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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306006288
Report Date: 10/04/2023
Date Signed: 10/04/2023 11:00:34 AM

Document Has Been Signed on 10/04/2023 11:00 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:WE CONQUER TOGETHER LLCFACILITY NUMBER:
306006288
ADMINISTRATOR:MENDEZ, ALBERTFACILITY TYPE:
772
ADDRESS:17367 ASPENGLOW LANETELEPHONE:
(626) 272-4246
CITY:YORBA LINDASTATE: CAZIP CODE:
92886
CAPACITY: 6CENSUS: 0DATE:
10/04/2023
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
08:05 AM
MET WITH:Albert MendezTIME COMPLETED:
11:15 AM
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Licensing Program Analyst (LPA) Sean Haddad conducted this announced inspection for the purpose of conducting a pre-licensing inspection. LPA met with Applicant (AP) Albert Mendez, discussed the purpose of the inspection, and toured the facility. Facility is to operate a Social Rehabilitation Facility. Application was submitted to Community Care Licensing on 12/19/2022. This is an initial application with no persons in care.

During the inspection, LPA and AP observed the following: Structure: this is a two-story home. Facility is a 4-bedroom, 5-bathroom, home with an attached garage that is being used for storage. There is a back yard with a patio cover for the clients. Facility telephone number is (323) 927-7541. Client Bedrooms: the 4 client bedrooms are spacious and will easily accommodate the clients’ furnishings. Lamps, chairs, linens, and storage for each client bedroom inspected. Staff Bedrooms: there are no staff bedrooms. Bathrooms were clean, faucets and toilets were operational. Water temperature: tested at 113 F degrees in the 1st floor common client bathroom, 113.5 in the 2nd floor common client bathroom, and 114.8 in the 2nd floor bedroom bathroom. Linens & Hygiene Supplies: new linens and fully stocked linen closets were observed. Emergency Phone Numbers, Exit Plan & Menu: reviewed. Food Service: AP stated they will obtain 2 days’ perishable and 7 days nonperishable food supply prior to getting their first client. Carbon Monoxide, Smoke Detectors, Fire Extinguisher: observed and tested, including the smoke detectors and carbon monoxide detectors. Appliances: stove burners, microwave, washer, and dryer inspected. Knives: will be locked in a lockbox. Toxins: observed locked in the garage and cleaning closet. Medication room is locked. First-Aid Kit & Activity Supplies: observed and available. Client & Staff Files: this is an initial inspection. LPA observed storage area for client and staff files. Fire clearance was approved by the Orange County Fire Authority on 01/31/2023. Backyard: the backyard exit gate is operational and unlocked. Back yard has shaded area for outdoor activities and sufficient seating for clients. Component III was completed with AP during today’s inspection. AP stated the facility already has liability insurance.
SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Sean Haddad
LICENSING EVALUATOR SIGNATURE: DATE: 10/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/04/2023
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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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: WE CONQUER TOGETHER LLC
FACILITY NUMBER: 306006288
VISIT DATE: 10/04/2023
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During the inspection, LPA explained the process of this application and about the post licensing inspection once the facility is licensed. AP was informed today that the facility is ready for licensure and final approval will be processed by the CAB supervisor in Sacramento. An exit interview was conducted and a copy of this report was discussed with and provided to AP.
SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Sean Haddad
LICENSING EVALUATOR SIGNATURE:

DATE: 10/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/04/2023
LIC809 (FAS) - (06/04)
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