCR Section 7303 Maintenance and Operation; and CCR 87570 Infection Control Requirements.

For this visit, no citation was issued at this time.

LPAs Marin and De Perio conducted an exit interview with AD Trujillo; and copies of this report, Guidelines on Video Surveillance, CCR 87355 and CCR 87303 were left in the facility.
SUPERVISOR'S NAME: Luz AdamsTELEPHONE: (714) 703-2855
LICENSING EVALUATOR NAME: Albert MarinTELEPHONE: (714) 309-7843
LICENSING EVALUATOR SIGNATURE:
DATE: 08/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/03/2022
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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