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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306005391
Report Date: 01/30/2023
Date Signed: 01/30/2023 02:51:21 PM

Document Has Been Signed on 01/30/2023 02:51 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
ORANGE & INLAND A/SC, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME:NSIGHT PSYCHOLOGY & ADDICTIONFACILITY NUMBER:
306005391
ADMINISTRATOR:BEATIFICATO, MARY HELENFACILITY TYPE:
772
ADDRESS:206 W.SIERRA DRIVETELEPHONE:
(949) 629-3722
CITY:SANTA ANASTATE: CAZIP CODE:
92707
CAPACITY: 6CENSUS: 2DATE:
01/30/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Denita TrowellTIME COMPLETED:
02:30 PM
NARRATIVE
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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 staff. LPA met with Denita Trowell, Program Director and explained the nature of the visit.

LPA Martinez accompanied by Program Director began the tour of the facility. There are two clients in care and no active covid case in the facility. LPA observed clients arriving while conducting the tour. There is a sign-in procedure in place. LPA observed required department posting and covid precautionary posting in the facility. The facility has a Mitigation plan on file with CCLD. Facility has required Emergency Disaster Plan poster. All bathroom observed to have a supply of soap, toilet paper and paper hand towels. LPA toured the client’s bedrooms, all bedrooms observed to have all required components. The facility is equipped with sufficient hygiene supplies, cleaning and disinfecting provisions. Facility has an emergency food and water supply. Facility has personal protective equipment (PPE) supply throughout the facility. Facility has a secure location for client’s medication and has a 30 day supply of medication for clients. LPA observed there are several seating areas for clients use.

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 facility representative and a copy of this report was provided to the facility.
SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Ruth Martinez
LICENSING EVALUATOR SIGNATURE: DATE: 01/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/30/2023
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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