Just Like You Are Home 1

Type of visit: Required - 1 Year

On September 12, 2025, Licensing Program Manager (LPM) Sheila Santos and Licensing Program Analyst (LPA) Garlli Tat conducted an unannounced visit to the facility for the purpose of a required annual inspection. LPA explained the purpose for the visit and was greeted and granted entry by staff on duty. During the visit, staff on duty contacted the facility administrator (AD) Alicia Lira about the visit. For this visit, there are three staff members on duty, all of which are background cleared and associated. AD later arrived to assist with the inspection. The PUB475 ‘See Something, Say Something’ poster was observed to be located by the front entrance. LPA observed the Administrator's Certificate for Alicia Lira, which expires on December 14, 2026. The facility is a Residential Care facility for the Elderly (RCFE) licensed for six residents, six of which may be non-ambulatory, none of which may be bedridden, and three of which may be on hospice. LPA toured the interior and exterior portions of the facility with AD. For this visit, there are a total of four non-ambulatory residents in care, two of which are on hospice, and none are bedridden. The facility is a two story home. There are a total of seven bedrooms, six of which are private resident rooms, and one serves as staff quarters. LPA toured each bedroom with the AD and observed that bedrooms were provided with furniture in good repair, clean linens, adequate storage space, and free of any hazards. LPA observed the staff quarters to be kept locked and inaccessible to residents in care. Smoke and carbon monoxide detectors as well as auditory exit alarms were tested and operational. There are a total of four bathrooms, three of which are for residents and one is for staff. Page 2. Restrooms were observed to be in good repair, toilets and faucets were operational and showers were equipped with grab bars and non-skid floor mats. Water temperature in the bathrooms were measured to be between 105.6 and 109.2 degrees Fahrenheit. Facility met the minimum two day perishable and seven day non-perishable food supplies. Sharp items and knives were locked in the kitchen and inaccessible to residents in care. Fire extinguisher was charged, mounted and located in the kitchen. Fire extinguishers were dated and tagged on May 16, 2025. LPA observed the emergency disaster and evacuation plan, which is posted in the dining room. Facility had back-up emergency food and water supply, located in the garage. LPA observed that the First Aid kit had all the required components. Medications and toxins were also observed to be locked in a cabinet in the kitchen, inaccessible to residents in care. For residents #2 and #4, medications were improperly administered. For the exterior portion, LPA observed patio furniture under shading. LPA observed a ladder in the backyard, which was accessible to residents. The ladder was later removed and made inaccessible by staff. There is one self-latching gate in the backyard that can be opened in case of an emergency. No bodies of water were observed. Based on today's observations, there are two deficiencies being cited per Title 22 of the California Code of Regulations. An exit interview was conducted with Alicia Lira. This report was reviewed with the administrator and a copy was provided at the end of the visit. Appeal Right were reviewed.the state’s words, verbatim · CDSS document, Sep 12, 2025

Type of visit: Prelicensing

Licensing Program Analysts (LPAs) Alvaro Ramirez, Jr. and Samer Haddadin made an announced visit to the facility for purpose of conducting a pre-licensing inspection to follow up on corrections identified during visit on August 9, 2024. LPAs met with Applicant Alicia Lira and toured the facility. An application for Change of Ownership (CHOW) to operate a Residential Care Facility for the Elderly (RCFE) was submitted to Community Care Licensing (CCL) on January 30, 2024. The facility is to have a capacity of six, of which six can be nonambulatory and zero bedridden. Facility phone number 714-202-5044. At 12:10 LPA toured the facility and observed the following: Licensee installed an evacuation chair next to the stairwell, Licensee replaced the missing bathroom sink faucet handle in bedroom #6, Licensee repaired the chipped/black discoloration areas in kitchen, behind the entrance door and in bedroom #1 and #2, Licensee cleaned the yellow discoloration in the kitchen sink, Licensee repaired the chipped baseboards throughout the facility. All items noted from visit on August 9, 2024 have been addressed. Component III: Conducted at the Pre-Licensing visit, information provided about how to operate the facility within compliance and reporting requirements. The applicant has met all pre-licensing requirements. LPA will submit notification to CAB (Central Applications Bureau) in Sacramento for final review prior to license being issued. Applicant was informed today that the final approval will be processed by CAB in Sacramento. Exit interview was conducted and a copy of this report was left with the applicant.the state’s words, verbatim · CDSS document, Aug 30, 2024

Type of visit: Prelicensing

Licensing Program Analysts (LPA) Alvaro Ramirez, Jr. conducted an announced visit to the facility to conduct the pre-licensing inspection. LPA met with Applicant Stevlyn Reroma and toured the facility. An application for Change of Ownership (CHOW) to operate a Residential Care Facility for the Elderly (RCFE) was submitted to Community Care Licensing (CCL) on January 30, 2024. The facility is to have a capacity of six, of which six can be nonambulatory and zero bedridden. Facility phone number 714-202-5044 LPA observed the following. Structure: The facility is a two level structure house with seven bedrooms, four full size bathrooms, a living room, a family room, a kitchen, a dining room, and an attached car garage. LPA did not observe an evacuation chair mounted next to the top of the stairwell. LPA observed the See Something, Say Something poster (PUB 475) in the facility mounted on the wall in the entranceway. There is a backyard with an exit gate on each side of the house. There is a shaded seating area and LPA did not observe any obstacles or hazards in the backyard. Air/Heating: Central air/heating system installed with a central panel to control entire house. Resident Bedrooms: There are six resident bedrooms. All resident bedrooms had the required furnishings. LPA observed all beds had linens and blankets. CONTINUED ON LIC809-C... Bathrooms: Bathrooms are clean and have working plumbing. Hot water measured between 107.4 and 109.0 degrees Fahrenheit. Sink faucet handle in bathroom # 6 is broken. Linens & Hygiene Supplies: A supply of extra linen for each resident was stored in a closet in the garage. Emergency Phone Numbers, Exit Plan & Menu: Posted & readily available for review an emergency disaster plan with means of exiting and emergency phone numbers listed. Menu was posted and available. Monthly menu available and posted in the kitchen refrigerator. Food Service: There are five residents living in the facility at this time. A supply of 2-day perishable and 7-day of non-perishable food was observed and will be maintained on hand. Smoke Detectors/Carbon Monoxide Detectors: Smoke detectors/carbon monoxide detectors are hardwired and tested operational. There is a fire extinguisher mounted on the wall by the kitchen, one by the family room and one by second floor stairwell. Appliances: There is one, four gas burner stove which lights unassisted, one oven, one microwave, a refrigerator, dishwasher, washer, and dryer. All appliances are clean and operational. Toxins: All and any toxic chemicals, cleaning solutions, laundry toxins and disinfectants are inaccessible to residents and will be stored in the garage. Water Temperature: Hot water was measured in all bathrooms. Hot water measured between 107.4 and 109.0 degrees Fahrenheit. Medications, First-Aid Kit & Book: The first aid kit and the first aid manual are stored in a cabinet by the dining room. The first aid kit has all the required elements. Medications will be stored in a locked cabinet by the kitchen.. Resident & Staff Files: The Resident and Staff Records will be kept in a locked cabinet by the kitchen. Reading Material, Games, Equipment & Materials: Arts and craft and board games are stored in a cabinet in the family room. There is one large screen television in the living room. Fire clearance: Fire Clearance approved by a fire inspector of Orange Fire Department on May 23, 2024. Special conditions noted, "Fire Clearance approved under the above noted conditions." Licensee to address the following corrections by 08/23/24: Licensee to install an evacuation chair next to the stairwell. Licensee to replace the missing bathroom sink faucet handle in bedroom #6. Licensee to repair the chipped/black discoloration areas in kitchen, behind the entrance door and in bedroom #1 and #2. Licensee to clean the yellow discoloration/rust in the kitchen sink. Licensee to repair the chipped baseboards throughout the facility.the state’s words, verbatim · CDSS document, Aug 9, 2024