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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306006213
Report Date: 08/31/2023
Date Signed: 08/31/2023 12:15:20 PM

Document Has Been Signed on 08/31/2023 12:15 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
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME:DREAMS OF AMERICAFACILITY NUMBER:
306006213
ADMINISTRATOR:FAZELI, TALAFACILITY TYPE:
775
ADDRESS:18 GOODYEAR STE 115TELEPHONE:
(949) 398-7067
CITY:IRVINESTATE: CAZIP CODE:
92618
CAPACITY: 140CENSUS: 68DATE:
08/31/2023
TYPE OF VISIT:Post LicensingUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Jordan Herman, Tala Fazeli, Monroe FazeliTIME COMPLETED:
12:30 PM
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This unannounced inspection is being conducted by Licensing Program Analyst (LPA) Sean Haddad for the purpose of conducting a Post Licensing inspection. LPA met with Assistant Administrator (AA) Jordan Herman, Administrator (AD) Tala Fazeli, and President Monroe Fazeli and discussed the purpose of the inspection.
LPA reviewed Infection Control requirements. At about 10:30AM, LPA and AD conducted a tour of the inside and outside of the facility, common areas, storage areas, breakroom, and bathrooms and observed the following: Structure: this is a large commercial facility which houses one day program. Facility has 6 common areas, multiple storage areas, 4 offices, and 4 bathrooms. The structure does not include any outside areas. The program hours are Monday through Friday, 9AM to 3PM. Morning and afternoon activities take place at the facility, but the program is community-based so clients and staff engage in activities outside in the community. LPA observed 1 staff and no clients present at the facility during the inspection because the clients are currently in the community. Bathrooms: the bathrooms were clean, faucets and toilets were operational. Water temperature: tested at 109 degrees F at the front left bathroom faucet, 106.5 at the back left bathroom, 107 at the back right bathroom, and 108.8 at the front right bathroom. LPA inspected all rooms in the facility. Emergency Phone Numbers and Exit Plan: reviewed. Food Service: this facility does not provide food service. Carbon Monoxide, Smoke Detectors, Fire Extinguisher: inspected. Appliances: microwave inspected. Knives: there are no sharp knives at the facility. Toxins: observed locked in the cleaning closet. Medication cabinet: facility does not handle medications. First-Aid Kit and Activity Supplies: observed and available. Facility’s licensing fees are paid. At about 11:00AM, LPA reviewed 5 client files and 5 staff files and interviewed 1 staff. Facility does not handle client medications or money.
There were no deficiencies observed in the areas inspected. 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. 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
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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