Facility Evaluation Report

Licensing Program Analysts (LPAs) Celine De Perio and Albert Marin conducted an announced pre-licensing visit with Area Director Tony Duarte and Facility Administrator (AD) Jennifer Kum. LPAs observed the Administrator's Certificate for Jennifer Kum, which expires on 4/21/24.

LPAs De Perio and Marin toured the facility with AD Kum and observed the following:

Structure: Facility is a single level structure . On May 26, 2022, The Orange County Fire Authority granted a fire clearance for a capacity of four of which four may be non-ambulatory. (Note: Facility is currently licensed under California Department of Public Health as a Intermediate Care Facility with a capacity of 6). There are two bathrooms, and four bedrooms, and the garage is utilized as a common area as an office, staff area and activity room. No bodies of water were observed. There is also a locked shed in the backyard that is used to store tools.

Resident Bedrooms: All four bedrooms were provided with furniture in good repair, clean linens, adequate storage space, and kept hazard free.

Bathrooms: The restrooms were observed to be in good repair, toilet was operational, and grab bars and non-skid floor mats were provided. Water temperature in restrooms were measured at 112.8 degrees Fahrenheit.

Linens and Hygiene Supplies: Adequate supply of linens is stored in the hallway.