Facility Evaluation Report

Licensing Program Analyst (LPA) Jerome Haley made an announced Pre-licensing visit and was greeted by Applicant Director/Administrator Alexander Tecson. Administrator (AD) Imelda Samonte was also present for the visit. Administrator Alexander Tecson has a current Administrator Certificate that expires 2/5/24. LPA Haley was pre screened and temperature checked upon entering the facility.

The facility is a single level structure with five bedrooms four rooms for the clients and one room for staff and three bathrooms. The Orange County Fire Authority granted the Fire Clearance for 4 Ambulatory clients on October 18, 2022. The initial application for an Adult Residential Facility with a capacity of four ambulatory clients was submitted to the Central Applications Bureau (CAB) on 8/17/22. Applicant Tecson and Samonte were present for the tour of the facility and the following was observed:

All client bedrooms were clean, neatly organized and equipped with the necessary requirements: bed, lamp, chair, and storage space. All bathrooms were clean, organized and hand washing signs were posted.

Hot water temperature was measured at 113.1 degrees Fahrenheit in Bathroom #1 in client Bedroom #1, 109.4 degrees Fahrenheit in Bathroom #2, and 113.0 degrees Fahrenheit in bathroom #4 in the client master bedroom.

In the hallway closet near bedrooms 2 and 3 LPA Haley observed a closet with a supply of clean linen. In the hallway closet across directly across LPA observed a locked closet with hygiene supplies, COVID supplies, and hazardous cleaning chemicals.

In the hallway near bedroom 4 and the staff bedroom LPA observed locked cabinets. The locked cabinets on top are for office supplies, Staff records, emergency PPE supplies: N95 Mask, Gowns, Gloves, and Hand Sanitizers. Continued on LIC809 C