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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306006099
Report Date: 08/31/2023
Date Signed: 08/31/2023 10:24:20 AM

Document Has Been Signed on 08/31/2023 10:24 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:DREAMS OF AMERICAFACILITY NUMBER:
306006099
ADMINISTRATOR:FAZELI, TALAFACILITY TYPE:
775
ADDRESS:14 GOODYEAR SUITE 110TELEPHONE:
(949) 500-7067
CITY:IRVINESTATE: CAZIP CODE:
92618
CAPACITY: 140CENSUS: 67DATE:
08/31/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
08:50 AM
MET WITH:Jordan Herman, Tala FazeliTIME COMPLETED:
10:30 AM
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This unannounced POC inspection is being conducted by Licensing Program Analyst (LPA) Sean Haddad for the purpose of verifying correction of deficiencies issued during the Required – 1 Year Inspection conducted on 07/27/23. LPA met with Assistant Administrator (AA) Jordan Herman and Administrator (AD) Tala Fazeli and discussed the purpose of the inspection. During the inspection, LPA, AA, and AD toured the facility, reviewed documents, and observed the following:

Type A Violation cited under California Code of Regulations (CCR) section 82019(e)(3) pertaining to staff associations was CLEARED on 07/28/2023. During today’s inspection, LPA confirmed that all facility staff are associated on Guardian.

Type B Violation cited under CCR section 82088(e)(1) pertaining to water temperatures has been CLEARED. The plan of correction stated that “Licensee stated they will work with maintenance to correct the water temperature and submit temperature logs to LPA by POC due date.” LPA had provided an extension of the due date to 08/26/23. On 08/15/23, AA sent LPA an email stating that the water temperature issue had been resolved. During today’s inspection, LPA tested the water temperatures and observed the water temperature tested at 109.5 F degrees in the front left bathroom, 109 in the back left bathroom, 106 in the back right bathroom, and 106.3 in the front right bathroom and confirmed the plan of corrections has been completed.

Type B Violation cited under CCR section 82065(g)(1) pertaining to staff health screenings has been CLEARED. The plan of correction stated that “Licensee stated they will obtain health screenings for all staff and submit proof to LPA by POC due date.” LPA had provided an extension of the due date to 08/26/23. During today’s inspection, LPA reviewed staff health screenings for 37 staff and confirmed the plan of corrections has been completed. LPA observed that most, if not all, health screenings were completed prior to 08/26/23.
SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Sean Haddad
LICENSING EVALUATOR SIGNATURE: DATE: 08/31/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/31/2023
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 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: DREAMS OF AMERICA
FACILITY NUMBER: 306006099
VISIT DATE: 08/31/2023
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Type B Violation cited under CCR section 82069(a) pertaining to client medical assessments has been CLEARED. The plan of correction stated that “Licensee stated they will obtain physician's reports for all clients and submit proof to LPA by POC due date.” LPA had provided an extension of the due date to 08/26/23. During today’s inspection, LPA reviewed client medical assessments for 40 clients and confirmed the plan of corrections has been completed. LPA observed that most, if not all, medical assessments were completed prior to 08/26/23.

An exit interview was conducted and a copy of this report was discussed with and provided to facility representative.
SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Sean Haddad
LICENSING EVALUATOR SIGNATURE:

DATE: 08/31/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2023
LIC809 (FAS) - (06/04)
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