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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306005485
Report Date: 07/05/2022
Date Signed: 07/05/2022 02:02:51 PM


Document Has Been Signed on 07/05/2022 02:02 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:RYAN'S OPEN ARMSFACILITY NUMBER:
306005485
ADMINISTRATOR:CHENG, CHIN-WENFACILITY TYPE:
740
ADDRESS:6942 DRESDEN CIRTELEPHONE:
(714) 894-2835
CITY:HUNTINGTON BEACHSTATE: CAZIP CODE:
92647
CAPACITY:6CENSUS: 5DATE:
07/05/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:25 PM
MET WITH:Administrators, Ryan Yu and Megan ChengTIME COMPLETED:
02:15 PM
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Licensing Program Analyst (LPA) Jenifer Tirre conducted an unannounced visit for the purpose of conducting a required annual visit. LPA was greeted, granted entry into the facility and temperature checked by Administrator and explained the reason for the visit.

During the visit LPA toured the facility with Administrator Ryan Yu. During visit, Administrator Megan Cheng arrived at facility. Facility is a 6 bedroom,( 4 resident bedrooms 2 staff bedroom) and 3 bathroom single story home. There are 5 Residents in care. LPA observed proper covid signage at front entrance of facility as well as sign in, sanitization and temperature check station. Facility has required Department postings. LPA observed copy of Administrators Certificate expiring September 16, 2023. LPA toured all Residents rooms, all rooms where within department guidelines. All restrooms observed contained soap, toilet paper, and paper towels. Restrooms had proper hand washing signs posted. Residents were observed relaxing in the bedrooms watching TV. Facility has operating smoke detectors. Facility has 2 fire extinguishers which are mounted and fully charged. Facility has 30 days supply of PPE. Facility has refrigerator with ample food supply. LPA observed facility has emergency food and water supply. Facility has required Emergency Disaster Plan and mitigation plan posted. Facility has a secured location for resident medication and files. Facility has 30 days supply of medications for clients. During today's visit, LPA observed 5 of 5 resident files. Resident emergency contact information and Physicians reports are current. Facility has a designated visitation area.

No deficiencies noted during todays visit. An exit interview was conducted with Administrator and a copy of report was left at facility.
SUPERVISOR'S NAME: Alisa OrtizTELEPHONE: (714) 703-2855
LICENSING EVALUATOR NAME: Jenifer TirreTELEPHONE: (714) 703-2840
LICENSING EVALUATOR SIGNATURE:
DATE: 07/05/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/05/2022
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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