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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306005727
Report Date: 12/01/2021
Date Signed: 12/01/2021 03:59:10 PM

Document Has Been Signed on 12/01/2021 03:59 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:ANGEL'S TOUCH RESIDENCE #2FACILITY NUMBER:
306005727
ADMINISTRATOR:CERDA, YASMIN SFACILITY TYPE:
740
ADDRESS:23911 VIA LA CORUNATELEPHONE:
(949) 206-1507
CITY:MISSION VIEJOSTATE: CAZIP CODE:
92691
CAPACITY: 6CENSUS: 0DATE:
12/01/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
03:30 PM
MET WITH:Administrator Yasmin CerdaTIME COMPLETED:
04:00 PM
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Licensing Program Analyst (LPA) Albert Marin made an announced visit to this facility to conduct a case management. LPA meet with Licensee / Administrator (AD) Yasmin Cerda, and stated the purpose of this visit.

On November 1, 2021, Licensee Javier Hernandez issued a letter addressed to the landlord of the property where this facility is located. The letter indicated that he was terminating the lease agreement on the property and returned the possession of the property to the landlord. On November 30, 2021, Community Care Licensing Division Orange Office received information from Licensees Hernandez and Cerda that they are not updating the lease agreement. Thus, the licensees lost control of the property.

For this visit, LPA toured the exterior portion of the facility. From the outside, LPA Marin did not observe any residents in care. AD Yasmin Cerda affirmed that there had been no residents in care since May 2021. AD Cerda surrendered the original license on site.

LPA Marin conducted and exit interview with AD Cerda. Due to technical issues, LPA will provide a copy of this report to AD via email. In turn, AD agreed to acknowledge its receipt.
SUPERVISORS NAME: Luz Adams
LICENSING EVALUATOR NAME: Albert Marin
LICENSING EVALUATOR SIGNATURE: DATE: 12/01/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/01/2021
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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