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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306006063
Report Date: 12/08/2022
Date Signed: 12/08/2022 01:59:39 PM


Document Has Been Signed on 12/08/2022 01:59 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
ORANGE & INLAND A/SC, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868



FACILITY NAME:EUROPEAN CHRISTIAN HOME IIFACILITY NUMBER:
306006063
ADMINISTRATOR:TRICE, THOMASFACILITY TYPE:
740
ADDRESS:2324 E. PURITAN LANETELEPHONE:
(562) 397-2591
CITY:ANAHEIMSTATE: CAZIP CODE:
92806
CAPACITY:6CENSUS: 6DATE:
12/08/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Thomas Trice - AdministratorTIME COMPLETED:
02:10 PM
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Licensing Program Analysts (LPAs) Lydia Martinez and Alvaro Ramirez, Jr. conducted an unannounced visit for the purpose of conducting a required annual visit. LPAs were greeted and granted entry into facility by Caregiver Mihala Dobre. LPAs explained the reason for the visit. Administrators (ADs) Lorenzi I Nunez and Thomas Trice arrived shortly after.

At 12:30 p.m., LPAs and Caregiver Dobre conducted a tour inside of the facility, common areas, Resident rooms, and kitchen. Six Residents were present during today’s visit. Facility is a 4-bedroom, 2-bathroom, and single story home with an attached garage. LPAs observed a screening and sanitizing station at the entrance of the facility. LPAs observed facility is not documenting Staff and Residents temperature. Residents were observed resting in their respective rooms watching television or finishing their lunch. All Resident rooms had required elements, including bed, chair, nightstand, closet space, and ample lighting. Restrooms are stocked with soap and paper towels and have hand washing posting signs. Facility has required Department postings including Valid License, Complaint Poster (PUB 475), Emergency Disaster Plan, Infection Control Plan and Personal Rights. LPAs observed the facility to have approximately a two-day perishable and seven-day non-perishable supply of food for six residents in care.

LPAs observed facility has 72-Hour emergency food and water supply. Centrally stored medications are locked in a kitchen cabinet. LPAs toured the outside grounds and observed the shaded outside visitation area. Exit gates are unlocked and self-closing. All Staff and all Residents are vaccinated for COVID-19. LPAs observed a four-week supply of PPE.

Based on the observations made during today’s inspection, no deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. This report was reviewed with AD Trice and a copy of this report was provided at time of exit.
SUPERVISOR'S NAME: Alisa OrtizTELEPHONE: (714) 703-2855
LICENSING EVALUATOR NAME: Alvaro Ramirez Jr.TELEPHONE: 714-703-2840
LICENSING EVALUATOR SIGNATURE:
DATE: 12/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/08/2022
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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