<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306005616
Report Date: 12/29/2022
Date Signed: 12/29/2022 02:04:48 PM

Document Has Been Signed on 12/29/2022 02:04 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:NEW JOURNEYS BEHAVIORAL HEALTHFACILITY NUMBER:
306005616
ADMINISTRATOR:KHARBANDA, ANDYFACILITY TYPE:
772
ADDRESS:7 MASLOWTELEPHONE:
(949) 336-6460
CITY:IRVINESTATE: CAZIP CODE:
92620
CAPACITY: 6CENSUS: 1DATE:
12/29/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:05 PM
MET WITH:Erin Franco- Program Director TIME COMPLETED:
02:25 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA) Andrea Mendivil conducted an unannounced visit for the purpose of conducting a required/ annual visit. LPA was greeted and granted entry into facility by Erin Franco, Program Director

At 1:05 PM, LPA toured the facility with Jennifer Welsh, Community Outreach Coordinator. Facility has 1 client present. LPA observed a screening and sanitizing station at entrance of the facility. LPA observed client relaxing in the facility. All client rooms had required elements, including bed, chair, closet space and ample lighting. Restrooms are stocked with soap and paper towels and have hand washing postings. Facility has 7 day non perishables and 2 day perishables. Facility has a secured location for client medication and files. LPA toured the outside grounds and observed outside visitation area. Facility has a plan for covid testing clients and staff as needed as well as a plan for isolation. LPA reviewed client files and all contained required documentation including updated emergency information.

No deficiencies noted during today's visit. An exit interview was conducted and a copy of this report was left at the facility.

SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Andrea Mendivil
LICENSING EVALUATOR SIGNATURE: DATE: 12/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/29/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1