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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306005824
Report Date: 07/12/2023
Date Signed: 07/12/2023 02:15:49 PM

Document Has Been Signed on 07/12/2023 02:15 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:EVERDEEN HOMESFACILITY NUMBER:
306005824
ADMINISTRATOR:MENDOZA, ALVIN C.FACILITY TYPE:
735
ADDRESS:1210 N. GROTON ST.TELEPHONE:
(714) 261-4530
CITY:ANAHEIMSTATE: CAZIP CODE:
92801
CAPACITY: 4CENSUS: 4DATE:
07/12/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:27 PM
MET WITH:Enrico Mendoza, Staff , Demetrio Fernandez, Staf and Alvin Mendoza, Administrator (Via telephone)TIME COMPLETED:
02:18 PM
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On today's date, while Licensing Program Analyst (LPA) Rosie Quiroz conducted a 10 day unannounced inspection visit to address complaint control #22-AS-20230707163950, LPA Quiroz along with Staff1 (S1) Enrico Mendoza toured the interior and exterior of facility premises. During today's visit, LPA Quiroz conducted interviews with staff and Client (1). During today's facility tour (C1)indicated being hot and wiping his forehead with his hand. LPA Quiroz along with (S1) and (C1) toured bedroom area of (C1), LPA Quiroz observed fan in bedroom area off and windows closed. Facility temperature was recorded to be 80 degrees. LPA Quiroz inquired about air conditioner to (S1). (S1) indicated "Yeah, it's warm I'll let Administrator know."

During today's visit, LPA Quiroz called and spoket to Administrator (AD) Alvin Mendoza and inquired about air conditioner. (AD) Alvin Mendoza indicated "We do have air conditioner, and the staff will call and let me know and I turn it on for them remotely."

During today's visit, LPA Quiroz provided consultation regarding California Code of Regulation (CCR) 80088 (a)(1)(A):
80088: Furniture, Fixtures, Equipment, and Supplies
(a)A comfortable temperature for clients shall be maintained at all areas.
(1)The licensee shall maintain the temperature in rooms that clients occupy between a minimum of 68 degrees F (20 degrees C) and a maximum of 85 degrees F (30 degrees C).
(A)In areas of extreme heat the maximum shall be 30 degrees F (16.6 degrees C) less than the outside temperature.

No citation issued during today's visit.

An exit interview was conducted with (S1), Staff 2 (S2) and (AD) Alvin Mendoza via telephone. A copy of this report was provided at exit and emailed to (AD) Alvin Mendoza.
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Rosie Quiroz
LICENSING EVALUATOR SIGNATURE: DATE: 07/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/12/2023
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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