Pre-licensing visit·October 1, 2025

Licensing Program Analyst (LPA) Garlli Tat and Licensing Program Manager (LPM) Sheila Santos conducted an announced pre-licensing visit to the facility and was greeted and granted entry by applicant Marie Maniago. LPA reviewed the Administrator's Certificate that expires on June 6, 2027. LPA toured the exterior and interior portion of the facility with Marie Maniago. Facility is a two-level structure home. On July 10, 2025, The Orange County Fire Authority granted fire clearance for a capacity of six residents (one of which may be ambulatory, four of which may be non-ambulatory, one may be bedridden, and a request for hospice waiver for six has been submitted for review). There are a total of six bedrooms, four of which are private resident rooms, one shared resident bedroom, and one staff bedroom. There is a garage that is utilized for storage. All bedrooms were provided with brand new furniture's, in good repair, clean linens, adequate storage space, and kept hazard free. The bathrooms were observed to be in good repair, toilets were operational, and grab bars and non-skid floor mats were provided. Water temperature in residents' bathrooms were measured at 134 degrees Fahrenheit . Applicant will have the water heater tank inspected since the water is still hot even after several attempts of adjustments were made during the visit. LPA will test the water on the 2nd pre-licensing visit schedule. Adequate supply of brand new linens are stored in the hallway. LPA observed the PUB475 "See Something, Say Something" poster posted by the front entrance. Emergency disaster plan is posted in the dining room. Facility met the minimum two days and seven-day non-perishable food supplies. Sharp items and knives were locked in the kitchen drawers. Facility had back-up emergency food and water supply located in the kitchen cabinet. Continued on LIC 809-C. Wired smoke and carbon monoxide detectors were tested and operational. All auditory exit alarms were tested and observed to be operational. Fire extinguisher was f ully charged, mounted, located in the kitchen, and tagged for the date of April 8, 2025. Stove is a four-burner induction stove, and there is single oven, dishwasher, refrigerator and freezer. Washer and dryer are located in the garage. All appliances were operational. Toxins were l ocked and inaccessible to residents underneath the kitchen sink. LPA observed that First-Aid kit had all the required components. Medication cabinet was observed in the dining room area. Applicant will keep this locked at all times. A body of water was observed in the backyard. A locked fence surrounds the pool area. There are two exit gates in the backyard, one of which is self-latching. Brand new binders were observed and kept in a locked cabinet located in the hallway for resident and staff files. The facility has activities that commensurate with plan of operation. LPA reviewed the Component III with applicant, Marie Maniago. A 2nd Pre-licensing visit will be scheduled on October 7, 2025 for the following to be corrected: Missing self-latching gate entrance on the right side facing the house. Applicant to clear the left side yard to ensure the safety of the residents, LPA observed multiple canned paints and boxes. Applicant will install a lock gate by the entrance of the small stairs going towards the staff room and office. Applicant will have the water heater tank inspected since the water is still hot even after several attempts of adjustments were made during the visit. Water temperature was measured 134F degrees. LPA will test the water on the 2nd Pre-licensing visit. LPA will provide copy of this report to Centralized Applications Bureau for review and final determination of the application. LPA conducted an exit interview with Marie Maniago and a copy of this report was reviewed and provided to the facility.