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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306005964
Report Date: 05/23/2022
Date Signed: 05/23/2022 04:29:13 PM

Document Has Been Signed on 05/23/2022 04:29 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:REIMAGINE NETWORKFACILITY NUMBER:
306005964
ADMINISTRATOR:WALKER, SANDRAFACILITY TYPE:
775
ADDRESS:1601 EAST SAINT ANDREW PLACETELEPHONE:
(714) 633-7400
CITY:SANTA ANASTATE: CAZIP CODE:
92705
CAPACITY: 100CENSUS: 0DATE:
05/23/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:33 AM
MET WITH:Cynthia NguyenTIME COMPLETED:
04:40 PM
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Licensing Program Analyst (LPA) Jessica Cho conducted an unannounced required annual inspection focusing primarily on the Infection Control. LPA Cho was greeted and granted entry after completing the Coronavirus 2019 (COVID-19) screening procedure. LPA met with Interim Program Director (PD) Cynthia Nguyen and stated the purpose of the visit.

Around 11:39 am, LPA and PD conducted a tour around the facility. There are two programs offered on site: Transitional Adult Program (TAP) and Community Based Adult Services (CBAS). TAP is solely licensed by the Department; and per PD, all fifteen clients are enrolled and not wanting to return to the program. As of today, the fifteen clients are currently learning from home. LPA observed a total of 28 staffs (who are associated to the CBAS & TAP Program) on duty wearing PPE. LPA verified that the seven staffs were not associated to the TAP Program. Per PD, Chief Human Resources & Custodian of Records, Erica Cruz, stated Guardian could not be accessed due to the account being disabled. LPA received a copy of the Fingerprint Clearance Reports for all seven staffs and requested a copy of the LIC9182, LIC508, and the California Driver's License during the visit. LPA will submit the requested documents to the Department to ensure association of the seven staffs. LPA inspected common areas, storage areas, music room, offices, and bathrooms. All areas were clean and organized and found no health and safety issues. Hot water was measured at 115.3 degrees Fahrenheit in the Music Room which is the only dedicated classroom for TAP clients. LPA observed the facility had sufficient PPE, cleaning, and incontinence supplies over 30 days' worth all of which were properly locked and stored. The smoke detectors were not tested as it would alert the entire facility, but Facility Manager, Vincent Hill verified that the smoke detectors were tested in August 2021 and are functioning. PD was present during this conversation and LPA Cho received a copy of the report during the visit. Medications were inaccessible to the clients in care. LPA observed cleaning supplies and a scissor were stored in an unlocked cabinet in the Music Room. The cabinets were locked during the visit. The fire extinguishers were mounted and charged.
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Jessica Cho
LICENSING EVALUATOR SIGNATURE: DATE: 05/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/23/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME: REIMAGINE NETWORK
FACILITY NUMBER: 306005964
VISIT DATE: 05/23/2022
NARRATIVE
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For this visit, there are no deficiencies cited in this review as per Title 22 Division 6 of the California Code of Regulations. An Advisory Note (LIC9102) was issued during the visit and the Program Manager and/or Administrator will follow-up with the corrections. An exit interview was conducted with Program Manager Cynthia Nguyen, and a copy of this report was provided.
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Jessica Cho
LICENSING EVALUATOR SIGNATURE:

DATE: 05/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/23/2022
LIC809 (FAS) - (06/04)
Page: 2 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME: REIMAGINE NETWORK
FACILITY NUMBER: 306005964
VISIT DATE: 05/23/2022
NARRATIVE
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For this visit, there are no deficiencies cited in this review as per Title 22 Division 6 of the California Code of Regulations. An Advisory Note (LIC9102) was issued during the visit and the Program Director and/or Administrator will follow-up with the corrections. An exit interview was conducted with Program Director Cynthia Nguyen, and a copy of this report was provided.
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Jessica Cho
LICENSING EVALUATOR SIGNATURE:

DATE: 05/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/23/2022
LIC809 (FAS) - (06/04)
Page: 4 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME: REIMAGINE NETWORK
FACILITY NUMBER: 306005964
VISIT DATE: 05/23/2022
NARRATIVE
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LPA provided technical assistance to post the Emergency Disaster Plan for Adult Day Programs (LIC610D) and the COVID-19 precautionary signs in a prominent place by both entrances and in the Music Room. LPA reviewed the COVID-19 mitigation plan.

For this visit, there are no deficiencies cited in this review as per Title 22 Division 6 of the California Code of Regulations. An Advisory Note (LIC9102) was issued during the visit and the Program Director and/or Administrator will follow-up with the corrections. An exit interview was conducted with Program Director Cynthia Nguyen, and a copy of this report was provided.
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Jessica Cho
LICENSING EVALUATOR SIGNATURE:

DATE: 05/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/23/2022
LIC809 (FAS) - (06/04)
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