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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306006604
Report Date: 10/17/2024
Date Signed: 10/17/2024 04:09:05 PM

Document Has Been Signed on 10/17/2024 04:09 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
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME:KRESEL HOME CARE LLCFACILITY NUMBER:
306006604
ADMINISTRATOR/
DIRECTOR:		QUIJANO, ELENA CFACILITY TYPE:
735
ADDRESS:9366 MERIDIAN LANETELEPHONE:
(714) 262-8629
CITY:GARDEN GROVESTATE: CAZIP CODE:
92841
CAPACITY: 4CENSUS: 0DATE:
10/17/2024
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:00 PM
MET WITH:Elena QuijanoTIME VISIT/
INSPECTION COMPLETED:
04:30 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) Michael Tea made an announced visit to the facility for the purpose of conducting a pre-licensing inspection. LPA Tea met with designated Licensee/Administrator (LE/AD) Elena Quijano.

An application to operate an Adult Residential Facility (ARF) was received by our agency on July 18, 2024 for a total capacity of four ambulatory clients. Fire clearance was approved by a fire inspector from the Orange County Fire Authority on August 26, 2024.

The facility is a two-story home with four client bedrooms, three bathrooms, a living room, a kitchen, a dining area, laundry room, care taker room and office area upstairs and attached two car garage. There is one backyard exit gate to the left of the house that is self-latching and unlocked. There is a shaded seating area for clients and LPA did not observe any obstacles or hazards in the backyard. There is activities such as games and puzzles for residents to play and participate in. There is also physical equipment for clients to play with. The backyard is surrounded by several various plants and flowers. There is a barbecue grill used for entertaining and cooking.

LPA observed Administrator certificate, Facility sketch and Emergency Disaster Plan in the facility mounted on the walls by the dining room and living room.. See Something, Say Something poster (PUB 475) and Personal Rights were posted upstairs. LPA advised to move the posters downstairs for them to be visible for clients and visitors so they are aware of their personal rights.

Client bedrooms had the required furnishings. LPA observed all beds had linens and blankets. Smoke detectors and carbon monoxide detectors tested operational. Hot water temperatures in the bathrooms measured at 108.3 F degrees. Toxins and laundry detergents are stored securely in the laundry room area. All additional toxic chemicals, cleaning solutions, and disinfectants are inaccessible to clients and will be stored and locked in cabinets in the garage.

Continuation on LIC809C
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Michael Tea
LICENSING EVALUATOR SIGNATURE: DATE: 10/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/17/2024
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 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME: KRESEL HOME CARE LLC
FACILITY NUMBER: 306006604
VISIT DATE: 10/17/2024
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
26
27
28
29
30
31
32
Medications will be stored in a locked closet in the living room area. The first aid kit is also stored in the locked closet in the living room area and has all the required elements. Client records will also be stored in the locked closet in the dining area. Reading materials, puzzle books, games and karaoke were observed in the living room. A phone is located in the kitchen for clients to use.

A supply of two day/seven-day of perishable and non-perishable food was observed. Gas burner stove, dishwasher, refrigerator, microwave, washer, and dryer are operational. Emergency food and water and additional supplies were observed to be well stocked in the kitchen pantry and garage. There is a computer station for clients in the office area. The fire extinguisher is in the kitchen and is fully charged and serviced in August 23, 2024.

The facility is ready to be licensed. LPA conducted the Component Three Orientation with Licensee Elena Quijano. Licensee was notified that the final application approval will be issued by the Centralized Applications Bureau in Sacramento. An exit interview was conducted, and a copy of this report was provided to the Licensee
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Michael Tea
LICENSING EVALUATOR SIGNATURE:

DATE: 10/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2024
LIC809 (FAS) - (06/04)
Page: 2 of 2