Newport Beach Senior Villa

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Ruth Martinez is conducting this unannounced visit for the purpose of completing an annual required inspection. LPA arrived at the facility and was greeted and granted entry by staff. LPA met with Deanna Landon, Administrator explained the nature of the visit. There are six (6) residents at the facility and there are three (3) residents receiving hospice services currently. LPA accompanied by Administrator began the tour of the inside and outside of the facility. LPA observed required department postings throughout the facility. Facility stays within the capacity limitations. There is a minimum of one week of non-perishables foods and two days of perishables foods available. There is additional food storage in a spare refrigerator, a freezer, and pantry located in the garage. The facility is maintained at a comfortable temperature. LPA inspected that medication is centrally stored in a safe locked storage cabinet located in the bedroom hallway by the kitchen and laundry room. LPA reviewed medication and observed medication was labeled and stored inaccessible to residents in care, LPA observed the first aid kit to be stored in a kitchen drawer. LPA inspected the facility bathrooms and LPA measured the hot water temperature which measured between 105.6 to 109.4 Fahrenheit degrees. All bathrooms observed to have a supply of soap, toilet paper and towels. Bathrooms are equipped with required safety measures such as non-skid mats and grab bars. Lighting is sufficient to ensure safety and comfort. The facility is equipped with sufficient hand hygiene, cleaning, and disinfecting supplies. LPA observed that toxic chemicals, cleaning solutions and disinfectants are stored locked underneath kitchen sink and locked storage cabinet in the garage. The facility has an available clean supply of linens. LPA inspected residents’ bedrooms which have sufficient lighting to ensure safety and comfort. All bedrooms observed to have all required components. Continued on LIC809-C Storage space is provided for residents in their bedroom. Smoke detectors/carbon monoxide detectors were tested and found to be operational. LPA toured the outside of the facility and observed outdoor passageways are free of obstructions. Outdoor parameters consist of two outdoor patios with furnishing and shade for residents’ enjoyment. LPA observed a fire extinguisher with service date of November 11, 2025, charged and mounted in the kitchen throughout the facility. Fire drills are conducted every three months, and the last drill was conducted September, 2025. LPA began reviewing records. LPA reviewed three resident records. All the required documentation was present and reviewed in the residents’ files. LPA reviewed two employee records. All employees present have a criminal record clearance and are associated to the facility. LPA observed records reviewed have a current First Aid certificate. Based on the observations made during today’s visit, no deficiencies were noted today in the areas inspected per Title 22 Division 6 of the California Code of Regulations. This report was reviewed with the Administrator, and a copy of this report was provided to the facility.the state’s words, verbatim · CDSS document, Dec 11, 2025

Type of visit: Prelicensing

On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made a scheduled visit to the facility for the purpose of conducting a pre-licensing inspection. LPA was greeted and granted entry by Ali Naghibi, prospective licensee and Deanna Landon, current administrator An initial application for a license to operate as a Residential Care Facility for the Elderly was received by the Department on January 24, 2024 for a capacity of six non-ambulatory residents. This is a application for change of ownership with residents in place. Five residents are currently admitted to the facility. Current hospice waiver for the present licensed location is for a capacity of four. Applicant has requested a hospice waiver for a capacity of six along with the present licensing application. LPA accompanied by applicant toured the physical plant. The facility is a one-level home with two central patios leading to an alley, as well as an attached two-car garage. There are six private bedrooms all equipped with private en-suite bathrooms. An additional room is assigned to be a staff room and is locked and inaccessible to residents. Necessary components of furnishing for all six bedrooms are observed to be present alongside an adequate supply of linen and bedsheets. Faucets used for personal hygiene are verified to be operational. Water temperature measured in three bathrooms throughout the property at 105.4F, 112F and 113.5F. Grab bars and slip mats are in place in all six bathrooms. Common living spaces are present and furnished as required. Facility is clean, sanitary and free of odors in all areas inspected. Required posted documents are observed to be present. Kitchen equipment is present and operating as required. Sharp items are stored in a drawer secure by a magnetic lock. Cleaning supplies are secured in the attached garage. A secure cabinet is also present in the kitchen. A sufficient supply of perishable and non-perishable food is present in the kitchen's refrigerator, freezer and pantry which are supplemented by a freezer/refrigerator combined with a freezer and additional pantry in the garage. CONTINUED ON FORM LIC809-C CONTINUED FROM FORM LIC809 The centrally stored medication storage is located in a secure cabinet where the first aid kit is also observed to be present and complete. The laundry area is located in a separate room with a glass door. Laundry supplies are stored in a locked cabinet. Sound alarms are present on the ways of egress and verified to be in operation during the walk-through. The fire clearance has been obtained on May 3, 2024 and provided to the Department before the pre-licensing visit. All bedrooms are cleared for non-ambulatory residents. There are no identified bedridden rooms on the fire clearance. Smoke and carbon monoxide detectors are observed throughout the facility and confirmed to be functional. Fire extinguishers present on the premises are observed to be charged and maintained in 2024. Proof of liability insurance coverage provided for the present licensed location and will be transferred once licensed. Quote have been requested and obtained ahead of the present visit. Telephone service is present. Facility staff is using a tablet for residents needing online access. Current staff will remained employed with the prospective licensee. A total of 11 current staff files were reviewed and found to include all necessary components including health screenings, background clearance and association to the present licensed location, training records along with first aid/CPR training. LPA and licensee toured the outside of the facility and observed it to be free of obstructions. Outdoor furniture and multiple shaded areas are present in both patios along with an appropriately screened outdoor fireplace. The perimeter gates present on both sides of the house are self-latching and can easily be opened in an evacuation. There are no bodies of water on the premises and delayed egress/locked perimeters are not in use. Component III was waived as the prospective licensee has already been acting as the current licensee and operator for other licensed locations. This report was reviewed with facility representative and a copy of this report was emailed to the applicant before the conclusion of the visit.the state’s words, verbatim · CDSS document, Nov 26, 2024

Type of visit: Office

Component II completion: Successful Facility Type: Residential Care Facility for the Elderly (RCFE) Application Type: Change in Ownership (CHOW) Capacity: 6 Census (if any clients in care): 6 COMP II Participants: Ali Naghibi, Applicant Deanna Landon, Administrator Interview Method: Telephone interview On September 27, 2024, Applicant and Administrator participated in COMP II. Identification of the Applicant and Administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, Applicant and Administrator confirmed that they have read and understand community care facility licensing laws included in the Health and Safety Codes and the California Code of Regulations Title 22. During COMP II, CAB analyst confirmed Applicant and Administrator’s understanding of following areas: 1. Facility Operation: License type, client/resident populations, and program, 2. Admission Policies 3. Staffing Requirements & Training 4. Restrictive/Prohibited Health Conditions 5. General Provisions 6. Emergency Preparedness 7. Complaints & Reporting 8. Pre-licensing Readiness Exit interview conducted with Applicant and Administrator. Report sent via email and informed to return sign copy by end of business day today.the state’s words, verbatim · CDSS document, Sep 27, 2024