The facility is licensed to operate for six (6) non-ambulatory of which one (1) may be bedridden and have a hospice waiver for two (2) residents. The facility is a single-story structure located in a residential neighborhood. It consists of the following: four (4) resident bedrooms, two (2) bathrooms, living room, dining room, kitchen, and an outside covered patio area.

LPA Kim toured indoor and outdoor of the physical plant with AD Lucero and AD Gardner. There are no bodies of water or obstructions on the premises. All rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting was provided, storage for each client’s personal belongings was observed. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. All bedrooms were inspected: Resident Room 1, Resident Room 2, Resident Room 3, and Resident Room 4. Bathrooms were found to be within Title 22 regulations and were clean and operational. The water temperature measured at 116.7 degrees F and 117.1 degrees F. A comfortable temperature of degrees 76 degrees F was maintained in the facility.

LPA Kim observed the facility to be sanitary and appropriately furnished at the time of visit. Storage areas for personal hygiene, cleaning supplies, toxins, and sharps objects were stored and not accessible to clients. The kitchen was inspected and there is a two-day supply of perishable and seven-day supply of non-perishable food available and maintained properly. The facility has two (2) fire extinguishers that are charged, and smoke/carbon monoxide detectors were found operable. The facility conducted a Fire/Safety Drill on June 2, 2024 and are done quarterly. A working telephone (949-393-7100) remains available. First Aid Kit contained all the necessary elements.

Evaluation Report Continues on LIC 809-C

LPA conducted an audit of resident files (R1-R5), staff files (S1-S5), and medication and medication administration review. LPA Kim conducted five (5) resident interviews and four (4) staff interviews.

A LIC 9102 Advisory Notes: Technical Violation was issued for the PUB 475 poster not meeting regulation 20"x26".

No deficiencies were cited during this inspection visit.

An exit interview was conducted, and a copy of this report was provided to Administrator Luis Lucero and Administrator Jeffrey Gardner .