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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306006372
Report Date: 10/14/2024
Date Signed: 10/14/2024 12:06:44 PM


Document Has Been Signed on 10/14/2024 12:06 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:HIGHTOWER RESIDENTIAL CAREFACILITY NUMBER:
306006372
ADMINISTRATOR:ARONNE, CELFAFACILITY TYPE:
740
ADDRESS:23391 CAVANAUGH ROADTELEPHONE:
(949) 500-3760
CITY:LAKE FORESTSTATE: CAZIP CODE:
92630
CAPACITY:6CENSUS: DATE:
10/14/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Norma AronneTIME COMPLETED:
12:30 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 Analyst (LPA) Joseph Alejandre made an unannounced visit to conduct the required annual inspection. LPA was greeted and granted entry by staff. LPA met with Administrator Norma Aronne and explained the reason for the visit. LPA observed the See Something, Say Something poster (PUB 475) posted in the main entry way of the facility. The Administrator's certificate expires on February 1, 2025. LPA and the Administrator toured the facility. The facility is a single story home with 4 resident rooms, 2 staff rooms, 2 bathrooms, activity room, living room, kitchen, dining room and a two car garage. LPA observed all resident rooms have the required furnishings. LPA observed both bathrooms are clean and operational. Hot water measured 109.8 in both bathrooms. LPA toured the kitchen. The kitchen is clean and organized. LPA observed a 2 day perishable and a 7 day non-perishable food supply on hand in the kitchen. LPA observed the knives are kept locked in a kitchen drawer. LPA observed the cleaning supplies are kept under the kitchen sink and are inaccessible to residents. LPA observed the fire extinguisher in the hallway is fully charged. LPA toured the garage and backyard. The garage is kept locked and off limits to residents. The garage is used to store supplies and emergency food. There are 2 sheds in the backyard. Both sheds are used for storage and kept locked. There are two exit gates, on each side of the house. Both exit gates are operational. No obstacles or hazards observed inside or outside of the house. The carbon monoxide detector tested operational. The smoke detectors tested operational. The last fire drill took place on October 1, 2024. LPA reviewed 2 staff files. 2 out of 2 staff members have the required annual training. Both staff members have current CPR/First Aid training. Both staff are background cleared and associated to the facility. LPA reviewed 6 resident records and medications. No discrepancies observed. LPA inspected the first aid kit. The first aid kit has all the required elements. No deficiencies are being cited as a result of this visit. An exit interview was conducted and a copy of the report provided.
SUPERVISOR'S NAME: Sheila SantosTELEPHONE: (714) 334-2062
LICENSING EVALUATOR NAME: Joseph AlejandreTELEPHONE: 714-705-6018
LICENSING EVALUATOR SIGNATURE:
DATE: 10/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/14/2024
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