Pre-licensing visit·April 3, 2025

Licensing Program Analyst (LPA) Claudia Gutierrez made an announced visit to the facility for purpose of conducting a pre-licensing inspection. LPA met with designated Administrator (AD) Gabby Garcia and Administrative Assistant Julian Garcia. An application to operate a Residential Care Facility for the elderly (RCFE) for (6) capacity, (0) ambulatory, (6) non-ambulatory, and (0) bedridden residents was received by CCL on October 21, 2024. Structure: The facility is a one-story house with four resident bedrooms, one staff room, two bathrooms, a living room, a kitchen, a dining room, and de-attached two car garage used for storage. LPA observed the See Something, Say Something poster (PUB 475) in the facility mounted on the wall in the living room. There is a backyard with an exit gate on one side of the house. There is a shaded seating area and LPA did not observe any obstacles or hazards in the backyard. Resident Bedrooms All resident bedrooms had the required furnishings. LPA observed all beds had linens and blankets. Signal system There is no signal system. Toxins: All and any toxic chemicals, cleaning solutions, laundry toxins and disinfectants are inaccessible to residents and will be stored and locked underneath the kitchen sink. Medications, First-Aid Kit & Book: Medication will be centrally stored in a locked closet. First aid kit is stored with the medication. The first aid kit has all the required elements. Resident & Staff Files : Records will be kept in a locked closet. Pool/Jacuzzi: No bodies of water were observed. Fire Extinguisher: Fire extinguishers were observed to be fully charged. Reading Material, Games, Equipment & Materials: The facility has activity books, arts and crafts supplies, board games and other recreational materials for resident use stored in the living room. Fire clearance: Was approved by a fire inspector of Anaheim Fire Department on November 14, 2024. Special conditions noted, “All rooms ok for non-amb use. No padlock on exterior gate.” Component III: Conducted at the Pre-Licensing visit, information provided about how to operate the facility within compliance and reporting requirements. Bedrooms Staff: There is one staff bedroom. Bathrooms: All bathrooms have working plumbing. Hot water measured at 105.9 degrees Fahrenheit. Linens & Hygiene Supplies: A supply of extra linen was stored in a hallway storage closet. Emergency Phone Numbers, Exit Plan & Menu: Posted and available, means of exiting, and emergency phone numbers. Food menu was also posted and available. Food Service: A supply of 2-day perishable and 7-day of non-perishable food was observed and will be maintained on hand. Smoke Detectors: Smoke detectors and carbon monoxide detectors tested operational. Appliances: Gas burner stove, refrigerator, microwave, washer, and dryer are operational. The designated AD was notified that the final application approval will be issued by the Centralized Applications Bureau in Sacramento. An exit interview was conducted, and a copy of this report was provided at the end of the inspection.