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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306004312
Report Date: 11/05/2024
Date Signed: 11/05/2024 01:09:13 PM

Document Has Been Signed on 11/05/2024 01:09 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:PRECIOUS HOME CARE IIFACILITY NUMBER:
306004312
ADMINISTRATOR/
DIRECTOR:		GRACE RADFORDFACILITY TYPE:
740
ADDRESS:24531 VANESSA DRIVETELEPHONE:
(949) 215-3090
CITY:MISSION VIEJOSTATE: CAZIP CODE:
92691
CAPACITY: 6CENSUS: 6DATE:
11/05/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:45 AM
MET WITH:Grace Radford- AdministratorTIME VISIT/
INSPECTION COMPLETED:
01:25 PM
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Licensing Program Analyst (LPA) Jessica Cho arrived at the facility unannounced for the purpose of conducting the Required 1-Year annual inspection using the CARE Inspection Tool. LPA met with Licensee/Administrator (Admin) Grace Radford and explained the reason for the visit.

The facility is a single story structure located in a residential neighborhood. Facility is licensed to operate for six (6) non-ambulatory of which one (1) may be bedridden and maintains a hospice waiver for six (6). There are five residents in care during today's visit with three caregivers on duty.

LPA observed the facility to be clean, sanitary, and operational. There are six resident bedrooms and four resident bathrooms. All common areas were inspected including the attached two car garage and laundry room. The residents' bedrooms were appropriately furnished. Beds and bedding supplies were in good condition, adequate lighting was provided, sufficient storage space for each residents' personal belongings were observed. Bathrooms were found to be in compliance, clean, and operational. The water temperature measured at 109.5, 110.3, 110.3, and 110.3 degrees Fahrenheit. Toxins, disinfectants, sharps, and medications were secured and inaccessible. LPA observed sufficient two-day supply of perishables and seven-day supply of non-perishable food available. LPA toured the exterior portion of the facility. There is a small elevated fountain and a secured shed in the backyard. LPA observed the outdoor passageway free of obstructions. The exit gates were self-closing and self-latching. LPA observed sufficient seating and shading. Facility maintains two fire extinguishers. Both were mounted, charged, and serviced on May 22, 2024. The auditory devices and smoke/carbon monoxide detectors were tested and operational. LPA observed the emergency disaster supplies including food/water in the garage. Emergency evacuation drills are being conducted quarterly. The first aid kit contains all necessary elements. A working facility telephone number, 949-215-3090, remains available.
SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Jessica Cho
LICENSING EVALUATOR SIGNATURE: DATE: 11/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/05/2024
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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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: PRECIOUS HOME CARE II
FACILITY NUMBER: 306004312
VISIT DATE: 11/05/2024
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LPA observed the required 'See Something, Say Something' (PUB475) poster in the correct size posted in the entry way. The Administrator's Certificate for Grace Radford expires on January 8, 2026 and on April 1, 2025 for Andy Radford.

LPA conducted an audit of six residents' files and three personnel files. No discrepancies were noted. Medications were audited for five residents. No discrepancies noted. Staff and resident interviews were conducted.

Based on the observations made during today's visit, no deficiency is being cited today.

An exit interview was conducted with Licensee/Administrator Grace Radford, and a copy of this report was provided at the end of the visit.

SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Jessica Cho
LICENSING EVALUATOR SIGNATURE:

DATE: 11/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/05/2024
LIC809 (FAS) - (06/04)
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