Routine inspection·November 25, 2025

Licensing Program Analyst (LPAs) Kimberly Lyman conducted an unannounced visit to Dana Point Manor. The purpose of today’s visit was to conduct the annual required inspection. LPA was allowed entry into the home and met with Caregiver Susan Arevalo and explained the reason for the visit. Facility is licensed for 6 non-ambulatory residents. Facility has an approved hospice waiver for 6 residents and the home currently has 5 residents, with 2 residents on hospice. Administrator Ramil De Los Santos has an administrator certificate expiring on 09/27/2026. Upon entry, facility appears clean, safe and sanitary. LPA Lyman along with Caregiver Arevalo toured the facility at 10:56 AM. LPA toured the physical plant, checked food service, facility documentation and the first aid kit. The home consists of 5 resident bedrooms, living room, dining room, and kitchen as well as 4 restrooms. Resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. LPA observed three residents with bed rails. Resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure and shower was free of mold/mildew. Water temperature measured between 107.7 degrees F and 110.8 degrees F in all restrooms. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked. Common areas were clean and clear of hazards. LPA toured the kitchen. Perishable and non-perishable food supply was checked and adequately stocked at time of visit. LPA observed sharps as well as cleaning supplies secured in the kitchen. Kitchen appliances were operational during today's visit. Smoke detectors and carbon monoxide detectors are hardwired and tested operational during today's visit. Fire extinguishers were fully charged. Facility conducts quarterly emergency drills with the last drill conducted on 08/15/2025. Outside grounds were toured. Walkways around the home were clear of hazards. There are no security bars or weapons on the premises. CONTINUED ON LIC 809C DATED 11/25/2025 First aid kit contained all required items including tweezers, scissors and thermometer. Facility conducts activities in the form of music, exercise and arts and crafts. There is ample shaded outdoor seating for residents. Exit gates are unlocked, self latching and operational. LPA observed ample emergency food and water supply. LPA reviewed five resident files and three staff files. All resident files contained required documentation including admission agreements, physician reports, resident appraisals, and physician orders for bed rails as indicated. Staff files reviewed contained required documentation including required annual training, medical assessment/ TB, criminal record clearance and proof of CPR training. LPA reviewed medication storage and administration. Medications are stored in a locked closet. Medications appear to be administered per physician order. Licensee has been asked to provide an updated LIC 500 (Personnel report), LIC 610 (Emergency Disaster Plan), LIC 308 (Designation of Facility Responsibility) and a copy of liability insurance by 12/09/2025. Based on the observations made during today’s visit, NO deficiencies are being cited. Exit interview conducted and a copy of this report was left at the facility.