Pre-licensing visit·April 28, 2025

On April 28, 2025, at 8:00 AM, Licensing Program Analyst (LPA) Edward Kim conducted an announced visit to the facility to conduct the pre-licensing inspection. LPA Kim met with Applicant Cristina Coman and toured the facility. An initial application to operate a Residential Care Facility for the Elderly (RCFE) was submitted to CCL on January 2, 2025. The facility is to have a capacity of six (6) residents, six (6) can be nonambulatory and has a hospice waiver for 2 residents. Facility phone number (714-463-4489). LPA Kim observed the following. Structure: The facility is a one-story house with an attached 2 car garage with three (3) resident bedrooms, two (2) bathrooms, dining area, a kitchen, and a living area. There are four (4) exits: one exit door in the dining area, one in the main entrance, one exit in the living area, and one exit in bedroom #3. Air/Heating: Central air/heating system installed with a central panel to control entire house located on the wall in the living area. Temperature was at 74 degrees Fahrenheit Resident Bedrooms: There are three (3) Resident Bedrooms: Bedroom #1, Bedroom #2, and Bedroom #3. The bedrooms are spacious and will easily accommodate the residents' belongings. Bedroom #3 is missing a door upon entering room from the hallway. Bedroom#1 has two hospital beds with full rails. Evaluation Report Continues on LIC 809-C Staff Bedrooms: There are no staff bedrooms. Bathrooms: All bathrooms have a working toilet, wash basin, and shower. All bathrooms are clean. Shower mats were missing in all two bathrooms. Hot water was measured in all bathrooms and measured between 136.5 degrees Fahrenheit to 138.9 degrees Fahrenheit. Linens & Hygiene Supplies: Adequate supply of linen stored in a cabinet in the resident hallway next to bedroom #1 and bedroom #2.. Emergency Phone Numbers, Exit Plan & Menu: Posted & readily available for review an emergency disaster plan with means of exiting and emergency phone numbers listed and are all posted on the wall in the living area. Food Service: There is 7-day non-perishable food supply on hand in the kitchen cabinet next to the refrigerator and in the closet across from bathroom #1 in the hallway. The emergency food is stored in the closet across from bathroom #1 in the hallway. Emergency water and emergency supplies are stored in the garage. Toxins: All cleaning supplies and chemicals are kept in the garage and locked underneath the kitchen sink Smoke Detectors/Carbon Monoxide Detectors: Smoke detectors/carbon monoxide detectors are hardwired and tested operational. There are two fire extinguishers that are fully charged and were bought on December 7, 2024, and are mounted on the wall next to the resident hallway entrance and in bedroom #3. Outdoor/Yard: There are two outdoor shaded areas that covers the tables and chairs in the yard. Evaluation Report Continues on LIC 809-C . Medications, First-Aid Kit & Book: All medications are stored in medical cabinet, which is in the living area. The first aid kit is stored in the closet across bathroom #1. The first aid kit was missing the first aid manual. Resident & Staff Files : The Resident and Staff Records will be kept locked in filing cabinets in the living room. Reading Material, Games, Equipment & Materials: Art supplies and activity supplies are stored in the living room and in the closet across bathroom #1. There is a large screen TV in the living room. The facility has a tablet dedicated for residential use that has internet access capability and has video teleconferencing software. Appliances: There is one five (5) gas burner stove which lights unassisted, oven, microwave oven, a refrigerator in the kitchen, a refrigerator in the garage, dishwasher, washer, and dryer. All appliances are clean and operational. Fire clearance: Fire Clearance approved by Orange County Fire Authority on February 3, 2025. Component III: Component three will be discussed on the next visit. During the pre-licensing inspection, LPA Kim observed the following items that must be corrected: 1) Bedroom #3 is missing a door upon entering bedroom #3, 2) Outdoor gate doors need to be self-closing, 3) First Aid Manual is missing, 4) Bathrooms missing shower mats, 5) Hospital beds with rails need to be replaced in bedroom #1, and 6) Bathroom hot water temperature is measuring between 136.5 degrees Fahrenheit and 138.9 degrees Fahrenheit. The applicant plans on making the necessary corrections and contacting LPA Kim to schedule a follow up pre-licensing inspection. Exit interview was conducted and a copy of this report was left with Applicant Cristina Coman.