Facility Evaluation Report

Licensing Program Analysts (LPAs) Celine De Perio and Albert Marin conducted an announced pre-licensing visit and was greeted and granted entry by Facility Administrators (AD) Rowena Marantal-Carrillo and Jireh Joy Mandap at 9:11 AM. LPAs observed the Administrator's Certificate for Rowena Marantal-Carrillo which expires on 6/24/2023 and is posted in the entrance of the facility. AD Mandap has an Administrator’s certificate that expires on 9/26/2022.

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

Structure: Facility is a single level structure. On January 22, 2022, The Orange County Fire Authority granted a fire clearance for a capacity of six residents of which five may be non-ambulatory and 1 may be bedridden. There are a total of 5 bedrooms, which there are 4 private rooms and 1 shared bedroom. There is a garage that is utilized as a staff office.

Resident Bedrooms: All five 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, toilets were operational, and grab bars and non-skid floor mats were provided. Water temperature in restrooms were measured at 120.0 degrees Fahrenheit.

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

Posters, Emergency Phone Numbers, Exit Plan: LPAs observed the COVID-19 precautionary signs posted, along with the PUB475 "See Something, Say Something" poster. Emergency disaster plan is posted in the entrance of the facility.