Pre-licensing visit·March 11, 2026

Licensing Program Analyst (LPA) Alvaro Ramirez, Jr. conducted an announced visit to the facility to conduct the pre-licensing inspection. LPA met with Applicant Chet Khay and toured the facility. An application for Change of Ownership (CHOW) to operate a Residential Care Facility for the Elderly (RCFE) was submitted to Community Care Licensing (CCL) on March 27, 2025. The facility is to have a capacity of 6 residents, (0) ambulatory, (5) non-ambulatory and (1) bedridden residents. Waiver requested for Hospice Care for (6). Facility phone number 657-223-7200. LPA observed the following. Structure: The facility is a one-story house with six resident bedrooms, three full size bathrooms, a living room, a kitchen, a dining room, and an attached car garage. LPA observed the See Something, Say Something poster (PUB 475) in the facility mounted on the wall by entryway. There are two gates in the backyard, which are self-closing and self-latching. 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 six 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 114.0 to 117.1 degrees Fahrenheit. Linens & Hygiene Supplies: A supply of extra linen for each resident was stored in the closet by the resident's 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 posted and available. Monthly menu available and posted in the kitchen refrigerator. Food Service: There are five residents living in the facility at this time. A supply of 2-day perishable and 7-day of non-perishable food was observed and will be maintained on hand. Smoke Detectors/Carbon Monoxide Detectors: Smoke detectors/carbon monoxide detectors are hardwired and tested operational. Fire extinguisher was charged, mounted and located in the kitchen. Appliances: There is one, gas burner stove which lights unassisted, one oven, one microwave, 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 the garage. Water Temperature: Hot water was measured in all bathrooms. Hot water measured between 114.0 to 117.1 degrees Fahrenheit. Medications, First-Aid Kit & Book: The first aid kit and the first aid manual are stored in the medication cabinet. The first aid kit has all the required elements. Medications will be stored in a locked cabinet by the entryway. Resident & Staff Files : The Resident and Staff Records will be kept in a cabinet next to the living room. Reading Material, Games, Equipment & Materials: Board games, puzzles, and movies are stored by the living room. There is one large screen television in the living room. Fire clearance: Fire Clearance approved by a fire inspector of Orange City Fire Department on June 26, 2025. Special conditions noted, "Fire clearance approved under the above noted conditions." Component III: Conducted at the Pre-Licensing visit, information provided about how to operate the facility within compliance and reporting requirements. The applicant has met all pre-licensing requirements. LPA will submit notification to Central Applications Bureau (CAB) 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.