Happy Family Guest Home

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Michael Tea conducted an unannounced visit. The purpose of today’s visit was to conduct the Annual Required inspection. At around 8:00 AM, LPA Tea was greeted and granted entry into the facility by Administrator (AD) Ida Marie Valencia and explained the reason for the visit. Administrator (AD) Victoria Valencia arrived shortly to assist with the visit. Facility is licensed for six, four may be non-ambulatory and one may be bedridden in Bedroom #2, with a hospice waiver for two. Currently there are four residents, of which there are none on hospice during today's visit. LPA Tea reviewed four resident files and two staff files. Resident files and staff files contained all the required documentation. AD Ida Valencia’s administrator certificate expires on March 5, 2027. AD Victoria Valencia’s administrator certificate expires on October 31, 2027. LPA Tea along with AD Ida Valencia toured the facility. LPA toured the physical plant, checked food service, and the first aid kit. The facility is a one-story home with four resident bedrooms, two half bathrooms, living room, kitchen, dining area, enclosed front yard, back yard and an attached car garage. There is an Additional Dwelling Unit (ADU) where Administrator Valencia lives in. LPA observed smoke detectors/carbon monoxide in common areas and bedrooms are operational. Resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. Resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure and shower was free of mold/mildew. The water temperature measured between 110.3 F to 114.9 Fahrenheit degrees. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked at time of visit. Common areas were clean and clear of hazards, and doorways were free of obstructions. First aid kit had all the required elements including dressing, bandages, tweezers, thermometer, and scissors. Kitchen was inspected. (Annual inspection continued on LIC809-C) Kitchen appliances are operational during today's visit. Perishable and non-perishable food supply were checked and adequately stocked at time of visit. LPA observed sharps locked and secured in a kitchen drawer. LPA also observed toxin substances to be secured and locked and inaccessible to clients underneath the kitchen sick and in the garage where residents have no access to. The fire extinguisher in the hallway is fully charged with a service date of July 11, 2025. The facility’s last disaster drill was conducted on October 25, 2025. LPA toured the outside grounds and there is ample seating with shade in the front yard and back yard. There are gates on both sides of the facility that are self-latching and operational. LPA observed emergency supplies, food and water in the garage. Activities that the residents enjoy are playing games and musical therapy. The administrator likes to take the residents out on outings like going to the beach, shopping, and getting something to eat. Or they will just go on a drive and visit the other facilities and interact with the other residents. At the time of the visit, LPA observed residents listening to music. LPA then reviewed medication storage and administration. Medications are stored in a locked cabinet in the kitchen. Medications are being administered per physicians order. P&I funds were accounted for and there were no discrepancies. LPA interviewed residents regarding their quality of care and spoke to staff present regarding care provided. Based on the observation made during today’s visit, no deficiencies were noted today in the areas inspected per Title 22 Division 6 of the California Code of Regulations. This report was reviewed with the facility and a copy of this report LIC809, 809-C, LIC858, LIC859 was read and provided to the facilitythe state’s words, verbatim · CDSS document, Nov 20, 2025

Type of visit: Prelicensing

Licensing Program Analysts (LPA) Jessica Cho and Eboni Bentley arrived announced for the purpose of conducting a Pre-Licensing visit for a Change of Ownership (CHOW). LPA conducted the visit with Applicant/Chief Executive Officer (CEO) Victoria Valencia and Administrator (Admin) Idamarie Valencia. The initial application to operate a Residential Care Facility for the Elderly (RCFE) was received by the Department of Social Services on April 17, 2024 for age range 60 and over. This facility is vendored by the Regional Center of Orange County (RCOC). This is a Level 4I home. LPAs began the tour of the interior and exterior portion of the facility with Applicant and Administrator Valencia, and observed the following: Structure: The facility is a single story property in a residential neighborhood comprised of four resident bedrooms and three resident bathrooms. LPAs observed all common areas which includes the living room, dining area, kitchen, and an attached two car garage which doubles as a laundry room. The Additional Dwelling Unit (ADU) is occupied by Administrator Idamarie and is under a different address: 12043 Gilbert St. Garden Grove. The backyard has two exit gates with one gate being secured as approved per the fire clearance. The patio also has sufficient shaded seating area. Telephone Number: Facility land line number (714) 867-6123 was tested and remains available. Signal System: No signal system, however residents utilize bells to alert the staff. Bedrooms: The resident bedrooms had all required components, are spacious, and easily accommodates the residents’ furnishings. Bathrooms: Bathrooms were clean and operational. Grab bars were secure and bath slip mats were in place. Linens and Hygiene Supplies: Clean linens and hygiene supplies were observed to be fully stocked. Appliances: Stove burners, microwaves, refrigerator, freezer, and washer/dryer were inspected and operating. Resident and Staff Files: Resident and staff records will be maintained on site. Reading Material, Games, Equipment, & Materials: The facility maintains reading material and games in the living room cabinet.. Emergency Phone Numbers/Exit Plan: Posted in the entry way on the bulletin board. Postings: The See Something, Say Something (PUB475) and the Ombudsman Poster were posted in the entry way. The Rights of the Resident Councils, Resident's Rights, Theft & Loss Policy, and Activity Schedule, and a copy of the Admission Agreement were posted on the bulletin board in the entry way. Food Service and Menu: Supply of seven day non-perishable and two day perishables were observed. The sample menu was available for review. The emergency food/water supply was also available in the garage. Smoke and Carbon Monoxide Detectors: The dual functioning smoke detectors/carbon monoxide alert systems and auditory devices were tested and found to be operational. Fire Extinguishers: Two fire extinguishers were mounted, fully charged, and serviced on June 3, 2024. Fire Clearance: Approved on June 6, 2024 for 1 ambulatory, 4 non-ambulatory, and 1 bedridden. Please note that non-ambulatory is permitted in bedrooms 2 & 3 of which bedroom 2 is permitted for bedridden resident only. Bedrooms 1& 4 are designated for ambulatory residents. Toxins and Sharps: Cleaning supplies, toxins, and sharps were observed to be secured and inaccessible. Water Temperature: The water temperature in the three resident bathrooms measured at 117.6, 112.2, and 113.1 degrees Fahrenheit. Medications, First Aid Kit, & Manual: The First Aid Kit was checked and found to be in order. The first aid manual was also available. Component III: Component III was waived because Applicant is operating other licensed facilities and has fulfilled this requirement. The Pre-Licensing is now complete, and the facility is ready for licensure. The license will be granted upon completion of a final review and approval from the Licensing Program Manager and the Central Applications Bureau. An exit interview was conducted with Applicant/CEO Victoria Valencia and Administrator Idamarie Valencia, and a copy of this report was provided at the end of the visit.the state’s words, verbatim · CDSS document, Nov 15, 2024

Type of visit: Office

Facility Type: RCFE Application Type: CHOW Capacity: 6 Census (if any clients in care): 4 COMP II Participants: Ida Marie Valencia (Board Member/Administrator) & Victoria Valenica (Board Member) Interview Method: Virtual interview via Microsoft Teams On October 28, 2024, applicant/administrator participated in COMP II. Identification of the applicant and administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, applicant 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 Applicant/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, Oct 28, 2024