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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306006082
Report Date: 11/21/2023
Date Signed: 11/21/2023 10:21:49 AM

Document Has Been Signed on 11/21/2023 10:21 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:WAYMAKERS TRANSITIONAL AGE YOUTH CRISIS RES PRGRMFACILITY NUMBER:
306006082
ADMINISTRATOR:SAMAAN, LISAFACILITY TYPE:
772
ADDRESS:17332 AMAGANSET WAYTELEPHONE:
(949) 410-0467
CITY:TUSTINSTATE: CAZIP CODE:
92780
CAPACITY: 6CENSUS: 3DATE:
11/21/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
08:35 AM
MET WITH:Lisa SamaanTIME COMPLETED:
10:35 AM
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On this day, Licensing Program Analyst (LPA) Claudia Gutierrez made an unannounced case management visit for the purpose of providing additional guidance to facility regarding admission and elopement procedures. LPA met with Administrator (AD) Lisa Samaan. Director of Shelter Programs Carol Carlson and Program Manger (PM) Jordan Aguayo. The following was discussed:
  • Assessment of clients prior to admission
  • Voluntary Discharge
  • AWOL
  • Hospitalization
  • 30-day evictions

The following was agreed upon:
  • Facility understands all clients must be thoroughly assessed prior to admission.
  • A client's departure is considered a voluntary discharge once all discharge procedures have been completed.
  • If discharge procedures have not been completed or are impartial, client status is AWOL.
  • Facility is to accept a client back into care following hospitalization.
  • Facility may serve a 30-day notice if level of care is no longer appropriate for client.

Based on observations made during today's visit, no deficiencies are being cited per Title 22, Division 6 of the California Code of Regulations. An exit interview was conducted and a copy of this report was left at the facility.
SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Claudia Gutierrez
LICENSING EVALUATOR SIGNATURE: DATE: 11/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/21/2023
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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