Bluebird Senior Living

Type of visit: Case Management - Deficiencies

Licensing Program Analyst (LPA) Jessica Cho made an unannounced visit for the purpose of issuing a deficiency in connection to complaint investigation control number: 22-AS-20260915141652. LPA met with Administrator Eric Overstrom and stated the reason for the visit. During the review of records, LPA observed facility did not complete the pre-admission appraisal prior to admitting Resident #1 (R1) resulting in the Administrator discovering a need not previously identified. The Functional Capability Assessment completed by R1's representative did not disclose R1 requiring a two-person and feeding assistance. Therefore, a violation exists, and a deficiency is being issued. An exit interview was conducted with Administrator Eric Overstrom, and a copy of this report including the appeal rights were provided at the end of the visit.the state’s words, verbatim · CDSS document, Sep 18, 2026

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87457(c87457(c) · Plan of correction due date: Sep 25, 2026

87457 Pre-Admission Appraisal (c) Prior to admission a determination of the prospective resident's suitability for admission shall be completed and shall include an appraisal of their individual service needs... This requirement was not met as evidenced by: Based on interview and record review, the pre-placement appraisal was not completed for R1 which poses a potential Health, Safety, and/or Personal Rights risk to persons in care.the state’s words, verbatim · CDSS document, Sep 18, 2026

Plan of correction: Adminstrator stated the pre-placement will be completed for R1 and will forward proof to LPA via email by POC due date.

Type of visit: Prelicensing

On November 24, 2025, Licensing Program Analyst (LPA) Brandon Lopez made an announced visit to the facility to conduct a Pre-licensing inspection. LPA was greeted and granted entry into the facility by Licensees (LIs) Eric and Annette Overstrom. LPA observed that Eric Overstrom has a valid Administrator certificate which expires on June 11, 2027. An initial application to operate a Residential Care Facility for the Elderly (RCFE) for a capacity of six residents, of which five can be non-ambulatory and one can be bedridden was received by Community Care Licensing (CCL) on April 24, 2025. This is an initial application with no residents in care. The facility received an approved Fire Clearance by the Orange Fire Department Inspector Robert Desimone Jr on June 17, 2025. The facility is a single story home with four resident bedrooms, two of which are shared, two shared resident bathrooms, a living room, a dining room, a kitchen, a lounge area, and an attached two car garage. On today's visit, LPA accompanied by the LIs, conducted a tour of the interior portions of the facility. LPA observed the See Something, Say Something poster (PUB 475) mounted on the wall by the entryway of the facility. LPA inspected the four resident bedrooms and observed them to be free of hazards. LPA observed resident bedrooms to have the required furnishings of a bed, a chair, a chest of drawers, and a lamp. LPA observed resident beds to have clean mattresses, linens, and blankets. LPAs observed additional linens to be stored in a hallway closet. LPA inspected the two shared resident bathrooms and observed them to be free of hazards. Resident bathrooms were equipped with grab bars and nonskid floor mats. Faucets and toilets were operational. Hot water temperature measured between 105.8 and 112.1 degrees Fahrenheit. LPA observed kitchen appliances such as the refrigerator, the stove, and the microwave to be clean and operational. LPA observed the five burner gas stove lights unassisted. CONTINUED ON 809-C LPA observed kitchen knives and sharps to be stored in a locked kitchen cabinet. LPA observed chemicals and toxins to be stored in a locked kitchen cabinet under the sink. LPA observed staff and resident files will be kept in a locked closet located in the resident hallway. LPA observed a fire extinguisher mounted on the wall in the resident hallway and it was observed to be charged and up to date on service. LPA tested the wired smoke detectors/carbon monoxide detectors which tested operational. LPA observed a fire place in the living room and it was observed to have a screen and not be in operation at time of visit. LPA observed activity materials such as cards, board games, and books stored in the lounge area. LPA observed medications will be kept in a locked closet in the resident hallway. LPA observed the facility has a first aid kit in the resident hallway and it has all the required components. LPA observed the attached two car garage to be kept locked. LPA observed the two car garage to be used for storage. LPA observed the facility has a three day emergency food and water supply stored in the garage. LPA, accompanied by the LIs, conducted a tour of the exterior portion of the facility. LPA observed the exterior to be free of any obstructions or hazards. LPA observed a shaded outdoor seating area with furniture for resident use. The perimeter gate of the facility is self-latching can be opened in an evacuation. There are no bodies of water on the premises. Component III was completed with the LIs, which provided information about how to operate the facility within compliance and reporting requirements. The LIs were notified that the final application approval will be issued by the Centralized Applications Bureau (CAB) in Sacramento. An exit interview was conducted with Licensees Eric and Annette Overstrom and a copy of this report was provided.the state’s words, verbatim · CDSS document, Nov 24, 2025