Facility Evaluation Report

Licensing Program Analysts (LPA) Alvaro Ramirez, Jr. conducted an announced visit to the facility to conduct the pre-licensing inspection. LPA met with Applicant Czarina Dumaliang and toured the facility.

An initial application to operate a Residential Care Facility for the Elderly (RCFE) was submitted to Community Care Licensing (CCL) on January 17, 2024. The facility is to have a capacity of 6, of which 5 can be nonambulatory and 1 bedridden. Facility phone number 949-446-4085. LPA observed the following.

The facility is a one-story house with five resident bedrooms, one staff bedroom, three full size bathrooms, two half bathrooms, a living room, a kitchen, a dining room, and an attached car garage. LPA observed the See Something, Say Something poster (PUB 475) in the facility mounted on the wall in the entranceway. There is a backyard with an exit gate. There is a shaded seating area and LPA did not observe any obstacles or hazards in the backyard.

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

There are five Resident bedrooms. All resident bedrooms had the required furnishings. LPA observed all beds had linens and blankets.