Golden Heritage Assisted Living

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Edward Kim made an announced visit to conduct the subsequent pre-licensing inspection. LPA Kim was greeted and granted entry by Applicant Daniela Usurelu. LPA Kim explained the reason for the visit upon entry. The first pre-licensing inspection was made on January 8, 2026 and several corrections were needed. The applicant requested a capacity of 5 nonambulatory residents and of which one (1) bedridden. Applicant has requested a hospice waiver for three (3) residents. The facility is a one-story house in a residential neighborhood with an attached 2 car garage with five (5) bedrooms, of which four (4) bedrooms are for residents and one bedroom (1) is for staff, two (2) full bathrooms, family room, dining room, a kitchen, and living room with a screened fireplace During a tour of the facility, LPA Kim observed that the following items have been corrected: 1) All five (5) beds are furnished and are not hospital beds in bedroom #1, bedroom #2, bedroom #3, and bedroom #5. 2) Exit outdoor gate on the right side is self-closing and self-latching. All items have been corrected. No new deficiencies were observed. The facility is ready for licensure. The pre-licensing visit and Component III Orientation are now complete. The facility meets the requirements for licensure. LPA Kim will forward this report to the Centralized Applications Bureau for review. The license will be granted upon completion of a final review and approval from the Centralized Applications Bureau. An exit interview was conducted and a copy of this report was provided to Applicant Daniela Usurelu.the state’s words, verbatim · CDSS document, Jan 22, 2026

Type of visit: Prelicensing

On January 8, 2026, at 8:00 AM, Licensing Program Analyst (LPA) Edward Kim conducted an announced visit to the facility to conduct the pre-licensing inspection. LPA Kim met with Applicant Daniela Usurelu and toured the facility. An initial application to operate a Residential Care Facility for the Elderly (RCFE) was submitted to CCL on March 15, 2025. The facility has a capacity of five (5) residents, of which five (5) can be nonambulatory and one (1) may be bedridden. Facility phone number (657-363-8464). LPA Kim observed the following. Structure: The facility is a one-story house with an attached 2 car garage with four (4) resident bedrooms, one (1) staff bedroom, two (2) bathrooms, dining area, a kitchen, and a living area. There are four (4) exits: one exit door next to the kitchen, one in the main entrance, one next to the dining area, and one in bedroom #2 which is the bedridden room. Resident Bedrooms: There are four (4) Resident Bedrooms: Bedroom #1, Bedroom #2, Bedroom #3, and Bedroom #5. The bedrooms are spacious and will easily accommodate the residents' belongings. All resident rooms had the furnishings. The resident rooms had hospital beds. Bedroom #1 has two hospital beds, Bedroom #2 has one hospital bed, Bedroom#3 has one hospital bed, and Bedroom #5 has one hospital bed. Applicant took off all half rails and removed the motor that adjusts each of the hospital beds. Evaluation Report Continues on LIC 809-C Staff Bedrooms: There is one (1) Staff Bedroom, Bedroom #4. Air/Heating: Central air/heating system installed with a central panel to control entire house located in the hallway. Bathrooms: All bathrooms have a working toilet, wash basin and shower. All bathrooms are clean. Shower mats were in all two bathrooms. Hot water was measured in all bathrooms. Hot water measured between 107.2 degrees Fahrenheit to 107.6 degrees Fahrenheit. Linens & Hygiene Supplies: Adequate supply of linen stored in hallway cabinets. Emergency Phone Numbers, Exit Plan & Menu: Posted & readily available for review an emergency disaster plan with means of exiting and emergency phone numbers listed and posted in the entrance hallway. Menus posted at the refrigerator. Food Service: There are no residents living in the facility currently. There is a 2-day perishable food. There is 7-day non-perishable food supply on hand. The emergency food and emergency supplies are stored in the pantry. Smoke Detectors/Carbon Monoxide Detectors: Smoke detectors/carbon monoxide detectors are hardwired and tested operational. There is one (1) fire extinguishers. One is mounted on the wall in the kitchen. The fire extinguisher is fully charged and was bought on May 4, 2025. Outdoor/Yard: There is a covered outdoor area and it has enough furniture with a table and chairs in the backyard. The Left outdoor gate is self-closing and self-latching. The Right outdoor gate is not self-closing. Evaluation Report Continues on LIC 809-C Toxins: All cleaning supplies and chemicals are kept in the garage and locked underneath the kitchen sink. Medications, First-Aid Kit & Book: The first aid kit and all medications are stored and locked in a cabinet next to the kitchen. The first aid kit has all the required elements. Resident & Staff Files: The Resident and Staff Records will be kept locked in a cabinet near the kitchen. Reading Material, Games, Equipment & Materials: Crossword puzzles, games, and reading material are stored in a cabinet near the kitchen. There is a large screen TV in the living room and each resident room. Appliances: There is one five (5) gas burner stove which lights unassisted, oven, microwave oven, a refrigerator in the kitchen, dishwasher, washer, and dryer. All appliances are clean and operational. Fire clearance: Fire Clearance approved by Orange County Fire Authority on June 19, 2025. Component III: This will be conducted on the subsequent Pre- Licensing visit. During the pre-licensing inspection, LPA Kim observed the following items that must be corrected: 1) Hospital beds need to be replaced in bedroom #1, bedroom #2, bedroom #3, and bedroom #5. 2) Exit outdoor gate on the right side needs to be self-closing. The applicant plans on making the necessary corrections and contacting LPA Kim to schedule a follow-up pre-licensing inspection. Exit interview was conducted and a copy of this report was left with Applicant Daniela Usurelu.the state’s words, verbatim · CDSS document, Jan 8, 2026

Type of visit: Office

Component II completion: Successful Facility Type: Residential Care Facility for the Elderly (RCFE) Application Type: Initial Capacity: 5 Census (if any clients in care): none COMP II Participants: Daniela Usurelu, Applicant/Administrator Virgil Prunaru, Applicant Interview Method: Virtual interview (Microsoft Teams) On December 9, 2025, Applicants and Administrator participated in COMP II. Identification of the Applicants and Administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, Applicants and Administrator confirmed that they have read and understand community care facility licensing laws included in the Health and Safety Codes and the California Code of Regulations Title 22. Signed LIC 809 with copy of photo ID have been obtained. During COMP II, CAB analyst confirmed Applicants and Administrator’s understanding of following areas: 1. Facility Operation: License Type, Client/Resident Populations, and Program. 2. Admission Policies 3. Staffing Requirements & Training 4. Restrictive/Prohibited Health Conditions 5. General Provisions 6. Emergency Preparedness 7. Complaints & Reporting 8. Pre-licensing Readinessthe state’s words, verbatim · CDSS document, Dec 9, 2025