Senior Care Records.

Facility Evaluation Report

Polly's Place, Placentia05/29/2026Licence 306006514

Capacity6
Census5
Date signed05/29/2026 03:19:39 PM
Name of licensing program analystClaudia Gutierrez
Name of licensing program managerLourdes Montoya
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 Maynard Datinguindoo and the purpose of the inspection was discussed. Assistant Administrator (AAD) Joanne Otbo arrived at approximately 2:00 p.m.

During the inspection, LPA and Staff Ma Lourdes "Mary Lou" Guinto 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. 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. Bathrooms were observed to be free of debris and mildew and faucets and toilets were operational. Water temperature tested between 101.8 - 107.0 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 19, 2026. Gas stove, microwave, and laundry washer and dryer were all 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. LPA reviewed three of five resident files and three staff files.

Based on the observations made during today’s inspection, no deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted, and a copy of this report was left at the facility.

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