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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306005709
Report Date: 06/28/2022
Date Signed: 06/30/2022 11:31:03 AM

Document Has Been Signed on 06/30/2022 11:31 AM - 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:GENERATIONS OF ANAHEIM ASSISTED LIVING, INCFACILITY NUMBER:
306005709
ADMINISTRATOR:MANALAD, JOSELITOFACILITY TYPE:
735
ADDRESS:1941 E. CENTER STREETTELEPHONE:
(714) 533-3640
CITY:ANAHEIMSTATE: CAZIP CODE:
92805
CAPACITY: 42CENSUS: DATE:
06/28/2022
TYPE OF VISIT:OfficeANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Joselito Manalad
Diosdado Mangune
Kyle Watanabe		TIME COMPLETED:
04:00 PM
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On 6/28/2022, an Informal Conference was conducted by the Department to discuss current renovation plans for Generations of Anaheim. Present at the meeting was Licensee, Generations of Anaheim Assisted Living, Inc. represented by Joselito Manalad, Administrator Diosdado Mangune, and corporate member serving as Advisor Kyle Watanabe. Representing the Department were Regional Manager (RM) Marina Stanic, Licensing Program Manager (LPM) Armando Lucero, and Licensing Program Analyst (LPA) Claudia Gutierrez.

Licensing Program Analysts (LPAs) Claudia Gutierrez and Lydia Martinez conducted an unannounced visit on 6/15/2022 to follow-up on a case management visit dated 6/14/2022. Based on the case management visits the Department determined that the Licensee made alterations to existing building, not consistent with original floor plan or fire clearance, without notifying the Department. The Licensee did not exercise health and safety risk checks as required by CCR, Title 22, Division 6, Chapter 1, Section 80086(a) Alterations to Existing Building or New Facilities and 80087(a) Buildings and Grounds.

The following was discussed:
· Reporting Requirements
· Importance of maintaining communication between facility and Department
· Various ways the facility can communicate with Department
· The Department’s consultation role
· Additional renovations taking place at the facility
SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Claudia Gutierrez
LICENSING EVALUATOR SIGNATURE: DATE: 06/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/28/2022
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME: GENERATIONS OF ANAHEIM ASSISTED LIVING, INC
FACILITY NUMBER: 306005709
VISIT DATE: 06/28/2022
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The following was agreed upon:
· The importance of maintaining a good working relationship
· The facility will not move forward with renovations without first notifying the Department
· Facility will provide the Department a detailed report of renovations done, including: when renovations initiated, when they will conclude, who will be doing health checks, where equipment will be stored, and how many additional bathrooms are available while renovations are being done on bathrooms.
· A separate conference will be scheduled to further support facility in their effort to preserve and expand their facility serving SSI adults diagnosed with mental illness with the Community Care Expansion Program.

An exit interview was conducted with the Licensee and a copy of this report LIC809 was provided to the Licensee.
SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Claudia Gutierrez
LICENSING EVALUATOR SIGNATURE:

DATE: 06/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/28/2022
LIC809 (FAS) - (06/04)
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