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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306006626
Report Date: 03/20/2025
Date Signed: 03/20/2025 02:20:41 PM

Document Has Been Signed on 03/20/2025 02:20 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
CENTRALIZED APP UNIT, 744 P STREET, MS 9-14-8201
SACRAMENTO, CA 95814
FACILITY NAME:MEGAN'S OPEN ARMSFACILITY NUMBER:
306006626
ADMINISTRATOR/
DIRECTOR:		YU, TSUNG-SUNGFACILITY TYPE:
740
ADDRESS:249 S CALLE DA GAMATELEPHONE:
(714) 267-4105
CITY:ANAHEIMSTATE: CAZIP CODE:
92807
CAPACITY: 3CENSUS: 0DATE:
03/20/2025
TYPE OF VISIT:OfficeANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:Chin-Wen Cheng, Applicant
Tsung-Shun Wu, Administrator		TIME VISIT/
INSPECTION COMPLETED:
02:00 PM
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Component II completion: Successful

Facility Type: Residential Care Facility for the Elderly (RCFE)
Application Type: Initial
Capacity: 3
Census (if any clients in care): none
COMP II Participants: Chin-Wen Cheng, Applicant
Tsung-Shun Wu, Administrator
Interview Method: Virtual interview (Microsoft Teams)

On March 20, 2025 at 1:00 PM, Applicant and Administrator participated in COMP II. Identification of the Applicant and Administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, Applicant and Administrator confirmed that they have read and understand community care facility licensing laws included in the Health and Safety Codes and the California Code of Regulations Title 22.

During COMP II, CAB analyst confirmed Applicant and Administrator’s understanding of following areas:
1. Facility Operation: License type, Client/Resident Populations, and Program.
2. Admission Policies
3. Staffing Requirements & Training
4. Restrictive/Prohibited Health Conditions
5. General Provisions
6. Emergency Preparedness
7. Complaints & Reporting
8. Pre-licensing Readiness

Exit interview conducted with Applicant and Administrator. Report sent via email and informed to return sign copy to CAB by end of business day today.
SUPERVISORS NAME: Tracy Thompson
LICENSING EVALUATOR NAME: Celia Phomphachanh
LICENSING EVALUATOR SIGNATURE: DATE: 03/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/20/2025
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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