331880594-2-7-2025-18-AS-APEZ-DDNR3S-20250207114024

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 331880594
Report Date: 02/07/2025
Date Signed: 02/07/2025 11:40:31 AM

Document Has Been Signed on 02/07/2025 11:40 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
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME:	ASTORIA CARE HOME		FACILITY NUMBER:	331880594
ADMINISTRATOR/ DIRECTOR:	ABRUDAN, TEODOR		FACILITY TYPE:	740
ADDRESS:	74101 PORTOLA POINTE LN		TELEPHONE:	(760) 674-7213
CITY:	PALM DESERT	STATE: CA	ZIP CODE:	92211
CAPACITY: 6	TOTAL ENROLLED CHILDREN: 0	CENSUS: 6	DATE:	02/07/2025
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:20 AM
MET WITH:	Caregiver Ermina Feliciano		TIME VISIT/ INSPECTION COMPLETED:	11:50 AM

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Licensing Program Analyst (LPA), Armando Perez made an unannounced visit to the facility for the purpose of conducting a required annual inspection. The LPA was granted entry by staff to conduct the inspection and met with caregiver Ermina Feliciano. LPA contacted Administrator Selina Abrudan by telephone and she stated she was in Orange County at a doctors appointment and it will take over 2 hours to arrive. Administrator stated that caregiver is authorized to assist with todays visit and can obtain required files for review. The inspection included the following:

LPA toured the facility inside and outside. LPA observed the facility to be clean and in good repair. The facility consists of six (6) resident bedrooms, one (1) staff bedroom, three (3) bathrooms, a kitchen and dinning area, a living room area, a garage and laundry room, and a patio and yard with sufficient seating and space for activities. LPA observed a pool in the backyard with the required fencing and locked gate. The home is maintained at a comfortable temperature for the clients. Lighting is sufficient for safety and comfort. Water temperature measured within regulation. Laundry facilities and a locked cabinet is present for storing laundry soap and other chemicals next to the garage entrance. All outdoor and indoor passageways are free of obstruction. Emergency lighting is available. There is a telephone working at this location. The LIC 610, emergency disaster plan is maintained. There are no firearms at this home.

LPA began review of client records. six (6) records were reviewed. LPA reviewed for identification and emergency information, admission agreement, medical assessment, and TB test results, needs and service plans, placement, functional assessment, centrally stored medication/destruction records, safeguard for personal property/valuables, and personal rights notification. LPA observed client records to be available and complete.

Jazmond D Harris	TELEPHONE: (951) 529-2439
Armando Perez	TELEPHONE: (951) 248-2222
	DATE: 02/07/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2025

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
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME: ASTORIA CARE HOME	FACILITY NUMBER: 331880594
	VISIT DATE: 02/07/2025

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LPA began review of employee records- five (5) records were reviewed. LPA reviewed employee records for first aid certification, criminal record clearance or an exemption, health screening and TB test results, employee rights, training verification, and current administrator certification; expiration date 11/30/2025. LPA observed personnel records to be available and complete.

LPA observed facility kitchen had the ability to prepare food in clean environment and possessed equipment in good working condition. Food supply meets the requirement of one (1) week supply of nonperishable and two (2) day supply of perishables. Emergency food and water supply is present. There is a locked location for chemicals and sharps in the kitchen.

Medications are centrally stored. There is a locked cabinet in the kitchen allocated for medication storage. Centrally stored medication and destruction logs are maintained. Medications reviewed appear to have been dispensed accurately.

LPA made observation throughout the inspection process to assess if the facility remains in conformity with the State Fire Marshall regulations. Smoke detectors and carbon monoxide detectors were tested and found to be operational. Fire extinguisher was last serviced, 07/02/2024. Fire drills are conducted quarterly at the facility with the last drill on 02/02/2025 .

Based on the information received during this visit today in the areas reviewed, there are no deficiency that are being cited per Title 22, Division 6 of The California Code of Regulations.

This LIC 809 report was reviewed with the facility representative and a copy was provided.

SUPERVISOR'S NAME: Jazmond D Harris	TELEPHONE: (951) 529-2439
LICENSING EVALUATOR NAME: Armando Perez	TELEPHONE: (951) 248-2222
LICENSING EVALUATOR SIGNATURE:	DATE: 02/07/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2025

LIC809 (FAS) - (06/04)

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