<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306006277
Report Date: 06/07/2023
Date Signed: 06/07/2023 12:55:56 PM


Document Has Been Signed on 06/07/2023 12:55 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868



FACILITY NAME:ROYAL RCFEFACILITY NUMBER:
306006277
ADMINISTRATOR:NORMAN, WILMAFACILITY TYPE:
740
ADDRESS:2547 E. NORM PLACETELEPHONE:
(714) 655-7970
CITY:ANAHEIMSTATE: CAZIP CODE:
92806
CAPACITY:6CENSUS: 2DATE:
06/07/2023
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Renee FuehrerTIME COMPLETED:
01:10 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA) Sean Haddad conducted this announced inspection for the purpose of conducting a pre-licensing inspection. LPA met with Applicant (AP) Renee Fuehrer, discussed the purpose of the inspection, and toured the facility. Facility is to operate a Residential Care Facility for the Elderly. Application was submitted to Community Care Licensing on 11/17/2022. This is a change of ownership with persons in care. This is the second pre-licensing inspection. Please see LIC809 dated 05/22/2023.

During the initial pre-licensing inspection, LPA and AP observed that the fire clearance stated the facility has an ambulatory capacity of 5, a non-ambulatory capacity of 0, and a bedridden capacity of 1, but based on review of resident files, 2 out of 2 residents were non-ambulatory. AP stated they would work with the fire inspector and CAB to update the fire clearance for as many non-ambulatory rooms as possible.

Since the initial pre-licensing inspection, AP obtained a new fire clearance which states the facility has an ambulatory capacity of 2, a non-ambulatory capacity of 3, and a bedridden capacity of 1. During today’s inspection, LPA and AP toured the facility and confirmed that the facility is following the new fire clearance. LPA confirmed the issue noted during the initial pre-licensing inspection has been addressed.

LPA explained the process of this application and about the post licensing inspection once the facility is licensed. AP was informed today that the facility is ready for licensure and final approval will be processed by the CAB supervisor in Sacramento. Component III was completed with AP during the initial pre-licensing inspection. An exit interview was conducted and a copy of this report was discussed with and provided to AP.
SUPERVISOR'S NAME: Armando J LuceroTELEPHONE: (714) 703-2840
LICENSING EVALUATOR NAME: Sean HaddadTELEPHONE: (714) 335-7094
LICENSING EVALUATOR SIGNATURE:
DATE: 06/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/07/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1