Routine inspection·May 30, 2025

On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility to conduct the required annual inspection. Upon LPA's arrival, caregiving staff was absent due to a medical appointment. Administrator Guadalupe De Veau was notified via telephone and arrived shortly afterwards to assist with the visit. There are currently three residents in care, none of which are receiving hospice care at this time. All three residents attend day program and are observed to be away during the present visit. No interviews were therefore conducted at this time. LPA accompanied by administrator toured the physical plant. The facility is a one-story house with an attached garage. The facility has four private bedrooms along with one locked staff room and a sunroom. Bedrooms appear clean and sanitary. No postural supports are observed to be in use on the premises. All resident bedrooms have the required furnishings. Bathrooms appear clean and sanitary and are equipped with grab bars and slip mats. Hot water temperature measured at 114F and 115F in two separate bathrooms equipped with faucets used for personal grooming. LPA observed the kitchen has a minimum two (2) day perishable and seven (7) day non-perishable food supply. Sharp items, cleaning supplies and the medication central storage are verified to be secured. CONTINUED ON FORM LIC809-C CONTINUED FROM LIC809 The wall-mounted fire extinguisher is charged, with up-to-date maintenance tag attached. LPA tested the smoke and carbon monoxide detectors which were found to be operational. The garage is inaccessible to residents and used for storage of food and supplies. The laundry room is accessible from the kitchen and office area however laundry supplies are confirmed to be inaccessible. LPA and facility staff toured the outside of the facility. LPA observed an shaded outdoor seating area with furniture for resident use. A large umbrella is stated to be scheduled for removal since it has been damaged. Consultation provided. There are self-latching gates on both sides of the property and the routes of egress are free of clutter and obstructions. There are no bodies of water on the premises. Facility does not utilize locked perimeters or delayed egress. LPA reviewed three resident records which included all necessary components. Facility is awaiting updates from Regional Center of Orange County for admission agreements as well as Purchase of Service Authorizations, some of which are still issued to the formerly licensed facility at this time. Consultation provided. Personal and incidental funds reviewed with no discrepancies found. LPA reviewed resident medication records and prescription orders for all residents with no discrepancies observed. Oxygen is not in use. LPA reviewed staff records for two staff members currently scheduled. Administrator has a current CPR certificate on file, however the caregiver scheduled has an expired certificate since February 2025. Type B citation issued. Annual training on file. Disaster drills are conducted three times a year with proof of attendance provided. Consultation provided. Both staff members present are background cleared and associated to the licensed location. Based on the observations made during today’s visit, one type B deficiency is being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted and a copy of this report along with appeal rights were provided to a facility representative.