Pre-licensing visit·July 2, 2024

Licensing Program Analyst (LPA) Dwayne Mason Jr. made an announced inspection to the facility for purpose of conducting a pre-licensing inspection. LPA arrived and was greeted and granted entry by Licensee Diana Manalo and Administrators Jonathan San Diego and Delia Pardo. An application to operate a Residential Care Facility for the Elderly (RCFE) for (6) capacity, (0) ambulatory, (5) non-ambulatory, and (1) bedridden residents was received by Community Care Licensing (CCL) on 3/26/2024. The facility is a one-story home with five resident bedrooms, two bathrooms, living room, dining room, kitchen, laundry room, caregiver room, backyard and 2-car garage. Resident Bedrooms have all the necessary requirements including bed, chair, storage for clothing and ample lighting. LPA observed all windows were screened. All bathrooms have working plumbing and designated hand washing posters. Hot water measured 105 and 120 degrees Fahrenheit in the Resident bathrooms. LPA observed the fire extinguisher to be fully charged as indicated by the arrow pointing in the green zone. The fire extinguishers were purchased on 4/8/2024. Medication and First-Aid Kit will be locked in a cabinet near the living room. Resident & Staff Files will be locked with medication. LPA observed chemicals, cleaning solutions, laundry toxins and disinfectants are inaccessible to residents and are stored and locked in the garage. Linens are store in hallway closets. Emergency Phone Numbers, Exit Plan, Activity Calendar and Menu are all posted and available for review. LPA observed other necessary postings near the living room and dining room. The fire clearance was approved by a fire inspector of Orange County Fire Authority on 4/9/2024. Smoke and Carbon Monoxide detectors are stationed throughout the home and are wired together. Both types of detectors were tested and noted as operational. Operational appliances include a gas stove, oven, one refrigerator, freezer, dishwasher, microwave, washing machine and dryer. LPA provided the Component III presentation to offer information and resources regarding maintaining facility compliance. The designated AD was notified that the final application approval will be issued by the Centralized Applications Bureau in Sacramento. Exit interview was conducted and a copy of this report was provided to designated AD.