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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306005726
Report Date: 12/17/2024
Date Signed: 12/17/2024 10:21:02 AM

Document Has Been Signed on 12/17/2024 10:21 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
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME:TRADITIONS AT STACEY LEEFACILITY NUMBER:
306005726
ADMINISTRATOR/
DIRECTOR:		DE LOS REYES, LORDELEFACILITY TYPE:
740
ADDRESS:5105 EAST STACEY LEE LANETELEPHONE:
(714) 769-5858
CITY:ORANGESTATE: CAZIP CODE:
92867
CAPACITY: 6TOTAL ENROLLED CHILDREN: 0CENSUS: 6DATE:
12/17/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:00 AM
MET WITH:Caregiver Maricel NeumanTIME VISIT/
INSPECTION COMPLETED:
10:40 AM
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On December 17, 2024, at 8:00am, Licensing Program Analyst (LPA) Edward Kim conducted an unannounced POC visit to follow up on deficiencies cited in forms LIC809D on June 14, 2024. LPA was greeted and granted entry into the facility by Caregiver (CG) Maricel Neuman. LPA spoke with Administrator (AD) Lordele De Los Reyes over the phone and explained the purpose of the visit. AD De Los Reyes said that CG Neuman can sign on her behalf for the report.

LPA Kim and CG Neuman toured the physical plant and made the following observations. Deficiency cited under Title 22 Regulation Health and Safety Code (HSC) 1569.618(a) pertaining to Notifying the Department of Social Services of Facility Manager being designated has been cleared. LPA Kim observed the LIC 308. Deficiency cited under Title 22 Regulation HSC 1569.625(b)(2) pertaining to Staff Training has been cleared. During the visit, LPA observed the facility had completed all the necessary training for staff. Deficiency cited under Title 22 Regulation HSC 1569.695(c) pertaining to Emergency Drill log has been cleared. During the visit, LPA observed the Emergency Drill was last conducted on November 4, 2024. Deficiency cited under Title 22 Regulation California Code of Regulations (CCR) 87303(a) pertaining to a Facility being clean, safe, sanitary, and being in good repair has been cleared. During the visit, LPA Kim observed the backyard next to the air conditioner has been cleaned and cleared.

Licensee has been advised to maintain all items especially those that were previously deficient in the facility in accordance with Title 22 Regulations.

An exit interview was conducted, and a copy of this report and two POC Clearance letters were provided to Caregiver Maricel Neuman.
Lourdes MontoyaTELEPHONE: (916) 956-7332
Edward KimTELEPHONE: (714) 293-1237
DATE: 12/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/17/2024
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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