Facility Evaluation Report, 06/06/2022 — Chase Special Care Home, Fountain Valley CA

On today's date at 8:32am Licensing Program Analyst (LPA) Rosie Quiroz made an attempted unannounced visit to facility to conduct an Annual Required inspection visit. LPA Rosie Quiroz called and spoke to Administrator (AD)Sarah Paul who indicated there are currently no clients in care at this facility. AD Sarah Paul indicated "Due to facility not being vendored by Orange County Regional Center, we haven't been able to move the clients to this facility. Currently have 6 clients at Aloe Special Care Home, Facility #306001386. The plan is to move 4 of 6 clients from Aloe Special Care Home to Chase Special Care Home upon vendorization from Orange County Regional Center."

AD Sarah Paul indicated she would be present at facility in the afternoon. LPA Quiroz returned to facility to conduct Annual required inspection.

LPA Quiroz was granted entry by AD Sarah Paul and discussed the purpose of the visit. On or about 1:54pm, LPA Quiroz along with AD Sarah Paul began tour of inside and outside of facility. The Facility temperature was recorded to be 75 degrees fahrenheit.

All restrooms observed to have a supply of soap, appeared to be clean and water temperatures were recorded to be within 114 degrees Fahrenheit. LPA Quiroz inspected resident’s bedrooms and appeared to be clean. All bedrooms observed to have all required components. LPA Quiroz observed the emergency and disaster and evacuation plan. Facility has a supply of emergency food, water in garage and kitchen area readily available for staff and clients. AD Sarah Paul indicated the PPE was transferred to Aloe Special Care Home to utilize. LPA Quiroz toured the outside of the facility and observed seating and shaded area for clients and visitors enjoyment in backyard area. LPA Quiroz observed locked and secured swimming pool area. The facility has completed the LIC 808 Mitigation Plan. The LIC 808 plan was received by the Department on July 10, 2021. During today's visit, LPA Quiroz reviewed and approved LIC 808 Mitigation Plan dated July 10, 2021.