306006248-6-10-2026-22-AS-JALE-DUX3ER-20260610181134

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 306006248
Report Date: 06/10/2026
Date Signed: 06/10/2026 06:11:43 PM

Document Has Been Signed on 06/10/2026 06:11 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:	MORNINGSTAR SENIOR LIVING OF MISSION VIEJO		FACILITY NUMBER:	306006248
ADMINISTRATOR/ DIRECTOR:	MANDVIWAL, MELINDA		FACILITY TYPE:	740
ADDRESS:	28570 MARGUERITE PARKWAY		TELEPHONE:	(949) 649-4855
CITY:	MISSION VIEJO	STATE: CA	ZIP CODE:	92692
CAPACITY: 198		CENSUS: 133	DATE:	06/10/2026
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	01:00 PM
MET WITH:	Danny Vera		TIME VISIT/ INSPECTION COMPLETED:	06:00 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analyst (LPA) Joseph Alejandre made an unannounced visit to conduct the required annual inspection. LPA was greeted and granted entry by staff. LPA met with Executive Director Danny Vera and explained the reason for the visit. Danny Vera's Administrator's Certificate expires on November 14, 2027. Facility is licensed for 76 ambulatory and 122 non-ambulatory of which 122 may be bedridden. Facility has an approved hospice waiver for 20 and there are 133 residents present today with 10 on hospice. LPA and the Executive Director toured the facility. The facility has 4 levels, the ground level (1st Floor) has the main entrance and lobby. There is basement level with an underground parking. The basement level has elevator access and has a game room for residents. LPA observed the facility emergency food and water supply stored in the basement level. The facility has a 3 day supply of food and water for emergencies. Residents reside on levels 1, 2 and 3. LPA observed all stairways have emergency evacuation chairs. All fire extinguishers in the facility were found to be fully charged. There is an outdoor patio on the First floor with shaded seating for the residents to sit outside. There is a pool in the outdoor patio. The pool is surrounded by a 5 foot tall fence with a gate a each end. Both gates are secured. LPA observed residents listening to a speaker in the theater room. LPA observed residents playing cards in the main sitting area in the lobby. The resident library on the first floor has a computer with internet access for dedicated resident use. LPA observed the See Something Say Something poster (PUB 475) in the main entrance of the facility. LPA and the Executive Director toured the kitchen and dining room. LPA observed the kitchen and dining room are clean and organized. LPA observed a 2 day perishable and a 7 day non-perishable food supply on hand in the kitchen. LPA observed the walk-in refrigerator in the kitchen was at 38.0 degrees Fahrenheit and the walk- in freezer was at 0.1 degrees Fahrenheit. LPA reviewed the temperature logs for the freezer and refrigerator and the logs are up to date. LPA inspected the medication room on the second floor. LPA observed all medications were secured in the medication room.

NAME OF LICENSING PROGRAM MANAGER: Sheila Santos
NAME OF LICENSING PROGRAM ANALYST: Joseph Alejandre
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 06/10/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/10/2026

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 4

California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

Page: 2 of 4

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: MORNINGSTAR SENIOR LIVING OF MISSION VIEJO	FACILITY NUMBER: 306006248
	VISIT DATE: 06/10/2026

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

LPA inspected the first aid kit in the medication room. The first aid kit has all the required elements. Memory care is on the first floor and has delayed egress exits. LPA tested the delayed egress exits and they are all operational. The memory care area has a patio with shaded seating areas. No bodies of water in the memory care patio. LPA toured 13 resident rooms with the Executive Director. Rooms inspected were on the first, second and third floors. Hot water measured 113.0 to 115.5 degrees Fahrenheit. LPA observed all rooms were clean and had the required furnishings and bed linens. LPA tested the smoke/carbon monoxide detectors in each room inspected. All detectors tested are operational. The last emergency drill (fire) was conducted on May 16, 2026. LPA reviewed 13 resident files, no discrepancies observed. LPA reviewed 3 staff files. All staff observed at the facility are background cleared and associated to the facility. LPA observed Staff 1 had over 20 hours of training but did not have 4 hours of training in postural supports, restricted health conditions and hospice care, Staff 1 only had 3 hours of training in those areas. No other discrepancies observed. Deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted with the Executive Director and a copy of the report along with appeal rights was provided.

NAME OF LICENSING PROGRAM MANAGER: Sheila Santos
NAME OF LICENSING PROGRAM ANALYST: Joseph Alejandre
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 06/10/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/10/2026

LIC809 (FAS) - (06/04)

Page: 3 of 4

Document Has Been Signed on 06/10/2026 06:11 PM - It Cannot Be Edited

Created By: Joseph Alejandre On 06/10/2026 at 05:51 PM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

FACILITY NAME: MORNINGSTAR SENIOR LIVING OF MISSION VIEJO	FACILITY NUMBER: 306006248
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/10/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1569.625(b)(2)

Other Provisions

(2) In addition to paragraph (1), training requirements shall also include an additional 20 hours annually, eight hours of which shall be dementia care training, as required by subdivision (a) of Section 1569.626, and four hours of which shall be specific to postural supports, restricted health conditions, and hospice care, as required by subdivision (a) of Section 1569.696. This training shall be administered on the job, or in a classroom setting, or both, and may include online training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based onrecord review, the licensee did not comply with the section cited above, Staff 1 did not have 4 hours of training in postural supports, restricted health conditions and hospice care, Staff 1 only had 3 hours of training in those areas which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 06/24/2026
	Plan of Correction
1 2 3 4	Licensee agrees to have Staff 1 trained in accordance with HSC 1569.625(b)(2) by the POC due date. Proof of training in postural supports, restricted health conditions and hospice care for a total of 4 hours to be submitted to the LPA by the POC due date.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

	Sheila Santos
NAME OF LICENSING PROGRAM MANAGER:

	Joseph Alejandre
NAME OF LICENSING PROGRAM ANALYST:

LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/10/2026

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/10/2026

LIC809 (FAS) - (06/04)

Page: 4 of 4