<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306006018
Report Date: 11/30/2023
Date Signed: 11/30/2023 10:18:31 AM


Document Has Been Signed on 11/30/2023 10:18 AM - 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:CRESCENT LANDING AT SANTA ANA MEMORY CAREFACILITY NUMBER:
306006018
ADMINISTRATOR:TORRES, JUDITHFACILITY TYPE:
740
ADDRESS:3730 S. GREENVILLE AVENUETELEPHONE:
(419) 247-2800
CITY:SANTA ANASTATE: CAZIP CODE:
92704
CAPACITY:72CENSUS: 49DATE:
11/30/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:10 AM
MET WITH:Judith Torres- Executive DirectorTIME COMPLETED:
10:30 AM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA) Jessica Cho continued the Case Management- Other visit in conjunction with a Case Management- Deficiencies visit and to deliver the findings into Complaint Control Number: 22-AS-20201109104853. It was determined upon the file review that the current licensee is the same as the former licensee.

An exit interview was conducted with Executive Director Judith Torres, and a copy of this report was provided at the end of the visit.
SUPERVISOR'S NAME: Sheila SantosTELEPHONE: (714) 334-2064
LICENSING EVALUATOR NAME: Jessica ChoTELEPHONE: 714-703-2840
LICENSING EVALUATOR SIGNATURE:
DATE: 11/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/30/2023
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 1