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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306005929
Report Date: 04/05/2022
Date Signed: 04/05/2022 03:47:53 PM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 04/05/2022 03:47 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:MARTINO LOVING CARE, INC.FACILITY NUMBER:
306005929
ADMINISTRATOR:TRIEU, THANHFACILITY TYPE:
740
ADDRESS:1904 W. RANDOM DRIVETELEPHONE:
(714) 858-3535
CITY:ANAHEIMSTATE: CAZIP CODE:
92804
CAPACITY:6CENSUS: 0DATE:
04/05/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Tranh Trieu, AdministratorTIME COMPLETED:
04:00 PM
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Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility in order to conduct a required annual inspection. LPA arrived at facility and rang the bell twice with no response. LPA called the phone number on file and asked whether the licensee could come to the facility to confirm the facility does not currently have any residents in care.

Licensee Tranh Trieu arrived at approximately 3:30pm, greeted and granted entry to LPA after being explained the purpose of the visit.

LPA accompanied by licensee toured the inside and outside of the facility. There are currently no residents in care. The four (4) bedrooms, two shared and two single, include all necessary components. Bathrooms are equipped with grab bars and slip mats. Facility appears to be clean, sanitary and free of odors in all areas inspected. Sharp instruments are kept in a drawer secured by a magnetic lock. Cleaning supplies and toxic substances are securely stored under lock as well.

LPA observed the facility has COVID-19 Precautions posters, required department postings as well as handwashing signs. As there are no residents in care, no supply of food was observed. Medication is centrally stored and locked in a cabinet or in a locking refrigerator if needed.

The perimeter gates are self-latching and can easily be opened in an evacuation. Outside space is clear and free of debris, with available outdoor furniture for the residents' enjoyment.

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. This report was reviewed with facility representative and a copy of this report was provided and left at facility. The licensee is reminded that the facility's assigned LPA needs to be informed in writing of the facility's intention to resume admitting residents into care.
SUPERVISOR'S NAME: Alisa OrtizTELEPHONE: (714) 287-4084
LICENSING EVALUATOR NAME: Kevin Saborit-GuaschTELEPHONE: 714-703-2851
LICENSING EVALUATOR SIGNATURE:
DATE: 04/05/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/05/2022
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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