Salem Christian Homes-Yorba Home

Type of visit: Case Management - Annual Continuation

Licensing Program Analyst (LPA) Javier Prieto conducted an unannounced annual required visit. This home is designated as a level 4C home by IRC. LPA toured the facility with Administrator Casilan. LPA accompanied with Ms Casilan, conducted a general overall inspection, which included, but was not limited to the following: Physical Plant: The facility was not operating over capacity or beyond any conditions and limitations on the license. There are no pools or other bodies of water located on the premises. There are no ammunition or firearms kept in the home. Facility is being maintained at a comfortable temperature for residents. All outdoor and indoor passageways are kept free of obstruction. Hot water temperature was measured at 109 degrees Fahrenheit in all resident bathrooms. There are grab bars for each toilet, bathtub and shower used by residents. Food Service: There is a minimum of one week supply of nonperishable foods and 2 days of perishable foods. Care and Supervision: The facility has ensured sufficient and competent staff to provide the services needed to meet resident needs. Record Review: LPA requested and reviewed (2) resident and (2) staff files. LPA reviewed staff files for current CPR/1st aide certificates, TB results, and required training's. LPA reviewed client files for admissions agreement, physician report, and IPP. Administration: LPA did not observe any excluded individuals on the premises at time of visit. The Administrator appears to be on the premises a sufficient number of hours to manage and oversee the business operation. Medical Related Services: Prescriptions and non-prescription PRN medications contain a signed and dated written order from a physician. Medications are centrally locked in the staff office and inaccessible to residents in care. Medications are being administered as prescribed by physician's directions. No deficiencies cited. An exit interview was conducted where this report was provided and discussed with Casilan.the state’s words, verbatim · CDSS document, Sep 1, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Javier Prieto conducted an unannounced annual required visit. This home is designated as a level 4C home by IRC. LPA toured the facility with Administrator Casilan. LPA accompanied with Ms Casilan, conducted a general overall inspection, which included, but was not limited to the following: Physical Plant: The facility was not operating over capacity or beyond any conditions and limitations on the license. There are no pools or other bodies of water located on the premises. There are no ammunition or firearms kept in the home. Facility is being maintained at a comfortable temperature for residents. All outdoor and indoor passageways are kept free of obstruction. Hot water temperature was measured at 109 degrees Fahrenheit in all resident bathrooms. There are grab bars for each toilet, bathtub and shower used by residents. Food Service: There is a minimum of one week supply of nonperishable foods and 2 days of perishable foods. Care and Supervision: The facility has ensured sufficient and competent staff to provide the services needed to meet resident needs. Record Review: LPA requested and reviewed (2) resident and (2) staff files. LPA reviewed staff files for current CPR/1st aide certificates, TB results, and required training's. LPA reviewed client files for admissions agreement, physician report, and IPP. Administration: The last fire drill was conducted on 08/01/2025 and the last earthquake drill was conducted on 10/16/2025. LPA did not observe any excluded individuals on the premises at time of visit. The Administrator appears to be on the premises a sufficient number of hours to manage and oversee the business operation. Medical Related Services: Prescriptions and non-prescription PRN medications contain a signed and dated written order from a physician. Medications are centrally locked in the staff office and inaccessible to residents in care. Medications are being administered as prescribed by physician's directions. No deficiencies cited. An exit interview was conducted where this report was provided and discussed with Casilan.the state’s words, verbatim · CDSS document, Nov 7, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Javier Prieto conducted an unannounced annual required visit. This home is designated as a level 4C home by IRC. LPA toured the facility with Administrator Justine Guillen' LPA accompanied with Ms Guillen, conducted a general overall inspection, which included, but was not limited to the following: Physical Plant: The facility was not operating over capacity or beyond any conditions and limitations on the license. There are no pools or other bodies of water located on the premises. There are no ammunition or firearms kept in the home. Facility is being maintained at a comfortable temperature for residents. All outdoor and indoor passageways are kept free of obstruction. Hot water temperature was measured at 109 degrees Fahrenheit in all resident bathrooms. There are grab bars for each toilet, bathtub and shower used by residents. Food Service: There is a minimum of one week supply of nonperishable foods and 2 days of perishable foods. Care and Supervision: The facility has ensured sufficient and competent staff to provide the services needed to meet resident needs. Record Review: LPA requested and reviewed (6) resident and (2) staff files. LPA reviewed staff files for current CPR/1st aide certificates, TB results, and required training's. LPA reviewed client files for admissions agreement, physician report, and IPP. Administration: The last fire drill was conducted on 10/10/2024 and the last disaster drill was conducted on 11/07/2024. LPA did not observe any excluded individuals on the premises at time of visit. The Administrator appears to be on the premises a sufficient number of hours to manage and oversee the business operation. Medical Related Services: Prescriptions and non-prescription PRN medications contain a signed and dated written order from a physician. Medications are centrally locked in the staff office and inaccessible to residents in care. Medications are being administered as prescribed by physician's directions. No deficiencies cited. An exit interview was conducted where this report was provided and discussed with Justine Guillen .the state’s words, verbatim · CDSS document, Nov 8, 2024

Allegation investigated: Licensee is operating beyond the scope of license.

Licensing Program Analyst (LPA) Javier Prieto arrived to the facility to conduct a complaint investigation regarding the above allegation. LPA Prieto met with administrator Justine Guillen and explained the elements of the complaint. Regarding the allegation that licensee is operating beyond the scope of licensee; The allegation is related to the number of Hospice Waiver and it's capacity. The facility is approved for one (1) Hospice and the facility is currently providing hospice service to two (2) clients in care. Files were reviewed for resident #1 (R1) and R2 and confirm that each resident is on hospice and being provided service from a hospice agency. ***continued in LIC 9099C*** Substantiated Based on LPA observations, interviews which were conducted and records review, the preponderance of evidence standard has been met. Therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations (Title 22, Division) are being cited on the attached LIC 9099D). This report was signed by LPA Prieto and administrator Guillen and a copy of this report was left with the facility along with the appeal rights.the state’s words, verbatim · CDSS document, Jun 3, 2024 · control 56-AS-20240530125539

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87632 · Plan of correction due date: Jun 14, 2024

Hospice Care Waiver -(a) In order accept or retain terminally ill residents and permit them to receive care from a hospice agency, the licensee shall have obtained a facility hospice care waiver from the Department. To obtain this waiver the licensee shall submit a written request for a waiver to the Department on behalf of any residents who may request retention, and any future residents who may request acceptance, along with the provision of hospice services in the facility. Faclity has a hospice waiver for one (1) and currently has two (2) clients on hospice carethe state’s words, verbatim · CDSS document, Jun 3, 2024

Plan of correction: Licensee to submit hospice waiver to CCLD LPA by POC date. Waiver to be submitted to LPA via mail or fax

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Javier Prieto conducted an unannounced annual required visit. LPA was greeted and granted entry to the facility by Caregiver, Angelica Martinez. LPA explained the nature of today's visit. Staff lead, Peter Pantoja arrived after visit began. This home is designated as a level 4C home by IRC. LPA accompanied with Mr Pantoja, conducted a general overall inspection, which included, but was not limited to the following: Physical Plant: The facility was not operating over capacity or beyond any conditions and limitations on the license. There are no pools or other bodies of water located on the premises. There are no ammunition or firearms kept in the home. Facility is being maintained at a comfortable temperature for residents. All outdoor and indoor passageways are kept free of obstruction. Hot water temperature was measured at 110 degrees Fahrenheit in all resident bathrooms. There are grab bars for each toilet, bathtub and shower used by residents. Food Service: There is a minimum of one week supply of nonperishable foods and 2 days of perishable foods. Care and Supervision: The facility has ensured sufficient and competent staff to provide the services needed to meet resident needs. Record Review: LPA requested and reviewed (4) resident and (2) staff files. LPA reviewed staff files for current CPR/1st aide certificates, TB results, and required training's. LPA reviewed client files for admissions agreement, physician report, and IPP. Administration: The last fire drill was conducted on 10/19/2023 and the last disaster drill was conducted on 09/16/2023. LPA did not observe any excluded individuals on the premises at time of visit. The Administrator appears to be on the premises a sufficient number of hours to manage and oversee the business operation. Medical Related Services: Prescriptions and non-prescription PRN medications contain a signed and dated written order from a physician. Medications are centrally locked in the staff office and inaccessible to residents in care. Medications are being administered as prescribed by physician's directions. No deficiencies cited. An exit interview was conducted where this report was provided and discussed with Justine Guillen .the state’s words, verbatim · CDSS document, Nov 20, 2023