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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306005546
Report Date: 09/20/2022
Date Signed: 09/20/2022 01:09:37 PM


Document Has Been Signed on 09/20/2022 01:09 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:REATA GLEN ORANGE COUNTY CCRC LLCFACILITY NUMBER:
306005546
ADMINISTRATOR:NASRATY, SUZANNEFACILITY TYPE:
741
ADDRESS:2 LAS ESTRELLAS LOOPTELEPHONE:
(949) 545-2250
CITY:RANCHO MISSION VIEJOSTATE: CAZIP CODE:
92694
CAPACITY:840CENSUS: 574DATE:
09/20/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:55 AM
MET WITH:Suzanne NasratyTIME COMPLETED:
01:30 PM
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Licensing Program Analysts (LPAs) Kimberly Lyman and Andrea Mendivil made an unannounced case management visit to the facility to follow up on a "Decision and Order" received by Community Care Licensing (CCL) on 09/09/2022. LPAs met with Administrator Suzanne Nasraty and explained the reason for the visit. Human Resources Director Lynda Early was present as well.

Decision and Order effective 09/06/2022 indicates Staff 1 (S1) is excluded from employment in the facility. S1 attempted employment at the facility as a custodian but was denied due to an exemption needed to clear background. The staff did not pursue an exemption and S1 was never hired at the facility. LPA reviewed facility personnel records and S1 is not present on any records for employment or termination.





Exit interview conducted and a copy of this report was left at the facility.

SUPERVISOR'S NAME: Alisa OrtizTELEPHONE: (714) 703-2855
LICENSING EVALUATOR NAME: Kimberly LymanTELEPHONE: (714) 795-1497
LICENSING EVALUATOR SIGNATURE:
DATE: 09/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/20/2022
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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