Care Phoebe

Type of visit: Required - 1 Year

On this day, Licensing Program Analyst (LPA) Andrea Mendivil made an unannounced visit to the facility today to conduct a required annual. LPA was greeted and granted entry by staff and explained the reason for the visit. The facility is a one-story home with five resident bedrooms, two bathrooms, living room, kitchen, dining room, staff room, laundry area, backyard and attached two car garage. Facility is licensed for 1 ambulatory, 5 non-ambulatory 1 of which may be bedridden. During today’s visit, LPA toured the facility and inspected the physical plant, including but not limited to testing all smoke detectors, testing hot water temperature in bathrooms. The hot water temperature measured between 112.2 and 112.4 degrees Fahrenheit and all smoke detectors were operational. The fire extinguishers are charged and were serviced on March 21st 2025. The facility’s last fire drill was conducted on December 3rd 2025. LPA inspected the facility food supply and observed the facility retained a minimum of two days perishable and seven days non-perishable food on hand. LPA observed medication storage in locked cabinet in hallway. LPA observed emergency food and water in facility storage room. LPA observed over the counter medication in room 4 for Resident 1 (R1) and physician's report stated R1 is not allowed to store their own medications. LPA reviewed four of four staff training and fingerprint records and conducted a complete review of resident records. LPA confirmed that administrator has a current administrator certificate which expires on July 19th 2026. Based on observations the following is being cited per Title 22. An exit interview was conducted and a copy of this report was provided along with appeal rights.the state’s words, verbatim · CDSS document, Dec 29, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA Samer Haddadin made an announced visit to the facility for purpose of conducting a required annual inspection. LPA arrived at the facility and was greeted and granted entry by staff (S1) Marcelo Jonathon, and later Administrator (AD) Adriel Pao joined the walk-through. The facility is a Residential Care Facility for the Elderly (RCFE) and approved for (6) capacity, (0) ambulatory, (5) non-ambulatory, and (1) bedridden clients. LPA started the tour with AD and observed the following: The facility is a one-story home with five resident bedrooms, two bathrooms, living room, kitchen, dining room, staff room, laundry area, backyard and attached two car garage. At time of visit, the facility had 6 residents present. Upon inspecting residents’ rooms, LPA observed that rooms were not sanitary or odorless, however, resident rooms were provided with furniture, chair and clean Lenin adequate storage space, and kept free of tripping hazards. Manual smoke detectors, carbon monoxide and exit alarms were tested to be operational. LPA observed one Dynwoun Cleanser spray in bathroom one. Staff immediately locked it after discovery however, both Bathrooms were observed to be in good repair and provided with grab bars and hot water was measured at 118.9 degrees Fahrenheit. Facility met the minimum two-day supply of perishable and seven-day supply of non-perishable food stock requirements. Fire extinguisher was observed with last inspection date of March, 22, 2024 . For the exterior portion, facility had outside furniture in good repair; and grounds were free of tripping hazards and ample space for activities.LPA found one pair of scissors and one knife in kitchen sink; staff immediately locked both items. However, Kitchen was in good repair with cleaning supplies and sharp items inaccessible to residents in care. LPA reviewed residents’ medication and observed that staff does not keep record nor count of medication. However, medications are kept locked separately in hallway. LPA reviewed the rest of resident’s and staff files and all had and contained all required documentation. Upon review of records, the facility does not maintain any records of quarterly fire drill. Based on the observations made during today’s inspection, 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 and appeal rights were provided to AD at end of inspection.the state’s words, verbatim · CDSS document, Dec 17, 2024

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Dwayne Mason Jr. made an announced visit to the facility for purpose of conducting a pre-licensing inspection for a change of ownership. LPA arrived at the facility and was greeted and granted entry by designated Administrator (AD) Adriel Pao. An application to operate a Residential Care Facility for the Elderly (RCFE) for (6) capacity, (0) ambulatory, (5) non-ambulatory, and (1) bedridden clients was received by Community Care Licensing (CCL) on 1/20/2023. Structure: The facility is a one-story home with five resident bedrooms, two bathrooms, living room, kitchen, dining room, staff room, laundry area, backyard and attached two car garage. There are two exit gates in the back yard. The backyard has a seating area. The garage has two additions for storage. These additions are not accessible to residents in care. Client Bedrooms: All resident bedrooms had the necessary furnishings. LPA observed all resident beds had linens and blankets. LPA observed all windows were screened. Bathrooms: The bathrooms have working plumbing. Hot water measured at 116.2 degrees Fahrenheit in the bathroom closest to the entrance and 116.9 degrees Fahrenheit in the bathroom toward the back of the house. Toxins: LPA observed chemicals, cleaning solutions, laundry toxins and disinfectants are inaccessible to client and will be stored under the kitchen sink and in cabinets above laundry machines. Medications, First-Aid Kit & Files: Medication will be stored in a locked cabinet in the dining room. The First Aid Kit will be stored on table in entryway. Records will be kept in a cabinet in the hallway. Fire Extinguisher: LPA observed the fire extinguishers to be fully charged as indicated by the arrow pointing in the green zone. Extinguishers were serviced on 3/1/2023 Fire clearance: Was approved by a fire inspector of Orange County Fire Authority on 5/22/2023. Component III: Information provided about how to operate the facility within compliance and reporting requirements. Activity Materials: Facility has a full activity calendar including but not limited to: karaoke, zumba, bingo, family time, movie days, exercise and more. Linens: A supply of extra linen is stored in the entryway closet Emergency Phone Numbers, Exit Plan and Menu: Posted and available for review. Food Service: There is 2-day supply of perishable food and a 7-day supply of non-perishable food on hand. Smoke Detectors: Smoke detectors and carbon monoxide detectors were tested and observed to be operational. Appliances: Gas stove, oven, refrigerator, dish washer, microwave, washer, and dryer are operational. The designated AD was notified that the final application approval will be issued by the Centralized Applications Bureau in Sacramento. Exit interview was conducted and a copy of this report was provided to designated ADthe state’s words, verbatim · CDSS document, Dec 12, 2023