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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306005964
Report Date: 08/30/2023
Date Signed: 08/30/2023 12:48:33 PM

Document Has Been Signed on 08/30/2023 12:48 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:SOFIA MARTINEZFACILITY TYPE:
775
ADDRESS:1601 EAST SAINT ANDREW PLACETELEPHONE:
(714) 633-7400
CITY:SANTA ANASTATE: CAZIP CODE:
92705
CAPACITY: 100CENSUS: 34DATE:
08/30/2023
TYPE OF VISIT:CollateralUNANNOUNCEDTIME BEGAN:
11:48 AM
MET WITH:Celine Trinh- Social Work AssistantTIME COMPLETED:
01:05 PM
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Licensing Program Analyst (LPA) Jessica Cho arrived unannounced to conduct a collateral visit in connection to Complaint Control #: 22-AS-20230616160340 pending at another facility. LPA was allowed entry and met with Social Work Assistant Celine Trinh after stating the purpose of the visit.

On today's date, LPA obtained pertinent client records and interviewed Client #1 (C1) in a private room.

An exit interview was conducted with Social Work Assistant Celine Trinh, and a copy of this report along with the LIC811 were provided to the social work assistant's email at the end of the visit.
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Jessica Cho
LICENSING EVALUATOR SIGNATURE: DATE: 08/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/30/2023
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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