Facility Evaluation Report

Licensing Program Analyst (LPA) Joseph Alejandre made an announced visit to conduct the Pre-licensing inspection for the facility. LPA was greeted and granted entry by the Administrator Giannina Adolfo. LPA inspected the facility with the Administrator. Facility is an RCFE, capacity is for 6 non-ambulatory residents of which 1 can be bedridden. Application was submitted to the Agency (CCL) on 08/04/2021 . Facility phone number is 949-305-5259. LPA observed the following: Structure . Facility is a one story home with 7 bedrooms and 3 bathrooms. Facility has an attached 2 car garage. LPA did not observed the see something say something poster (pub 475) in the entrance of the facility. Backyard . The backyard has a patio with a seating area for residents. The exit gate leaving the backyard is operational. No bodies of water observed. LPA did not observe any obstacles or hazards in the backyard. Clients Bedrooms . The resident bedrooms are spacious and will easily accommodate the client's belongings. All bedrooms had the required furnishings. LPA observed the bedroom right off of the living room has a fireplace that is not screened. Living area & Dining room. LPA observed the living area and dining room have enough space to accommodate residents and visitors. Bathrooms , all 3 bathrooms are clean, faucets and toilets were operational. Water temperature measured, 115 degrees Fahrenheit in bathroom 1, 118 in bathroom 2 and 120 degrees in bathroom 3 . Linens & Hygiene Supplies . new linens and towels were observed. Emergency Phone Numbers, Exit Plan & Menu : Reviewed. Food Service. LPA observed a two day perishable and seven day non-perishable food supply on hand. LPA observed the kitchen is clean and organized. Carbon Monoxide & Smoke Detectors & Fire Extinguisher s were observed. All fire extinguishers were fully charged. Smoke detector/carbon monoxide detectors tested operational. Appliances . The stove and microwave oven are clean and operational. LPA observed the stove lit unassisted. Knives : are kept locked under the kitchen sink. Toxins : LPA observed chemicals locked under the kitchen sink. Medication cabinet is kept locked and located in the kitchen. First-Aid Kit & Activity Supplies. observed and available. First Aid kit had all the required elements Resident & Staff Files change of ownership, no files reviewed. Fire clearance was approved by Orange County Fire Authority Inspector Michael Longbardo on 9/16/2021 . The following items must be corrected in order for the facility to be licensed; 1. Fireplace in the bedroom adjacent to the living room needs a fireplace screen.