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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306006547
Report Date: 11/15/2024
Date Signed: 11/15/2024 04:42:06 PM

Document Has Been Signed on 11/15/2024 04:42 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:COMFORT FIRST HOME CAREFACILITY NUMBER:
306006547
ADMINISTRATOR/
DIRECTOR:
PHAM, MINHFACILITY TYPE:
740
ADDRESS:645 S MAGNOLIA AVETELEPHONE:
(714) 244-5687
CITY:ANAHEIMSTATE: CAZIP CODE:
92804
CAPACITY: 6CENSUS: 0DATE:
11/15/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
04:25 PM
MET WITH:Minh Pham, AdministratorTIME VISIT/
INSPECTION COMPLETED:
05:00 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 Analysts (LPAs) Rose Ruppert and Fred Arias returned to the facility to complete a pre-licensing visit, from this morning, that required corrections in order to meet licensing requirements. LPAs were greeted and granted entry by Administrator, Minh Pham at 4:25 PM. Administrator and LPAs toured the facility and observed the following items corrected from this morning's visit.

Two non-ambulatory bedrooms will have auditory alarms installed on exit doors, as well as an exterior door in the hallway next to resident rooms and the main sliding glass door from the indoors to exterior. Administrator was installing alarms at time of this report.

A shaded canopy was placed over the seating area in the patio to provide shade. Two fire extinguishers were inspected by Fire Prevention Services after LPAs left this morning and are fully charged as of November 15, 2024. Administrator created a locked drawer for sharps and secured the knives and oven knobs in the locked drawer. A screen for the living room fireplace was purchased. Six gallon jugs of water were purchased for emergencies.

Administrator reached out to the Centralized Applications Bureau (CAB) Analyst regarding obtaining background clearance for the renter who lives on the property.

LPAs verified all corrections were made and AD 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 Licensee.
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: RoseMarie Ruppert
LICENSING EVALUATOR SIGNATURE: DATE: 11/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/15/2024
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 1