Facility Evaluation Report

Licensing Program Analyst (LPA) Dwayne Mason Jr. made an announced inspection to the facility for purpose of conducting a pre-licensing inspection. LPA arrived and was greeted and granted entry by Administrators Marisa Hernandez and Chris Hanly. An application to operate an Adult Residential Facility (ARF) for (4) capacity, (4) ambulatory, (0) non-ambulatory, and (0) bedridden clients was received by Community Care Licensing (CCL) on 10/16/2023.

The facility is a one-story home with four client bedrooms, two bathrooms, living room, dining room, kitchen, staff room, covered patio, laundry room and backyard. There is a large garage attached to the laundry room. This room is not included in the fire clearance and will remain locked and inaccessible to clients.

Client Bedrooms have all the necessary requirements including bed, chair, storage for clothing and ample lighting. LPA observed all windows were screened.

All bathrooms have working plumbing and designated hand washing posters. Hot water initially measured above 120 degrees Fahrenheit. AD adjusted the hot water heater during the inspection. LPA observed the hot water to be within the correct range during the inspection. LPA issued a technical assistance advising the AD to maintain a daily water log to ensure proper temperatures are maintained.

LPA observed the fire extinguisher to be fully charged as indicated by the arrow pointing in the green zone.

Medications, First-Aid Kit, Resident & Staff Files will be locked in a lock box and shelving in the living room and cabinets in the kitchen.

The fire clearance was approved by a fire inspector of Orange County Fire Authority on 12/14/2023.