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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306005809
Report Date: 10/25/2024
Date Signed: 10/25/2024 10:57:57 AM

Document Has Been Signed on 10/25/2024 10:57 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:BRITTA CAREFACILITY NUMBER:
306005809
ADMINISTRATOR/
DIRECTOR:		MANGISI, FRANKFACILITY TYPE:
740
ADDRESS:106 S JEANINE WAYTELEPHONE:
(714) 630-4791
CITY:ANAHEIMSTATE: CAZIP CODE:
92806
CAPACITY: 6CENSUS: 6DATE:
10/25/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:44 AM
MET WITH:Norkisa Baldec-CaregiverTIME VISIT/
INSPECTION COMPLETED:
11:13 AM
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On this day Licensing Program Analysts (LPAs) Alvaro Ramirez, Jr. and Brandon Lopez made an unannounced Plan of Correction (POC) visit in conjunction with the Required 1 Year Inspection and citation issued on October 02, 2024. LPAs were greeted and granted entry into the facility by Caregiver Norkisa Baladec. LPAs explained the reason for the visit.

On October 18, 2024, AD failed to correct the following:


*Deficiency cited under Title 22 Regulation 1569.625(b)(2) pertaining to training requirements. As of 10/25/24, Deficiency cited under Title 22 Regulation pertaining to training requirements has been CLEARED.

Based on the observations made during today's visit, no deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations.

An exit interview was conducted with facility representative and a copy of this report were provided at the time of this visit.
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Alvaro Ramirez Jr.
LICENSING EVALUATOR SIGNATURE: DATE: 10/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/25/2024
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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