Pre-licensing visit·April 15, 2025

Licensing Program Analyst (LPA) Michael Tea made an announced visit to the facility for the purpose of conducting a pre-licensing inspection. LPA Tea met with designated Administrators (ADs) Norma Roman and Crystal Lopez. An application to operate a Residential Care Facility for Elderly (RCFE) was received by our agency on January 15, 2025, for a total capacity of six; six non ambulatory and six maybe on hospice. Fire clearance was approved by a fire inspector from the Orange County Fire Authority on February 10, 2025. The facility is a one-story home with three resident bedrooms, that will be all shared rooms, a staff office room, two bathrooms, a living room, a kitchen, a dining area, a breakfast nook, and an attached two car garage. All exiting doors inside the facility had alarm notifications. There is one exit gate on the right side of the house that is self-latching and unlocked. There is a shaded seating area and LPA did not observe any obstacles or hazards in the backyard. There is a lovely garden area with plants and flowers. LPA observed the See Something, Say Something poster (PUB 475), Personal Rights, Ombudsman poster, Facility sketch and Emergency Disaster Plan in the facility mounted on the wall around the facility entryway and kitchen. The administrator certificate is hanging in the office, the administrator will display another copy by the front entryway. Fire extinguishers are located in the dining room area and resident hallway, and they are fully charged with an inspection date of April 4 2025. Resident bedrooms had the required furnishings. LPA observed all beds had linens and blankets. All toxic chemicals, cleaning solutions, and disinfectants are inaccessible to residents and will be stored and locked in Continuation of Pre-licensing on LIC 809-C cabinets in the garage. Medications will be stored in a locked cabinet in dining area. The first aid kit is also stored in the locked cabinets in the living room and has all the required elements along with a first aide book. Staff and resident records will also be stored and locked in the cabinets in the staff office room. Reading materials and games were observed in the living room with a phone and computer laptop for residents can use in the kitchen. A supply of two day perishable and seven day non-perishable food was observed and will be maintained on hand. Smoke detectors and carbon monoxide detectors tested operational. Gas burner stove, dishwasher, refrigerator, microwave, washer, and dryer are operational. Hot water temperatures in the bathrooms measured between 109.5 and 114.8 degrees Fahrenheit. Emergency food and water and additional supplies were observed to be well stocked in the garage. The facility is ready to be licensed. LPA conducted the Component Three Orientation with ADs. ADs 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 to Licensee