Facility Evaluation Report

Polly's Place, Placentia05/16/2025Licence 306006514

Capacity6
Census5
Date signed05/16/2025 03:43:48 PM
Name of licensing program analystClaudia Gutierrez
Name of licensing program managerArmando J Lucero
The inspector’s account

Licensing Program Analyst (LPA) Claudia Gutierrez made an unannounced visit for the purpose of conducting a Required/Annual Inspection. LPA was greeted and granted entry by Staff Ma Lourdes Guinto and explained the purpose of the inspection. Administrator (AD) Ines Otbo arrived at approximately 2:00 p.m.

During the inspection, LPA and Staff John Pontillas conducted a tour of the inside and outside of the facility, common areas, resident rooms, kitchen, garage and observed the following:

This is a one-story home with six resident bedrooms, one staff room, four bathrooms, and attached two-car garage. In the garage, LPA observed an assembled bunk bed with a mattress lying flat at the top with a fitted sheet. Staffs' personal belongings were observed on the bunk bed, including clothing and shoes; a Deficiency was cited on today’s date. All resident bedrooms had the required furnishings. LPA observed all resident beds had linens and blankets. The backyard has a shaded sitting area. LPA observed residents watching television in the living room and resting in their respective bedrooms. Bathrooms were observed to be free of debris and mildew, faucets and toilets were operational. Water temperature tested between 110.1-117.8 degrees Fahrenheit.

LPA observed the facility has a 2-day supply of perishables and a 7-day supply of non-perishable food as required by regulations. Smoke detectors and carbon monoxide detectors tested operational. Fire extinguisher was observed to be fully charged with service tag dated February 25, 2025. Gas stove, microwave, washer, and dryer were all inspected and observed to be operable. Toxic chemicals, cleaning solutions, and disinfectants were observed to be inaccessible to residents. Medication was observed to be centrally stored in a locked cabinet.

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