Pre-licensing visit·April 15, 2025

Licensing Program Analyst (LPA) Alvaro Ramirez, Jr. conducted an announced visit to the facility to conduct the pre-licensing inspection. LPA met with Applicant Abel Marica and toured the facility. An initial application to operate a Residential Care Facility for the Elderly (RCFE) was submitted to Community Care Licensing (CCL) on September 05, 2024. The facility is to have a capacity of six residents, (1) ambulatory, (4) non-ambulatory and (1) bedridden residents. Applicant requested a Hospice Waiver for (6). Facility phone number is 714-583-8555. LPA observed the following. Structure: The facility is a one-story house with four resident bedrooms, two full size bathrooms, a living room, a kitchen, a dining room, and a garage Accessory Dwelling Unit. LPA observed the See Something, Say Something poster (PUB 475) in the facility mounted on the wall by entryway. There is one gate by the front entrance. There is a shaded seating area and LPA did not observe any obstacles or hazards in the backyard. Air/Heating: Central air/heating system installed with a central panel to control entire house. Resident Bedrooms: There are four resident bedrooms. All resident bedrooms had the required furnishings. LPA observed all beds had linens and blankets. CONTINUED ON LIC809-C... Bathrooms: All bathrooms are clean and have working plumbing. Hot water measured between 111.2-113.1 degrees Fahrenheit. Linens & Hygiene Supplies: A supply of extra linen for each resident was stored in the closet by the residents' bedroom hallway. Emergency Phone Numbers, Exit Plan & Menu: Posted & readily available for review an emergency disaster plan with means of exiting and emergency phone numbers listed. Menu was posted and available. Menu available and posted on the board. Food Service: There are no residents living in the facility at this time. There is 7-day non-perishable food supply on hand. Smoke Detectors/Carbon Monoxide Detectors: Smoke detectors/carbon monoxide detectors are hardwired and tested operational. Fire extinguishers were charged, mounted and one was located by the entryway and one by the residents' bedroom hallway. Appliances: There is one gas stove, one oven, microwave oven mounted above the stove, a refrigerator, dishwasher, washer, and dryer. All appliances are clean and operational. Toxins: All and any toxic chemicals, cleaning solutions, laundry toxins and disinfectants are inaccessible to residents and will be stored in locked cabinets under the kitchen and restroom sinks. Water Temperature: Hot water was measured in all bathrooms. Hot water measured between 111.2-113.1 degrees Fahrenheit. Medications, First-Aid Kit & Book: The first aid kit and the first aid manual are stored in a cabinet next to the dining room. The first aid kit has all the required elements. Medications will be stored in locked cabinet next to dining room. Resident & Staff Files : The resident and staff records will be kept in a locked cabinet in the living room. Reading Material, Games, Equipment & Materials: The activities plan include playing card games, books, newspaper reading and outings. Fire clearance: Fire Clearance approved by a fire inspector of Orange County Fire Authority on November 20, 2024. Special conditions noted, "Garage ADU approved for staff only; no client use. All bedrooms approved for ambulatory clients. Bedroom 1: Non-ambulatory. Bedroom 2: Non-ambulatory or bedridden. Bedroom 3: Non-ambulatory." Component III: Conducted at the Pre-Licensing visit, information provided about how to operate the facility within compliance and reporting requirements. LPA advised Applicant to use the general email address: CCLASCPOrangeCountyRO@dss.ca.gov for inquiries and to submit incident reports. The applicant has met all pre-licensing requirements. LPA will submit notification to CAB (Central Applications Bureau) in Sacramento for final review prior to license being issued. Applicant was informed today that the final approval will be processed by CAB in Sacramento. Exit interview was conducted and a copy of this report was left with the applicant.