<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306006314
Report Date: 09/25/2024
Date Signed: 09/25/2024 02:50:17 PM

Document Has Been Signed on 09/25/2024 02:50 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 COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME:HILLS OF BROWNING, THEFACILITY NUMBER:
306006314
ADMINISTRATOR/
DIRECTOR:		BENCITO, JEFFREYFACILITY TYPE:
740
ADDRESS:12911 BROWNING AVENUETELEPHONE:
(714) 430-7672
CITY:SANTA ANASTATE: CAZIP CODE:
92705
CAPACITY: 6CENSUS: DATE:
09/25/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:30 PM
MET WITH:Joanna GomezTIME VISIT/
INSPECTION COMPLETED:
03:00 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analysts (LPAs) Joseph Alejandre and Samer Haddadin made an unannounced visit to conduct a case management visit. LPAs were greeted and granted entry by staff. LPAs explained the reason for the visit and toured the facility with staff. LPAs observed the See Something, Say Something poster (PUB 475) posted in the main entry of the facility. LPAs observed the facility has all utilities, a 2 day supply of perishable food and a 7 day supply on non-perishable food. No obstacles or hazards observed at the facility. LPAs interviewed staff and residents. No health or safety concerned noted during the visit. An exit interview was conducted and a copy of the report provided.
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Joseph Alejandre
LICENSING EVALUATOR SIGNATURE: DATE: 09/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/25/2024
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 1