Pre-licensing visit·May 1, 2025

Licensing Program Analyst (LPA) Sean Haddad conducted this announced inspection for the purpose of conducting a pre-licensing inspection. LPA met with Applicant (AP) Janice Jabonero, discussed the purpose of the inspection, and toured the facility. Facility is to operate a Residential Care Facility for the Elderly. Application was submitted to Community Care Licensing on November 20, 2024. This is a change of ownership with persons in care. During the inspection, LPA and AP observed the following: Structure: facility is a five-bedroom, two-bathroom, one-story house with an attached garage that is being used for storage. Facility telephone number is (657) 251-0692. Resident Bedrooms: the five resident bedrooms are spacious and will easily accommodate the residents’ furnishings. Lights, chairs, linens, and storage for each resident bedroom inspected. Staff Bedrooms: there are no staff bedrooms. Bathrooms: were clean, faucets and toilets were operational. Water temperature: tested between 112 and 118 degrees F in the two bathrooms. Linens & Hygiene Supplies: new linens and fully stocked linen closets were observed. Emergency Phone Numbers, Exit Plan & Menu: reviewed. Food Service: two days perishable and seven days nonperishable food supply reviewed. Carbon Monoxide, Smoke Detectors, Fire Extinguisher: observed and tested. Appliances: stove burners, microwave, washer, and dryer inspected. Knives: observed locked in the kitchen. Toxins: observed locked in the garage. Medication cabinet is locked. First-Aid Kit & Activity Supplies: observed and available. Resident & Staff Files: LPA reviewed two resident files and two staff files. Fire clearance was approved by the City of Garden Grove Fire Department on January 22, 2025, for five non-ambulatory and one bedridden. Backyard exit gate is operational and unlocked. Backyard has shaded area for outdoor activities and sufficient seating for residents. Component III was completed with AP during today’s inspection. Facility is currently operating under the liability insurance of current facility ANGELS CARE GUEST HOME (306005476). AP will switch liability insurance to new facility once the application is approved. During the inspection, LPA explained the process of this application and about the post licensing inspection once the facility is licensed. AP was informed today that the facility is ready for licensure and final approval will be processed by the CAB supervisor in Sacramento. An exit interview was conducted and a copy of this report was discussed with and provided to AP.