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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306005507
Report Date: 01/15/2025
Date Signed: 01/15/2025 03:42:36 PM

Document Has Been Signed on 01/15/2025 03:42 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 COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME:BRIARWOOD HOUSEFACILITY NUMBER:
306005507
ADMINISTRATOR/
DIRECTOR:		COOPER, JULIEFACILITY TYPE:
734
ADDRESS:618 BRIARWOOD DRTELEPHONE:
(714) 332-0518
CITY:BREASTATE: CAZIP CODE:
92821
CAPACITY: 5CENSUS: 5DATE:
01/15/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:05 PM
MET WITH:Julie Cooper, AdministratorTIME VISIT/
INSPECTION COMPLETED:
04:00 PM
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Licensing Program Analyst (LPA) Rose Ruppert made an unannounced visit to the facility today to conduct an Annual Required Evaluation. LPA was greeted and granted entry by Staff #1 at 12:05pm. During today’s visit, LPA met with Julie Cooper, Administrator.

The facility is a single story, five bedroom, two bathroom home with an approved fire clearance of five non-ambulatory. The facility currently has a census of five clients in care. Four were present at the time of visit and one was out for a medical appointment with two staff members and two staff members remained in the facility.

During today’s visit, LPA toured the facility and inspected the physical plant, including but not limited to testing all smoke detectors, testing hot water temperature in two of two client bathrooms, and testing auditory devices on all exits. The hot water temperature measured between 111.0 to 113.9 degrees Fahrenheit and all smoke detectors were operational. The fire extinguisher is charged and was serviced on December 24, 2024 The facility’s last fire drill was conducted on December 12, 2024. LPA inspected the facility food supply and observed the facility retained a minimum of two days perishable and seven days non-perishable food on hand. LPA observed medication storage and reviewed the centrally stored medications. Per review medications are being given as prescribed. First Aid Kit had all the required elements and an American Red Cross Manual was ordered on January 14, 2025.

LPA reviewed three of three staff training and fingerprint records and conducted a complete review of client records. Client P&I records were reviewed and were accurate. LPA interviewed alert clients regarding their quality of care and spoke to staff present regarding care provided. LPA confirmed that administrator has a current administrator certificate which expires on July 9, 2026.

(Continued on LIC 809-C)
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: RoseMarie Ruppert
LICENSING EVALUATOR SIGNATURE: DATE: 01/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/15/2025
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME: BRIARWOOD HOUSE
FACILITY NUMBER: 306005507
VISIT DATE: 01/15/2025
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(Continued from LIC 809)

LPA observed clients listening to music in the living room and others resting in their bedrooms. All bedrooms had the required furnishings and fixtures LPA observed an Automated External Defribrillator (AED) that was checked on January 1, 2025. Each bedroom has a hoyer lift attachment fro the ceiling. All clients have access to oxygen, as needed. LPA observed a spacious backyard that overlooks a golf course and a covered patio with walking paths for clients. A small area was cordoned off in the kitchen hallway due to water leak repair.

Based on the observations made during today’s visit, the facility appears to be in compliance with Title 22 Division 6 of the California Code of Regulations, no deficiencies cited on this date. An exit interview was conducted with Julie Cooper, Administrator and a copy of the report and files reviewed (LIC 858 & LIC 859) were given at the time of the visit.
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: RoseMarie Ruppert
LICENSING EVALUATOR SIGNATURE:

DATE: 01/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2025
LIC809 (FAS) - (06/04)
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