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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306005985
Report Date: 07/19/2021
Date Signed: 07/19/2021 10:01:33 AM

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:ROYAL CARE FAMILY HOMESFACILITY NUMBER:
306005985
ADMINISTRATOR:ASIS, EMELYNFACILITY TYPE:
740
ADDRESS:506 N. ROYAL ST.TELEPHONE:
(562) 461-9820
CITY:ANAHEIMSTATE: CAZIP CODE:
92806
CAPACITY:6CENSUS: 3DATE:
07/19/2021
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Emelyn AsisTIME COMPLETED:
10:15 AM
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This is a second announced Pre-Licensing visit conducted by Licensing Program Analyst (LPA) Lydia Martinez to verify the correction of outstanding item noted during the first Pre-licensing visit of 7/01/2021. LPA Martinez met with Administrator Emelyn Asis.

LPA conducted walk through of the facility and noted 3 resident and 1 staff in the facility.

The following outstanding item was reviewed and has been corrected:


- Structure/room in garage has been demolished,

LPA Martinez let Administrator Asis know that if she plans to build a room in the garage she must go through the proper channels such as city permits, fire clearance but first let CCL know of the plans.

The Pre-Licensing inspection has been completed. It appears this facility meets Title 22 requirements. The license will be granted upon completion of a final review and approval from the Application Specialist.
SUPERVISOR'S NAME: Marina StanicTELEPHONE: (714) 703-2840
LICENSING EVALUATOR NAME: Lydia MartinezTELEPHONE: (714) 703-2840
LICENSING EVALUATOR SIGNATURE:

DATE: 07/19/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2021
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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