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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306006035
Report Date: 10/14/2021
Date Signed: 10/15/2021 09:57:21 AM

Document Has Been Signed on 10/15/2021 09:57 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:LCS HOMES/POINSETTIAFACILITY NUMBER:
306006035
ADMINISTRATOR:SANTOS, CECILFACILITY TYPE:
735
ADDRESS:7912 POINSETTIA DRIVETELEPHONE:
(657) 239-0473
CITY:BUENA PARKSTATE: CAZIP CODE:
90620
CAPACITY: 4CENSUS: 0DATE:
10/14/2021
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Cecil & Leonardo Santos, AdministratorsTIME COMPLETED:
01:45 PM
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 Analysts, Kathrina Chin and Beverly Thompson-Gracia made an unannounced visit for a pre-licensing evaluation. LPAs met with Cecil & Leonardo Santos, Administrator. The facility has four bedrooms, two bathrooms and is a single story with a two car garage. The inspection is as follows:

A fire clearance was granted on August 20, 2021 for 4 ambulatory.

LPAs toured the facility, interior and exterior, including all resident bedrooms. Hot water were tested in a bathroom and observed to be 108.8 degrees Fahrenheit. Fire extinguishers were mounted and charged. Smoke detectors were centrally wired throughout and have been checked by the fire department. Carbon monoxide detectors are operational. There is a sufficient supply of linens. Bedrooms are appropriately furnished. There is sufficient lighting. There are non-skid mats in the showers.

There was one locked medication closet which stores four first aid kits. There were several locked closets for storage of toxins, cleaning equipment, PPEs in the garage. All exit has auditory devices. The kitchen area was checked and there is a sufficient supply of food items. There were emergency food supplies and water. LPAs observed activity calendars, theft and loss policy, residents rights, admission agreement, and emergency plans were posted including a Let Us Know poster. LPA reviewed the outdoor area and with outdoor furniture.

A Component III was completed during the visit with Leonardo Santos, Administrator. LPAs reviewed Personnel Policies, Prohibited Health Conditions, Fingerprinting, Abuse Reporting Procedures, In-Service Training and Medication Procedures. (Continued LIC 9099C)
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Kathrina Chin
LICENSING EVALUATOR SIGNATURE: DATE: 10/14/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/14/2021
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 2
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: LCS HOMES/POINSETTIA
FACILITY NUMBER: 306006035
VISIT DATE: 10/14/2021
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
26
27
28
29
30
31
32
It appears that this facility meets the requirements for licensure. Both the license will be granted upon final review and approval from the Central Applications Bureau.

An exit interview was conducted with Administrator, Leonardo Santos and a hard copy of this report was provided.
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Kathrina Chin
LICENSING EVALUATOR SIGNATURE:

DATE: 10/14/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/14/2021
LIC809 (FAS) - (06/04)
Page: 2 of 2