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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 345920159
Report Date: 10/30/2024
Date Signed: 10/30/2024 10:00:09 AM

Document Has Been Signed on 10/30/2024 10:00 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
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:MAKARIOS HOME CAREFACILITY NUMBER:
345920159
ADMINISTRATOR/
DIRECTOR:		REDHAIR, IDAFACILITY TYPE:
735
ADDRESS:8134 DONNAWOOD WAYTELEPHONE:
(916) 242-0423
CITY:ORANGEVALESTATE: CAZIP CODE:
95662
CAPACITY: 4CENSUS: 0DATE:
10/30/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:35 AM
MET WITH:Ida RedhairTIME VISIT/
INSPECTION COMPLETED:
10:00 AM
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On 10/30/24 , Licensing Program Analyst (LPA) Talwinder Bains met with Applicant, Ida Redhair to conduct a announced Pre- Licensing visit.

The facility has a fire clearance (04/04/24) for 3 ambulatory (Room 1,2,3) and 1 non ambulatory (Room # 4) residents. Facility has 1 staff room and office area. Facility has no residents at this time.



LPA conducted an inspection of the care home to ensure compliance with Title 22 regulations. LPA inspected 4 bedrooms for residents, 2 bathrooms, 1 staff room, common area, kitchen, laundry area and outdoor area. LPA observed facility to be properly furnished, including appropriate bedding and lighting in the facility . Bathrooms were in sanitary condition and properly maintained. LPA checked the kitchen area for the ability to prepare and store food. LPA observed cleaning products and other toxins to be locked away. LPA observed the area used for medication to be locked and inaccessible to residents. LPA observed smoke detectors and carbon monoxide detectors at the care home to be operational. Fire extinguisher and first aid kit are maintained and ready for emergency use. LPA observed all required postings in common area. Licensee agrees to notify LPA once first consumer is admitted.

Pre-licensing passed and Component III (ARF) was waived as applicant was operating another ARF licensed by Department.

Facility has satisfied all requirements in accordance to Title 22, California Code of Regulations. Application is pending and LPA will forward findings to the Centralized Application Bureau (CAB) for final review and approval. CAB will further contact applicant on final status of application.

A copy of this report was provided to the facility. Exit interview conducted.

SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Talwinder Bains
LICENSING EVALUATOR SIGNATURE: DATE: 10/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/30/2024
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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