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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306005349
Report Date: 04/14/2022
Date Signed: 04/14/2022 12:20:06 PM


Document Has Been Signed on 04/14/2022 12:20 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:LAS PALMASFACILITY NUMBER:
306005349
ADMINISTRATOR:MONICA CASTILLOFACILITY TYPE:
740
ADDRESS:24962 CALLE ARAGONTELEPHONE:
(949) 586-3393
CITY:LAGUNA WOODSSTATE: CAZIP CODE:
92637
CAPACITY:220CENSUS: 139DATE:
04/14/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Monica Castillo, AdministratorTIME COMPLETED:
12:30 PM
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Licensing Program Analyst (LPA) Ruth Martinez conducted an unannounced visit for the purpose of conducting a required annual inspection. LPA was greeted and granted entry into the facility by receptionist. LPA was checked in via Covid guidelines. LPA met with Monica Castillo, Administrator and explained the nature of the visit.

LPA Martinez accompanied by Administrator toured the physical plant of the facility. LPA observed an electronic check in station in the main entry of the facility. There are 139 residents in care and there are no active Covid-19 case in the facility. LPA observed several residents throughout the facility. All observed residents appeared to be clean and well taken care of. LPA observed required Department postings, covid-19 precautionary postings and hand washing signs throughout the facility. LPA observed sanitary precaution throughout the facility. Resident bedrooms are apartment style with all required components. Restrooms observed to have supply of soap and appeared to be clean. Facility has a back up emergency food and water supply. LPA observed a storage unit with PPE supply. LPA observed several shaded seating areas for the residents’ enjoyment. The facility has completed the LIC808 Mitigation plan, the Department reviewed and approved the plan on April 21, 2021. LPA was informed facility has been compliant with resident and staff on completing the Covid booster shots.

Based on the observation made during today’s visit, no deficiencies were noted today in the areas inspected per Title 22 Division 6 of the California Code of Regulations.

This report was reviewed with the Administrator and a copy of this report was provided to the facility.
SUPERVISOR'S NAME: Sheila SantosTELEPHONE: (714) 334-2062
LICENSING EVALUATOR NAME: Ruth MartinezTELEPHONE: (657) 285-1397
LICENSING EVALUATOR SIGNATURE:
DATE: 04/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/14/2022
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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