Ablelight, Inc. - Osprey

Type of visit: Case Management - Incident

This unannounced Case Management – Incident inspection visit is being conducted by Licensing Program Analyst (LPA) Edward Kim for the purpose of following up on self-reported incident reports received in the Orange County Regional Office (OCRO) on September 29, 2026, regarding Resident #1 (R1) and Resident #2 (R2). LPA Kim spoke with Administrator (ADMIN) Jill Bonnin over the phone and explained the purpose of the visit. ADMIN Bonnin could not attend today's visit and stated Lead Direct Support Professional Cara Estep could sign on behalf of the facility. During today's visit, LPA Kim conducted a physical tour of the facility. LPA Kim reviewed and obtained copies of resident roster and staff roster. LPA will receive through email from the facility by October 1, 2026, 5:00 PM, a copy of two residents record which include: Admission Agreement, Identification and Emergency Information, Physician's Report, incident reports, Physician's Orders, Needs and Services Plans/Reappraisal, and other pertinent records. LPA will also receive through email from the facility by October 1, 2026, 5:00 PM a copy of one staff records which include: LIC501, LIC503, training records, and other pertinent records. Based on the information gathered, further investigation is needed. An exit interview was conducted, and a copy of this report was provided to the Lead Direct Support Professional Cara Estep.the state’s words, verbatim · CDSS document, Oct 1, 2026

Type of visit: Required - 1 Year

On August 4, 2026, at 1:45 PM, Licensing Program Analyst (LPA) Edward Kim conducted an unannounced required 1-Year annual visit using the CARE Inspection Tool. Upon arrival at the facility, LPA Kim met with Administrator (ADMIN) Jill Bonnin and explained the purpose of the visit . The facility is licensed to have a capacity of four (4) nonambulatory residents and a hospice waiver for two (2) residents. LPA Kim observed the following. The facility is a one-story house with an attached 2-car garage with four (4) resident bedrooms, two (2) bathrooms, dining room, a kitchen, a living room, outdoor shed, and outdoor shaded area. LPA Kim toured inside and outside of the physical plant. There are no obstructions or bodies of water on the premises. All rooms were inspected. 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. 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 between 105.7 degrees F and 106.7 degrees F. A comfortable temperature of 74 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 residents Evaluation Report Continues on LIC 809-C During the visit, LPA Kim observed the facility's infection control practices. LPA observed screening protocols for visitors, staff, and residents, and sanitizing stations in common areas. LPA observed the facility has a 30-day supply of Personal Protective Equipment (PPE). 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. Emergency food, emergency water and emergency supplies are stored in the garage. All mandated inspection control posters were posted. The facility has smoke detectors and carbon monoxide detectors that were operable. Surety Bond effective from January 20, 2025, to January 20, 2028. The Certificate of Liability Insurance is effective from May 1, 2026, to May 1, 2027. The facility conducts Fire/Safety Drills monthly and was last conducted on 7/19/2026 . Two (2) fire extinguishers are mounted in the facility in the garage and in the kitchen that were serviced on January 22, 2026. A working telephone Facility phone number (949-837-5385) and electronic devices dedicated to the residents both remain available. First Aid Kit contained all the necessary elements. LPA Kim conducted an audit of four (4) residents (R1-R4) files, and nine (9) staff (S1-S9) personnel files, and medication and medication administration records that were all in order and complete. LPA conducted interviews with two staff. There are no deficiencies cited during the visit. An exit interview was conducted, and a copy of this report was provided to Administrator Jill Bonnin.the state’s words, verbatim · CDSS document, Aug 4, 2026

Type of visit: POC

Licensing Program Analyst (LPA) Celine Rodriguez conducted an announced visit to the facility for the purpose of a plan of correction (POC). LPA explained reason for visit and was greeted and granted entry by staff on duty (S1) Fely Marcelo, who notified facility administrator (AD) Jill Bonnin about visit. AD Bonnin provided consent for S1 to receive and sign report. On 8/15/2025, LPA observed that the Physician's Report (LIC602) for all 4 current residents were missing, therefore, facility was cited for the following: Title 22 Division 6 of the California Code of Regulations- 87458(a) Medical Assessment As a plan of correction, facility was to schedule appointments for all 4 residents on or by 8/18/2025, to obtain a completed LIC602. On 8/18/2025, AD Bonnin provided LPA the LIC602s for all current residents. For today's visit, LPA reviewed the resident files and observed that all resident LIC602s were completed and placed in their files. POC has been completed and citation has been cleared. For this visit, no citations were issued. An exit interview was conducted with S1 Marcelo and AD Bonnin via phone. A copy of this report was provided and explained.the state’s words, verbatim · CDSS document, Aug 19, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Celine Rodriguez conducted an unannounced visit for the required annual inspection. LPA Rodriguez explained the purpose of today’s visit, and was greeted and granted entry by staff on duty, who informed facility administrator (AD) Jill Bonnin about visit. AD Bonnin was unable to be present during visit, however provided consent for staff on duty (S1) Fely Marcelo to receive and sign report. For today’s visit, LPA Rodriguez observed a total of 4 residents in care and 2 staff members on duty. LPA Rodriguez observed the Administrator's Certificate for Jill Bonnin, which expires on 3/17/2026. LPA Rodriguez observed the PUB 475 "See Something Say Something" poster located in the entrance. LPA Rodriguez toured the interior and exterior portions of the facility with staff on duty. The facility is a single level structure and is licensed for 4 residents of which 2 may be on hospice. There are a total of 4 private resident rooms, 1 staff office, and 2 bathrooms. LPA Rodriguez toured each bedroom in the facility and observed that bedrooms were provided with furniture in good repair, clean linens, adequate storage space, and kept free of tripping hazards. Smoke and carbon monoxide detector and auditory exit alarms were tested and operational. Restrooms were observed to be in good repair, toilets were operational, and grab bars and non-skid floor mats were provided. Water temperature was tested and observed to be at 109.4 degrees Fahrenheit. Facility met the minimum two-day perishable and seven-day non-perishable food supplies. Sharp items and knives were locked and inaccessible to residents in care. Fire extinguisher was mounted, charged, tagged for the date 2025, and was located in the kitchen. LPA Rodriguez observed the emergency disaster and evacuation plan, which is located in the facility binder which is located in the staff office. Facility had back-up emergency food and water supply located in the garage. LPA Rodriguez observed that First Aid Kit had all the required components. LPA Rodriguez observed that medications and toxins were locked and inaccessible to residents in care. For the exterior portion, LPA Rodriguez observed a shaded area, patio furniture, and the grounds were free of any hazards. There are 2 gates in the backyard, which were observed to be self-closing and self-latching. No bodies of water were observed. LPA Rodriguez reviewed all four resident files and observed that the staff currently present at the facility were background cleared and associated to the facility.. For today's visit, deficiencies were issued per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted with AD Bonnin via phone and S1 Marcelo. A copy of this report and appeal rights were provided and explained.the state’s words, verbatim · CDSS document, Aug 15, 2025

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 caregiving staff after introducing himself and stating the reason of the visit. Facility administrator Jill Bonnin was notified of the visit via telephone abut could unfortunately not come in person to assist. Fellow Ablelight administrator Steven Martinez was dispatched instead and assisted with the visit. 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 with four private bedrooms and one staff admin office in addition to the facility's common living areas. There are two shared bathrooms, observed to be equipped with grab bars and slip mats. All resident bedrooms have the required furnishings. LPA observed all beds have linens and blankets. Three out of four beds are equipped with half rails for postural support. Physician orders for all three residents are present in the resident files. There are currently four residents admitted to the facility, three of which are away at day program at the time of the visit. Bathrooms faucets and toilets are 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. Fire and emergency drills have been conducted regularly. LPA observed the facility has a 2-day supply of perishables and a 7-day supply of non-perishable food. Smoke and carbon monoxide detectors tested operational. Fire extinguishers present are observed to be fully charged with up-to-date maintenance tags. There is adequately shaded outside space with outdoor furniture present. There are self-latching gates on both sides of the house and routes of egress are free of obstructions. CONTINUED ON FORM LIC809-C CONTINUED FROM FORM LIC809 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 seven staff files. Resident records include all necessary components. All staff members are confirmed to be cleared and associated with this particular licensed location. Based on the observations made during today’s inspection, no deficiencies are being issued per Title 22 Division 6 of the California Code of Regulations. A Technical Assistance advisory note is provided with a consultation on physician reports. An exit interview was conducted, and a copy of this report along was left at the facility.the state’s words, verbatim · CDSS document, Aug 29, 2024

The state marks this report as 3 pages; the online copy we transcribed has 2. You can request the full file from the county licensing office.