Pre-licensing visit·May 27, 2021

Licensing Program Analyst (LPA) Joseph Alejandre made this announced visit for the purposes of conducting a Pre-licensing inspection. LPA met with Rebecca Langdon, Susan Peterson and Scott Gardner. Facility is to operate a Residential Care Facility for the elderly. Facility is for residents with Dementia. Capacity is for 70 non-ambulatory residents. Application was submitted to CCL on 12/11/2020 . Structure ; Facility is a two story building with a central courtyard and surrounding parking lot. No bodies of water observed. LPA inspected all 58 resident rooms, kitchen, dining rooms, laundry room, medication room and theater room. LPA observed that only the two model rooms had furnishings. LPA observed no obstacles or hazards in the facility. Call system is operational. LPA observed a wired smoke/carbon monoxide detector in each room. System tested during Fire inspection. All bathrooms were clean and operational and grab bars were secure. Hot water temperature measured between 114.6 degrees Fahrenheit and 120.0 degrees Fahrenheit. LPA toured the courtyard and outside parking lot, no obstacles or hazards observed. All fire extinguishers were fully charged. LPA observed the emergency chair lift mounted next to the stairway. Facility telephone number is 949-485-2022. Bathrooms , were clean, faucets and toilets were operational. LPA observed that the kitchen was clean and knives are kept secured. First-Aid Kit & Activity Supplies. observed and available. Resident & Staff Files facility has no residents at this time, no files reviewed. Delayed Egress exit doors are operational. Fire clearance was approved by Orange County Fire Authority Inspector Michael Longobard on 05/4/2021 . LPA informed applicants that the facility is required to provide furniture to include, bed, nightstand, lamp and chair, in good working order for residents who require it. Applicants stated they understood. Facility meets Title 22 Division 6 of the California Code of Regulations. Facility is ready for licensure. LPA explained the process of this application and also about post licensing visit once the facility is licensed. Applicant was informed today that the final approval will be processed by the CAU supervisor in Sacramento. Component III was completed with applicant. An exit interview was conducted and a copy of this report, LIC809 was explained and provided to Susan Peterson.