Dedicated Guest Home

Type of visit: Required - 1 Year

On February 19, 2026, at 12:00 PM, Licensing Program Analyst (LPA) Edward Kim conducted an unannounced required 1-Year annual visit using the CARE Inspection Tool. Upon arrival at the facility, LPA Kim met with Administrator (ADMIN) Claudia Olteanu and explained the purpose of the visit. ADMIN Olteanu could not stay for the visit and stated that Direct Care Staff Mylene Manze could sign on behalf of the facility. The facility has a capacity of six (6) residents, of which one (1) may be bedridden, and four (4) may be nonambulatory. Room #4 is approved for one (1) bedridden. Waiver granted for hospice care for six (6) residents. The facility is a one-story house with an attached 2 car garage with five (5) resident bedrooms, one (1) staff bedroom, three (3) bathrooms, an office, dining area, a kitchen, a living area, and outdoor covered patio area. LPA Kim toured inside and outside of the physical plant. There were no bodies of water or obstructions in the facility. All rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting was provided, storage for each resident's personal belongings was observed. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. The Resident’s rooms were inspected: Resident Room 1, Resident Room 2, Resident Room 3, Resident Room 4, and Resident Room 5. Bathrooms were found to be within Title 22 regulations and were clean and operational. The water temperature measured between 115.8 degrees F to 116.2 degrees F. A comfortable temperature of 75 degrees F was maintained in the facility. Evaluation Report Continues on LIC 809-C LPA Kim observed the facility to be appropriately furnished at the time of visit. Storage areas for personal hygiene, cleaning supplies, toxins, and sharps objects were stored and not accessible to residents. The kitchen was inspected and there is a two-day supply of perishable and seven-day supply of non-perishable food both were available and maintained properly. Emergency food, emergency water, and emergency supplies are stored in the garage. During the visit, LPA Kim observed the facility's infection control practices, plan of operation, and screening protocols for visitors, staff, and residents. LPA observed the facility has a 30-day supply of Personal Protective Equipment (PPE). All mandated inspection control posters were posted. The smoke detectors and carbon monoxide detectors were operable. A working telephone (714) 646-9158 and video teleconferencing tablet dedicated to the residents both remain available. Last emergency drill was conducted on January 9, 2026, and drills are conducted quarterly. First aid kit is maintained and contains all the necessary elements. The facility has two (2) fire extinguishers where one is mounted in the resident hallway and the other mounted next to the staff bathroom. The fire extinguishers are charged and were last inspected on January 6, 2026. Certificate of Liability of Insurance is effective from December 11, 2025 to December 11, 2026. Surety bond is effective from June 24, 2024. LPA Kim conducted an audit of resident files (R1-R4), staff files (S1-S7), Resident P&I funds, and medication and medication administration record were in all in order and complete. LPA Kim conducted interviews with three (3) staff and two (2) residents. No deficiencies were cited during this visit. An exit interview was conducted, and a copy of this report was provided to Direct Care Staff Mylene Manze.the state’s words, verbatim · CDSS document, Feb 19, 2026

Type of visit: Prelicensing

On November 20, 2024, at 1:00pm, Licensing Program Analyst (LPA) Edward Kim conducted an announced visit to the facility to conduct the pre-licensing inspection. LPA Kim met with Applicant Claudia Olteanu and toured the facility. An initial application to operate a Residential Care Facility for the Elderly (RCFE) was submitted to CCL on June 7, 2024. The facility has a capacity of six (6) residents, of which one (1) is ambulatory, four (4) can be nonambulatory and one (1) may be bedridden. Facility phone number (714-646-9158). LPA Kim observed the following. Structure: The facility is a one-story house with an attached 2 car garage with five (5) resident bedrooms, one (1) staff bedroom, three (3) bathrooms, an office, dining room, a kitchen, and a living room. There are four (4) exits: one exit door in the dining room, one in the main entrance, one in bedroom #4 which is the bedridden room, and one next to bedroom #5. Air/Heating: Central air/heating system installed with a central panel to control entire house located in the living room. Resident Bedrooms: There are five (5) Resident Bedrooms: Bedroom #1, Bedroom #2, Bedroom #3, Bedroom #4, and Bedroom #5. The bedrooms are spacious and will easily accommodate the residents' belongings. All resident rooms had the required furnishings. Evaluation Report Continues on LIC 809-C Staff Bedrooms: There is one (1) Staff Bedroom. Bathrooms: All bathrooms have a working toilet, wash basin and shower. All bathrooms are clean. Shower mats were in all three bathrooms. Hot water was measured in all bathrooms. Hot water measured between 105.5 degrees Fahrenheit to 107.7 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 garage. Emergency Water is stored in a closet between Resident Room #3 and Resident Room #4. Smoke Detectors/Carbon Monoxide Detectors: Smoke detectors/carbon monoxide detectors are hardwired and tested operational. There are two (2) fire extinguishers. One is mounted on the wall in the kitchen, and one is mounted next the exit by the resident room 5. The fire extinguishers are fully charged and was serviced on November 11, 2024. Outdoor/Yard: There is an outdoor furniture with an umbrella to cover the table and chairs in the backyard. All outdoor gates are self-closing and self-latching. 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 in the hallway leading to resident room #5. The first aid kit has all the required elements. Resident & Staff Files: The Resident and Staff Records will be kept locked in a cabinet in the hallway leading to resident room #5. Reading Material, Games, Equipment & Materials: Board games are stored in the staff office. There is a large screen TV in the living room. Appliances: There is one five (5) gas burner stove which lights unassisted, oven, microwave oven, a refrigerator in the kitchen, a refrigerator in the garage, dishwasher, washer, and dryer. All appliances are clean and operational. Fire clearance: Fire Clearance approved by Orange County Fire Authority on July 3, 2024. Component III: Component three waived during visit. Applicant is Licensee/Administrator of other licensed facilities. The pre-licensing visit and Component III Orientation are now complete. It appears this 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. Exit interview was conducted and a copy of this report was left with Applicant Claudia Olteanu.the state’s words, verbatim · CDSS document, Nov 20, 2024