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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306005571
Report Date: 04/05/2022
Date Signed: 04/05/2022 02:05:05 PM

Document Has Been Signed on 04/05/2022 02:05 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:ENDEAVORS RESIDENTIAL CARE, INC.FACILITY NUMBER:
306005571
ADMINISTRATOR:PENALOSA, BRANDONFACILITY TYPE:
735
ADDRESS:1777 W BEACON AVETELEPHONE:
(310) 938-0700
CITY:ANAHEIMSTATE: CAZIP CODE:
92804
CAPACITY: 4CENSUS: 4DATE:
04/05/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Clifford Valmeo, House Manager
Brandon Penalosa, 		TIME COMPLETED:
02:20 PM
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Licensing Program Analysts (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility in order to conduct a required annual inspection. LPA arrived at facility, was greeted and granted entry by Clifford Valmeo, house manager after explaining the purpose of the visit. Administrator Brandon Penalosa was called and indicated that he was on his way to assist with the visit.

At approximately 1:30pm, LPA accompanied by administrator toured the inside and outside of the facility. There are currently four (4) clients in care, with two (2) clients back in person at their day program while two (2) other ones are still online. The clients are observed to be relaxing in their bedrooms or in the common areas and appear well taken care of. The four (4) individual bedrooms include all necessary components. Bathrooms are equipped with grab bars and slip mats. Facility appears to be clean, sanitary and free of odors in all areas inspected. Sharp instruments are kept in a drawer secured by a key lock. Cleaning supplies and toxic substances are securely stored under lock.

LPA observed the facility has COVID-19 Precautions posters, required department postings as well as handwashing signs. Facility has an adequate supply of PPE. A LIC808 Mitigation Plan has been submitted on 08/11/2021.

LPA observed a sufficient supply of food and water. The facility also has a emergency supply of food and water on hand. A 30-day supply of medication is centrally stored and locked in a cabinet. The perimeter gate is self-latching and can easily be opened in an evacuation.

Based on the observations made during today’s visit, no deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. This report was reviewed with facility representative and a copy of this report was provided and left at facility.
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Kevin Saborit-Guasch
LICENSING EVALUATOR SIGNATURE: DATE: 04/05/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/05/2022
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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