Emy's Place of Mission Viejo

Type of visit: Required - 1 Year

On this day Licensing Program Analyst (LPA) Fred Arias made an unannounced visit to conduct a required annual visit. LPA was greeted and granted entry into the facility by staff and explained the reason for the visit. Facility is licensed for six non-ambulatory residents of which one may be bedridden. Facility has an approved hospice waiver for two residents and the home currently has five residents, with no residents on hospice. Administrator (AD) Emiliana Pinera assisted with the visit. LPA along with AD toured the facility at 9:10 AM. LPA toured the physical plant, checked food service, and facility documentation. The home consists of five resident bedrooms, staff room, living room, dining room, and kitchen, three bathrooms and an attached garage. Resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. Resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure and shower was free of mold/mildew. Water temperature measured between 107 degrees F and 114.2 degrees F in all bathrooms. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked. Common areas were clean and clear of hazards. Auditory exit alarms were operational during today's visit. LPA toured the kitchen and observed sharps locked in a cabinet during today's visit. Perishable and non-perishable food supply was checked and adequately stocked at time of visit. Kitchen appliances were operational during today's visit. Smoke detectors tested operational during today's visit. Fire extinguisher was fully charged. LPA reviewed the emergency disaster plan. Facility conducts quarterly emergency drills with the last drill conducted on 6/1/2026. Outside grounds were toured. Walkways around the home were clear of hazards. There is shaded outdoor seating for residents. Exit gates are unlocked and operational. LPA observed the emergency food supply. First aid kit contained all required items including tweezers, scissors and thermometer. LPA reviewed five resident files and two staff files. All resident files contained required documentation including admission agreements, physician reports, and resident appraisals. Two out of two staff files reviewed did not contain evidence of annual training. One out of two staff files did not contain evidence of a health screening and TB testing. LPA reviewed medication storage and administration. Medications are stored in a locked closet. One resident medication review did not contain a physician's order for over the counter medication. AD has agreed to participate in the technical support program. Based on the observations made during today’s visit, 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 along with appeal rights.the state’s words, verbatim · CDSS document, Jun 19, 2026

The state marks this report as 9 pages; the online copy we transcribed has 5. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility to conduct the required annual inspection. LPA was greeted and granted entry by facility administrator Emiliana Pinera after stating the purpose of the visit. There are currently three residents in care, none of which are receiving hospice care at this time. LPA observed residents relaxing in the facility's common living areas or in their respective bedrooms. LPA accompanied by facility staff toured the physical plant. The facility is a one-story house with an attached garage. The facility has four bedrooms along with one locked staff room along with two shared bathrooms and one en-suite bathroom off of a shared room which currently only houses one occupant. Bedrooms appear clean and sanitary. Two residents are observed using half-rails postural supports at the time of the visit, consultation provided and licensee instructed to submit adequate physician orders at the earliest convenience. 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 111F 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. The wall-mounted fire extinguisher is charged with up-to-date maintenance. Smoke and carbon monoxide detectors were found to be operational. The garage is inaccessible to residents and used for laundry as well as additional storage of supplies. CONTINUED ON FORM LIC809-C CONTINUED FROM LIC809 LPA and facility staff toured the outside of the facility. LPA observed a shaded outdoor seating area with furniture for resident use. There are two self-latching gates on each side of the property. One gate was damaged off its hinge during a facility renovation and is scheduled for repairs. The identified route of egress is however 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. Consultation provided on regular physician assessments. One resident self-administers their own weekly Ozempic injection and is able to self-administer per staff assessment. Their physician report however needs to be updated as soon as possible as the assessment does not corroborate the resident's current condition. LPA reviewed resident medication records and prescription orders for all residents with no discrepancies observed. Oxygen is currently in use on the premises with adequate signs observed. There are no residents currently assessed as being bedridden at the time of the visit. Resident interviews were conducted or attempted during the visit along with staff interviews. LPA reviewed staff records for two staff members present during the visit. Present staff member has a current CPR certificates on file, however administrator Emiliana Pinera also provides care and covers the overnight shift. CPR training for Mrs. Pinera has lapsed. Type B citation issued. Annual training on file, consultation provided on the need to document dates for annual and initial staff training. Disaster drills are conducted however they are not held quarterly nor documented. Type B citation issued. Both staff members present are background cleared and associated to the licensed location. Based on the observations made during today’s visit, two type B deficiencies are 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.the state’s words, verbatim · CDSS document, Jun 2, 2025

The state marks this report as 9 pages; the online copy we transcribed has 4. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility for the purpose of conducting the Required Annual Inspection. LPA was greeted and granted entry by facility administrator Emiliana Pinera. During the inspection, LPA and facility staff conducted a tour of the physical plant and observed the following: The facility is a one-story home. Facility has four private rooms and one staff room, as well as two shared bathrooms and one half bathroom in addition to the common living areas. All resident bedrooms have the required furnishings. LPA observed all beds have linens and blankets. The backyard has a shaded area and the routes of egress are free of clutter and obstructions. There are currently four residents admitted to the facility with one currently at the hospital. Two residents are receiving hospice care. Residents are observed to be clean and appear well taken care of. Bathrooms faucets and toilets were operational. Water temperature was verified to be within acceptable range. LPA observed emergency disaster plan with means of exiting and emergency phone numbers listed and posted. LPA observed the facility has a 2-day supply of perishables and a 7-day supply of non-perishable food as required. Combined smoke and carbon monoxide detectors tested operational. Fire extinguisher present is observed to be fully charged with up-to-date maintenance. Medication, sharp items and cleaning supplies were confirmed to be inaccessible throughout the physical plant. The medication central storage was also observed to be secure and reviewed for accuracy during the visit. LPA reviewed four resident files and two staff files. Based on the observations made during today’s inspection, one type B deficiency is being cited per Title 22 Division 6 of the California Code of Regulations. Four Technical Assistance Advisory Note were provided to the licensee based on consultation provided during the visit. An exit interview was conducted, and a copy of this report along with appeal rights was left at the facility.the state’s words, verbatim · CDSS document, Jun 3, 2024

The state marks this report as 6 pages; the online copy we transcribed has 2. You can request the full file from the county licensing office.