Senior Care Records.

Facility Evaluation Report

Polly's Place, Anaheim04/24/2024Licence 306006178

Capacity6
Census6
Date signed04/24/2024 10:07:53 AM
The inspector’s account

Licensing Program Analyst (LPA) Joseph Alejandre conducted an unannounced case management visit in conjunction with complaint visit 22-AS-20240416125427. LPA met with Administrator Polly Valencia. LPA explained the reason for the visit. During the visit LPA observed the following. The smoke detectors in the kitchen and TV room next to the kitchen that both smoke detectors have been removed. LPA observed that the base plates are attached with the wires to connect the smoke detectors hanging freely from the ceiling/wall. LPA toured the facility. LPA observed the bathroom next to the living room does not have a screen in the window.

Deficiencies are being cited per Title 22, Division 6 of the California Code of regulations. An exit interview was conducted and a copy of the report along with the LIC 809D, LIC 421IM and appeal rights was provided.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction