306006645-1-23-2025-22-AS-NGUN-DD7MAY-20250123082703

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 306006645
Report Date: 01/22/2025
Date Signed: 01/23/2025 08:27:13 AM

Document Has Been Signed on 01/23/2025 08:27 AM - 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:	WARM HEART HOMES I		FACILITY NUMBER:	306006645
ADMINISTRATOR/ DIRECTOR:	WARMSLEY, DREW		FACILITY TYPE:	735
ADDRESS:	7552 11TH STREET		TELEPHONE:	(562) 522-4590
CITY:	BUENA PARK	STATE: CA	ZIP CODE:	90621
CAPACITY: 6		CENSUS: 0	DATE:	01/22/2025
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	04:41 PM
MET WITH:	Drew Warnsley		TIME VISIT/ INSPECTION COMPLETED:	06:37 PM

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Licensing Program Analyst (LPA) Nancy Guillen and Licensing Program Manager (LPM) Sheila Santos conducted an announced visit to the facility for purpose of a pre-licensing evaluation.

An initial application to operate an Adult Residential Facility for six ambulatory clients was submitted to CCL on September 23, 2024.

LPA and LPM met with Applicant/Administrator Drew Warmsley and Tony Piper who was present for the visit. LPA observed that Administrator Drew Warmsley has a valid Administrator certificate which expires on December 10, 2026. Drew Warmsley is background cleared and associated to the facility. The facility received an approved Fire Clearance by Orange County Fire Authority Inspector Kevin Chaney on October 24, 2024.

The facility is a one-story home with three client bedrooms, two client bathrooms, a kitchen, a dining room, a living room, and a front porch. LPA and LPM accompanied by the applicant, conducted a tour of the physical plant. LPA inspected the three client bedrooms. The three client bedrooms are clean and free of hazards. LPA observed all the client bedrooms have the required furnishings of a bed, a chair, chest of drawers, and a lamp. Client beds have clean linens and blankets. LPA observed additional linens stored in the bathroom storage shelves. Client bathrooms are clean. Bathrooms were equipped with grab bars and non slip mats were purchased during the visit. Faucets and toilets were operational. Hot water temperature measured between 105.9 to 106.5 degrees Fahrenheit. LPA observed the facility has an emergency food and water supply in the kitchen cabinets.

Continued LIC 809-C

SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Nancy Guillen
LICENSING EVALUATOR SIGNATURE:	DATE: 01/22/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/22/2025

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

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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: WARM HEART HOMES I	FACILITY NUMBER: 306006645
	VISIT DATE: 01/22/2025

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LPA observed the facility has board games, DVDs, coloring books, reading material and other recreational materials for the client's use stored in the living room. The facility has an internet device for client use. Client and staff records will be kept locked in a storage cabinet in the living room.

LPA observed the kitchen has a minimum two-day perishable and seven-day non-perishable food supply. LPA observed the gas stove, the refrigerator, the microwave, and the dishwasher to be clean and operational. LPA observed knives to be locked inside a kitchen cabinet. Fire extinguisher is located in the living room with a purchase date of September 17,2024. Fire extinguisher was observed to be fully charged. LPA tested the wired smoke/carbon monoxide detectors which tested operational. The centrally stored medication will be located inside a locked kitchen cabinet. LPA observed the First Aid Kit had all the required components. Cleaning supplies and toxins are locked and located under the kitchen sink.

LPA and LPM accompanied by the applicant toured the outside of the facility and observed it to be free of obstructions and hazards. LPA observed a shaded outdoor seating area with furniture for client use on the front porch. The perimeter gate on the exterior of the facility is self-latching and can easily be opened in an evacuation. There are no bodies of water on the premises.

Component III was completed with the applicant which provided information about how to operate the facility within compliance and reporting requirements. The applicant was notified that the final application approval will be issued by the Centralized Applications Bureau (CAB) in Sacramento for final review prior to license being issued. An exit interview was conducted, and a copy of this report was left with the applicant.

SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Nancy Guillen
LICENSING EVALUATOR SIGNATURE:	DATE: 01/22/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/22/2025

LIC809 (FAS) - (06/04)

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