Pre-licensing visit·November 12, 2025

Licensing Program Analysts (LPA) Jerome Haley made an announced visit for the purpose of conducting a pre-licensing evaluation. LPA Haley was greeted and granted entry by Applicant Augustine Au Initial application: To operate a Residential Care Facility for the Elderly (RCFE), with a capacity of four (ambulatory only) residents, was submitted to the department for licensure. However, the facility needs to be licensed for four non-ambulatory residents. Fire clearance: Orange County Fire Authority granted the Fire Clearance August 21, 2025 Structure: The facility is a one-level structure, with an attached garage. There’s a total of 6 bedrooms (4 for residents, and 2 activity rooms) and 2 bathrooms for the residents in care. There’s a living room space, a dining space, backyard, and attached garage. Bedrooms: all bedrooms have the required furnishings: bed, lamp, chair, and storage space. Bathroom(s): Bathrooms are equipped with a working toilet, wash basin, and shower. Non-skid matts were observed. Hot water was measured in the range or 109.4 – 111.5 degrees F. Kitchen: 4 of 4 burners and the warmer are operational on the stove. Sharps are kept locked in a drawer near the stove. Chemicals are kept locked below the kitchen sink. Food Service: A supply of perishable and non-perishable food items was observed. Garage Area: The garage is clean and organized. A washer and dryer was observed. Chemicals are stored in a locked cabinet. Incontinent care supplies are stored in the garage, and additional hygiene supply of hygiene item are stored in the garage. A washer and dryer and an exercise bike was observed. Walkways are free of obstruction. Continued on LIC809C Toxins: All toxic chemicals, soaps, detergents, and cleaning solutions are inaccessible to residents and locked under the sink in the kitchen and locked in a cabinet in the garage area. Resident & Staff Files : Files are stored in the main office and in the locked closet next to the front door. Medications/First-Aid Kit: Resident medications are stored in the locked closet next to the front door. Linens & Hygiene Supplies: Hygiene items were observed in the bathroom. Additional hygiene items were observed in the garage. Additional linens were observed. Backyard/Exterior: The backyard is clean and organized. A shaded patio area with a table and chairs was observed. Two locked storage sheds were observed. Both storage sheds are empty. Bodies of Water: None. Smoke/Carbon Monoxide Detectors: Smoke and carbon monoxide detectors tested operational. Fire Extinguisher: Fire extinguisher was observed mounted on the wall in the kitchen. Emergency Phone Numbers, House Rules, Exit Plan & Menu: There’s a postings board with emergency phone numbers, personal rights, and other postings in the main hallway area. Additional Comments: Facility contact information was reviewed and updated during the visit. Component III: was not presented at this time. The applicant needs to be licensed for three non-ambulatory residents. The current fire clearance was granted for 4 ambulatory clients only. The facility is not ready to be licensed at this time. An exit interview was conducted, and a copy of this report was provided.