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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306006457
Report Date: 04/24/2024
Date Signed: 04/24/2024 10:20:40 AM

Document Has Been Signed on 04/24/2024 10:20 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:ADULT ENRICHMENT CENTER - ANAHEIMFACILITY NUMBER:
306006457
ADMINISTRATOR/
DIRECTOR:		PEREZ, PEDROFACILITY TYPE:
775
ADDRESS:1901 E CENTER ST.TELEPHONE:
(714) 576-2688
CITY:ANAHEIMSTATE: CAZIP CODE:
92805
CAPACITY: 60CENSUS: 0DATE:
04/24/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:40 AM
MET WITH:Reese Perez
William Kelsey		TIME VISIT/
INSPECTION COMPLETED:
10:35 AM
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Licensing Program Analyst (LPA) Claudia Gutierrez made an announced visit to the facility for purpose of conducting a pre-licensing inspection. LPA met with Chief Strategy Officer (CSO) Reese Perez and Chief Operating Officer (COO) William Kelsey. An application to operate an Adult Day Program (ADP) for (60) capacity, (60) ambulatory, (0) non-ambulatory, and (0) bedridden clients was received by CCL on November, 23 2023.

Structure:
The facility is a two-story building, with one computer lab, two bathrooms, four activity rooms, two staff offices, and a main activity room on the first floor. The second floor consists of six activity rooms, a library, two bathrooms, and a staff lounge. There is no backyard or patio space. LPA observed the See Something, Say Something poster (PUB 475) in the facility posted on the wall in the entranceway.

Toxins:
All and any toxic chemicals, cleaning solutions, and disinfectants are inaccessible to clients and will be stored and locked in a storage closet.

Medications, First-Aid Kit & Book:
Facility will not manage clients’ medication. First aid kit is stored in the staff office. The first aid kit has all the required elements.

Resident & Staff Files:
Records will be kept in a locked file cabinet.

Pool/Jacuzzi:
No bodies of water were observed.
SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Claudia Gutierrez
LICENSING EVALUATOR SIGNATURE: DATE: 04/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/24/2024
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: ADULT ENRICHMENT CENTER - ANAHEIM
FACILITY NUMBER: 306006457
VISIT DATE: 04/24/2024
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Fire Extinguisher:
Fire extinguishers were observed to be fully charged with service tag dated October 16, 2023

Reading Material, Games, Equipment & Materials:
The facility has arts and crafts supplies, board games, puzzles, exercise equipment and other recreational materials for client use stored in various activity rooms.

Fire clearance:
Was approved by a fire inspector of Anaheim Fire Department on December 15, 2023. No special conditions noted.

Component III:
Conducted at the Pre-Licensing visit, information provided about how to operate the facility within compliance and reporting requirements.

Bathrooms:
All bathrooms have working plumbing. Hot water measured at 105 degrees Fahrenheit.

Emergency Phone Numbers, Exit Plan & Menu:
Posted and available, means of exiting, and emergency phone numbers. Facility will not provide food service.

Smoke Detectors:
Smoke detectors and carbon monoxide detectors tested operational.

Appliances:
Refrigerator and microwave are operational.

The CSO and COO were notified that the final application approval will be issued by the Centralized Applications Bureau in Sacramento. An exit interview was conducted, and a copy of this report was provided at the end of the inspection.

SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Claudia Gutierrez
LICENSING EVALUATOR SIGNATURE:

DATE: 04/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/24/2024
LIC809 (FAS) - (06/04)
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