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Inspection visit

Routine inspection

SERENE HAVEN ASSISTED LIVING MISSION VIEJOLicense 3060065633 citations on this visit
3 citations recorded

Inspector’s narrative

What the inspector wrote

On November 21, 2025, Licensing Program Analyst (LPA) Garlli Tat conducted an unannounced visit to the facility for the purpose of a required annual inspection. LPA explained the purpose for the visit and was greeted and granted entry by staff on duty. During the visit, staff on duty contacted the facility administrator (AD) Aira Kamil Seleky about the visit. For this visit, there are two staff members on duty, both of which are background cleared and associated. The PUB475 ‘See Something, Say Something’ poster was observed to be located near the front entrance. LPA observed the Administrator's Certificate for Aira Kamil Seleky, which expires on May 27, 2027. The facility is a Residential Care facility for the Elderly (RCFE) licensed for six residents, six of which may be non-ambulatory, none of which may be bedridden, and a hospice waiver for three. LPA toured the interior and exterior portions of the facility with staff. For this visit, there are a total of five non-ambulatory residents in care, three of which are on hospice, and none are bedridden. The facility is a two-story home. There are a total of 11 bedrooms, six of which are private resident bedrooms, and one bedroom is for staff. The upper story consists of four bedrooms, which is vacated by a family. All of which are cleared and associated. LPA toured each bedroom with staff and observed that bedrooms were provided with furniture in good repair, clean linens, adequate storage space, and free of any hazards. LPA observed the staff room is kept locked and inaccessible to residents in care. Smoke and carbon monoxide detectors as well as auditory exit alarms were tested and operational. There are a total of three bathrooms. Continued on LIC 809-C. Bathrooms were observed to be in good repair, toilets and faucets were operational and showers were equipped with grab bars and non-skid floor mats. Water temperature in the bathrooms were measured to be between 116.7 and 117.6 degrees Fahrenheit. Facility met the minimum two-day perishable and seven-day non-perishable food supplies. Sharp items and knives were locked in the kitchen cabinet and inaccessible to residents in care. Fire extinguisher was charged, mounted and located in the kitchen. Fire extinguisher was dated and tagged on April 5, 2025. LPA observed the emergency disaster and evacuation plan, which is posted in the dining room. LPA observed the facility conducted their last emergency disaster drill on July 1, 2025. Facility had back-up emergency food and water supply, located in the medication cabinet. LPA observed that the First Aid kit had all the required components. Medications were observed to be locked in a medication cabinet in the dining room, inaccessible to residents in care. Chemicals were observed to be locked underneath the kitchen sink. LPA observed the door leading to the attached one car garage is kept locked and inaccessible to residents in care. The garage is used for storage and laundry. For the exterior portion, LPA observed patio furniture under shading. There are two exit gates in the backyard that can be opened in case of an emergency. No bodies of water were observed. During this visit, five resident files and two staff files were reviewed. All staff are background cleared and associated with the facility. LPA reviewed residents’ medication and medication records and two resident interviews were conducted. Based on today's observations, there are deficiencies being cited per Title 22 of the California Code of Regulations. There are two technical violations issued at the time of the visit. An exit interview was conducted with staff Reymark Gatbonton. This report was reviewed with staff and a copy was provided at the end of the visit. Appeal Rights were reviewed.

Citations

3 citations recorded*CCLD

What does Type A vs Type B mean?

Type A. Serious citation. Imminent or substantial risk to children. The regulator requires corrective action immediately and may impose a civil penalty.

Type B. Lower-severity citation. Corrective action required, no imminent risk. The regulator monitors compliance on the next visit.

  • 1569.605Type B

    Based on observation and record review, the licensee did not have a current liability insurance on file which poses a potential health, safety or personal rights risk to persons in care. The current liability insurance on file was effective 10/27/2023 to 10/27/2024.

  • 1569.625(b)(1)Type B

    Based on observation and record review, one out of two staff (Staff #1) did not have sufficient training for the year of 2025 which poses a potential health, safety or personal rights risk to persons in care.

  • Maintain admission agreement and appraisal

    Based on observation and record review, Resident #5 did not have a signed, initialed, or dated Admission Agreement which poses a potential health, safety or personal rights risk to persons in care.

FAQ · About this visit

Common questions about this visit

What happened during the November 21, 2025 inspection of SERENE HAVEN ASSISTED LIVING MISSION VIEJO?

This was an inspection of SERENE HAVEN ASSISTED LIVING MISSION VIEJO on November 21, 2025. 3 citations were issued: 3 Type B.

Were any citations issued to SERENE HAVEN ASSISTED LIVING MISSION VIEJO on November 21, 2025?

Yes, 3 citations were issued (0 Type A, 3 Type B). The first citation was for: "Based on observation and record review, the licensee did not have a current liability insurance on file which poses a po..."

What type of inspection was this?

This was an inspection. Inspections are conducted by CCLD as part of their licensing oversight.

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