Pre-licensing visit·December 11, 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 Licensee (LE) Robert Barcelona and Administrator (AD) Sheila Ben. An application to operate a Residential Care Facility for the Elderly (RCFE) was received by our agency on August 1, 2025, for a total capacity of six residents, three maybe non-ambulatory, and one maybe bedridden in Bedroom #5. The fire clearance was approved by a fire inspector from the Orange County Fire Authority on August 28, 2025. The facility is a one-story home with six resident bedrooms, four bathrooms, living room, kitchen, and dining area and detached garage. There are two exit gates on both sides of the house that are self-latching and unlocked. There is a shaded seating area for clients in the backyard. LPA did not observe any obstacles or hazards. There are activities such as games and puzzles for residents to play and participate in. LPA observed Administrator certificate, Facility sketch and Emergency Disaster Plan in the facility mounted on the wall in the dining area. The See Something, Say Something poster (PUB 475), Long Term Care Ombudsman poster, and Personal Rights were posted up on the walls of the dining area as well. Resident bedrooms had the required furnishings. Bedrooms with doors to the backyard and outside had working door alarms. LPA observed all beds had linens and blankets. There is an ample supply of linens and towels. Smoke detectors and carbon monoxide detectors tested operational. Hot water temperatures in the bathrooms measured around 109.2 Fahrenheit degrees. Bathrooms were observed to be operational and have a working toilet, wash basin, and bathtub/shower, as well as grab bars and non-skid surface mats. Toxins are secured and locked underneath the kitchen sink and garage. (Pre-licensing Report continuation on LIC809-C) Medications will be stored in a locked cabinet in the hallway by the kitchen. The first aid kit with all the required elements and first aid guidebook was observed in the medication cabinet as well. Records will also be stored alongside medication in the locked cabinet. A phone is in the dining room for residents to use. The facility also has a laptop for residents to use and keep in touch with family. A supply of perishable and non-perishable food was observed. Electric stove burners, refrigerator, dishwasher, microwave, washer, and dryer are operational. Sharps are stored in a container, locked and secured in a cabinet in the kitchen. Emergency food and water and additional supplies were observed to be well stocked in the hallway. The fire extinguisher by the front door is fully charged. The facility is ready to be licensed. LPA conducted the Component Three Orientation with Licensee Robert Barcelona and Administrator Sheila Ben. Facility 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 the Licensee and Administrator.