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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306005693
Report Date: 02/21/2025
Date Signed: 02/21/2025 01:15:47 PM

Document Has Been Signed on 02/21/2025 01:15 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
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME:SILVERADO SENIOR LIVING- NEWPORT MESAFACILITY NUMBER:
306005693
ADMINISTRATOR/
DIRECTOR:		HEATHER YOUNANFACILITY TYPE:
740
ADDRESS:350 W BAY STREETTELEPHONE:
(949) 631-2212
CITY:COSTA MESASTATE: CAZIP CODE:
92627
CAPACITY: 82TOTAL ENROLLED CHILDREN: 0CENSUS: 51DATE:
02/21/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:35 AM
MET WITH:Heather YounanTIME VISIT/
INSPECTION COMPLETED:
01:30 PM
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On this day Licensing Program Analysts (LPAs) Andrea Mendevil and Fred Arias made an unannounced visit to conduct a required annual visit. LPAs were greeted and granted entry into the facility by staff and explained the reason for the visit. The facility is approved for eighty-two (82) non-ambulatory and hospice waiver for twenty (20) residents. The facility is a two-story structure located in a residential neighborhood. It consists of the following: forty-one (41) resident bedrooms, forty-six (46) bathrooms, 4 dining areas, kitchen, and outside covered patio area. Resident reside on the first floor only. Administrator (AD) Heather Younan was present to conduct facility tour. AD provided updated liability insurance that expires on 7/1/2025.

Around 9:20am LPAs toured inside and outside grounds of the physical plant with AD Younan. There were no bodies of water or obstructions on the premises. Beds and bedding supplies were in good condition, adequate lighting was provided, storage for each resident’s personal belongings was observed. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. Five resident’s rooms were inspected. Bathrooms were found clean and operational. Toilets and water faucets worked properly, grab bars were secure and shower was free of mold/mildew. The water temperature measured at 106.3-121.4 degrees F.

LPA 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 residents. 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 kitchen is inaccessible to residents. Emergency food & water was observed to be adequate. Facility provided documentation dated June 4, 2024 by Fire Safety Service confirming all smoke detectors, and carbon monoxide were operable. Facility's last conducted Fire/Safety Drill on January 16, 2025. Drills are done quarterly. LPA's observed Department posters were posted. First Aid Kit contained all the necessary elements. LPAs reviewed five resident files and five staff files. Medications were audited for 5 residents. Medications are stored in the medication room inside locked carts.

CONTINUED ON LIC808-C DATED 2/21/2025

Alisa OrtizTELEPHONE: (714) 287-4084
Fred AriasTELEPHONE: (714) 703-2840
DATE: 02/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/21/2025
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME: SILVERADO SENIOR LIVING- NEWPORT MESA
FACILITY NUMBER: 306005693
VISIT DATE: 02/21/2025
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Based on the observations made during today’s visit, no deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. This report was discussed with the facility representative and a copy was provided.
SUPERVISOR'S NAME: Alisa OrtizTELEPHONE: (714) 287-4084
LICENSING EVALUATOR NAME: Fred AriasTELEPHONE: (714) 703-2840
LICENSING EVALUATOR SIGNATURE:

DATE: 02/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2025
LIC809 (FAS) - (06/04)
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