Facility Evaluation Report

Licensing Program Analyst (LPA) Lydia Martinez conducted a visit to the facility to conduct an announced Pre-Licensing evaluation. Upon arrival, LPA met with Applicant Melody Bungcayao and Administrator Felix Pesigan. An initial application to operate an Adult Residential Facility (ARF) was submitted to the Central Applications Unit (CAU) for a capacity of 4 Ambulatory clients. Facility is an existing facility and 4 clients were present. The Orange County Fire Authority Planning and Development Services conducted a Fire Safety Inspection on 10/15/2021 and granted a Fire Clearance. A tour of the physical plant was conducted inside and out at approximately 3:40 PM with Applicant and Administrator and the following was observed:

Facility is a one story house with 6 bedrooms and 3 bathrooms. Bedroom #4 and #6 are designated as staff bedrooms. There is a living room/dining area, office and kitchen.

Central air/heating system installed with a central panel to control entire house.

The client bedrooms accommodate clients' furnishings and meet Title 22 regulation at this time.

The 3 bathrooms have a working toilet, wash basin, and shower. Grab bars and non-slip mats were present.

Adequate supply of linens and hygiene items were observed

Ombudsman Poster, Personal Rights and See Something Say Something Poster

Ombudsman poster will be obtained once licensed, Personal Rights was posted and See Something Say Something will be printed and posted.

Adequate supply of 7-day non-perishable and 2 day perishables will be stored in the kitchen and pantry and will include fruits and vegetables.