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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306005774
Report Date: 01/31/2025
Date Signed: 01/31/2025 03:46:44 PM

Document Has Been Signed on 01/31/2025 03:46 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
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME:EASTERSEALS SENIOR DAY CAREFACILITY NUMBER:
306005774
ADMINISTRATOR/
DIRECTOR:		PHILLIPS, KELLYFACILITY TYPE:
775
ADDRESS:3100 E BIRCH STTELEPHONE:
(714) 672-0343
CITY:BREASTATE: CAZIP CODE:
92821
CAPACITY: 40CENSUS: 23DATE:
01/31/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:Elisa Lopez, SupervisorTIME VISIT/
INSPECTION COMPLETED:
04:15 PM
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Licensing Program Analyst (LPA) Rose Ruppert made an unannounced visit to the facility today to conduct an Annual Required Evaluation. LPA was greeted and granted entry at 1pm and met with Elisa Lopez, Supervisor.

The facility is a single story industrial building with an approved fire clearance of forty non-ambulatory participants. The facility currently has a census of twenty-three participants in attendance. During today’s visit, LPA toured the facility and inspected the physical plant. LPA observed participants in one large area with various activities in progress. LPA observed a card game, karaoke, and crafts at various tables. LPA obtained documentation of the most recent building fire alarm and carbon monoxide inspection which was tested on August 22, 2024. LPA observed the First Aid Kit had all of the required elements.

LPA tested hot water temperature in one of one participant restrooms. The hot water temperature measured 111.7 degrees Fahrenheit. The fire extinguishers were charged and serviced on February 22, 2024. The facility’s last fire drill was conducted on January 22, 2025.

LPA inspected the facility food supply and observed the facility retained a minimum of seven days non-perishable food on hand. LPA observed participants used the refrigerators for stored lunches and a coffee/water station was always available. On Fridays a food truck is available and clients handle their own funds to purchase food. There are also cubbies and lockers available for participants to store personal items. All cleaning supplies were locked in a cabinet.

LPA reviewed three of three staff training and fingerprint records and reviewed three of three participant records. LPA interviewed alert participants regarding their quality of services and spoke to staff present regarding services provided.
(Continued on LIC 809-C)
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: RoseMarie Ruppert
LICENSING EVALUATOR SIGNATURE: DATE: 01/31/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/31/2025
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
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME: EASTERSEALS SENIOR DAY CARE
FACILITY NUMBER: 306005774
VISIT DATE: 01/31/2025
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(Continued from LIC 809)

Based on the observations made during today’s visit, the facility appears to be in compliance with Title 22 Division 6 of the California Code of Regulations, no deficiencies cited on this date. An exit interview was conducted with Elisa Lopez, Supervisor and a copy of the report and files reviewed (LIC 858 & LIC 859) were given at the time of the visit.
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: RoseMarie Ruppert
LICENSING EVALUATOR SIGNATURE:

DATE: 01/31/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2025
LIC809 (FAS) - (06/04)
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