Pre-licensing visit·April 29, 2026

On today's date Licensing Program Analyst (LPA) William Vanegas conducted an announced visit for the purposes of completing a pre licensing inspection. LPA was greeted and granted entry to the facility by Administrator (AD). LPA began a tour of the facility accompanied by AD and observed the following. The AD has a valid Administrator certificate valid from February 13, 2026 through February 12, 2028. An initial application to operate a Residential Care Facility for the Elderly (RCFE) for a capacity of six (6) non-ambulatory residents was received by community care licensing (CCL) on April 6, 2026. This is a change of location with no residents in care. The department received an approved fire clearance from the Anaheim fire department inspected by Brian Ribbs on April 27, 2026. The facility is a single storied home with four bedrooms which will all be utilized by resident in care, two bathrooms one of which will be used for residents in care and one shared bathroom for visitors and staff. The facility has a detached two car garage as well. LPA observed the facility to have all required postings found posted in the main entrance of the facility; these postings include the PUB475 sign, residents rights, resident rights to a resident council, visiting policy, theft and loss policy, and the ombudsman poster. LPA observed the facility to have a sufficient amount of fire extinguishers, smoke detectors, and carbon monoxide detectors. LPA observed all to be in good repair and tested operational. LPA observed first aid kit to have all required items such as bandages, scissors, tweezers, adhesive tape, a thermometer, and a first aid manual. CONTINUED ON LIC 809-C LPA inspected all resident rooms and all rooms were observed to be free of any hazards, debris, and obstructions. LPA observed resident rooms to have all required furnishings such as a bed, a chest of drawers, clean linens in good repair; meaning no strains or tears, a reading lamp, and enough storage space to store personal belongings. LPA observed kitchen area to have a refrigerator, a gas stove, and a microwave, all appliances appeared to be in good repair and tested operational. Facility is equipped with a washer and dryer that appeared to be in good repair and tested operational. All toxins were observed to be locked away and inaccessible to residents in care. Sharps were observed to be locked away and inaccessible to residents in care. LPA observed all bathrooms to be clean and free of any mildew and debris. LPA observed all water faucets and toilets to be operational. Bathrooms were observed to have all required furnishings including grab bars, slip resistant floor matts, and a shower chair. Hot water temperature tested between 101.2 and 107.3 degrees Fahrenheit. LPA toured the exterior of the facility and observe for there to be an outdoor shaded sitting area in the front yard and in the backyard. LPA observed the outdoor areas of the facility to be clean and free of any hazards, debris, and obstructions along the exit routes of the facility. Side doors were observe to be self latching and unlocked. Additionally LPA observed for the facility to have a two day supply of perishable food and seven day supply of non perishable food along with a sufficient amount of emergency water on hand. LPA conducted component III with AD, and advised that the facility is ready to be licensed and that LPA will report findings to the centralized application bureau (CAB). LPA advised that CAB will be in contact with them in regard to finalizing their license. An exit interview was conducted and a copy of this report was provided to the facility.