Adult Care Oc I

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 Brian Schott, Administrator explained the nature of the visit. There are four (4) residents at the facility and there is two (2) residents receiving hospice services currently. LPA accompanied by staff 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 in the garage. The facility is maintained at a comfortable temperature. LPA inspected that medication is centrally stored in a safe locked storage closet located in the bedroom hallway. LPA reviewed medication and observed medication was labeled and stored inaccessible to residents in care. LPA observed the first aid kit and a first aid manual. LPA inspected the facility bathrooms and LPA measured the hot water temperature which measured 117.1 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 in a kitchen cabinet and locked storage cabinet in the garage. The facility has an available clean supply of linens. LPA inspected residents’ bedrooms which has sufficient lighting to ensure safety and comfort. All bedrooms are observed to have all the required components. Continued on LIC809-C Storage space is provided for residents in their bedroom. Smoke detectors were tested and found to be operational. LPA toured the outside of the facility and observed outdoor passageways are free of obstructions. LPA observed there are shaded seating areas for residents’ enjoyment in the front yard as well as the backyard of the facility. LPA observed a fire extinguisher with service date of December 17, 2024, charged and mounted in the kitchen. Fire drills are conducted every three months, LPA verified fire drill logs are kept and the last drill was conducted on September 8, 2025. Facility has a second floor which is inaccessible to residents in care, door that leads to the second floor is in the hallway leading to the dining room. There are no residents residing on the second floor of the facility. LPA verified resident in care do not have access to the second floor. LPA began reviewing records. LPA reviewed three resident records. All the required documentation was present and reviewed in the residents’ files. LPA reviewed three employee records. All employees present have a criminal record clearance and are associated with the facility. LPA observed records reviewed have a current First Aid certificate. LPA as a reminder provided annual fee dues information. 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 facility representative and a copy of this report was provided to the facility.the state’s words, verbatim · CDSS document, Sep 15, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Alvaro Ramirez, Jr. conducted an unannounced visit for the Required 1 Year Inspection. LPA explained the purpose of today’s visit, and was greeted and granted entry by Caregiver Tino Soufyan. Administrator (AD) Brian Schott arrived shortly after. For today’s visit, LPA observed a total of six residents in care and two staff members on duty. LPA observed the Administrator's Certificate for Brian Schott which expired on July 23, 2024, however, AD provided proof of payment to show that the certificate is in renewal process. Renewed certificate has not yet been received and is pending. LPA reminded Licensee to post certificate once received. LPA toured the interior and exterior portions of the facility with AD Schott. The facility is a two-story structure and is licensed for one ambulatory resident, five non-ambulatory residents, of which six may be on hospice and zero bedridden. The two-story home consists of five resident bedrooms and four resident bathrooms. There is one staff bedroom and bathroom. The second floor is the living area for the Licensee/AD Schott. LPA 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 tested between 111.0-112.8 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 charged and located by the kitchen. CONTINUED ON LIC809-C... LPA observed the emergency disaster and evacuation plan which is located by entryway. Facility had back-up emergency food and water supply. LPA observed that First Aid Kit had all the required components. LPA observed that medications and toxins were locked and inaccessible to residents in care. For the exterior portion, LPAs observed a shaded area, patio furniture, and the grounds were free of any hazards. There are two gates in the backyard, which both are self-closing and self-latching. No bodies of water were observed. LPA reviewed six resident and two staff files. LPA interviewed residents and staff present. During today's visit LPA observed a blank pre-admission appraisal in one of six resident files: A Deficiency was issued today. For today's visit deficiencies were issued per Title 22 Division 6 of the California Code of Regulations. LPAs advised AD Schott to use the general email address: CCLASCPOrangeCountyRO@dss.ca.gov for any inquiries and to specify attention to the assigned LPA. An exit interview was conducted with AD Schott. A copy of this report and Appeal Rights were provided at the time of exit.the state’s words, verbatim · CDSS document, Sep 30, 2024

Allegation investigated: Staff did not allow resident to select their own hospice agency

This unannounced inspection is being conducted by Licensing Program Analyst (LPA) Sean Haddad for the purpose of delivering findings for the investigation into the above identified complaint allegation. LPA met with Administrator (AD) Fairlane Delos Reyes, discussed the purpose of the inspection, and explained the allegation. The investigation into the allegation that staff did not allow resident to select their own hospice agency revealed the following: During the course of the investigation, LPA inspected the facility, interviewed AD, residents, staff, and witnesses, and obtained and reviewed copies of the resident roster, staff roster, and resident files. CONTINUED Unsubstantiated Regarding the allegation that staff did not allow resident to select their own hospice agency: it was alleged that the facility forces residents to use Equinox hospice agency by charging a higher rate for residents who use other agencies. LPA interviewed two staff, but did not obtain information corroborating the allegation. LPA reviewed resident files and noted that two residents are currently on hospice and both use Equinox hospice agency. LPA interviewed the two residents on hospice, one of whom was unable to communicate, and did not obtain information corroborating the allegation. LPA interviewed AD, the licensee, and a witness associated with the facility who denied the allegation and stated that while both residents on hospice at this facility are currently using Equinox hospice agency this has not always been the case and the licensee’s other facilities house residents using other hospice agencies, that the facility recommends Equinox hospice agency to residents due to the better and more responsive care residents receive from this agency as opposed to other agencies, and that while the facility prefers Equinox hospice agency because it is more responsive to staff calls and resident needs the facility does not pressure residents to choose this agency other than by simply recommending use of this agency. LPA interviewed one witness and attempted to interview two additional witnesses and obtained conflicting information. The information obtained is conflicting. Based on the information gathered during the investigation and review of all documents obtained, the Department is unable to ascertain if the above allegation occurred as reported. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove or refute the alleged violation occurred; therefore, this allegation is deemed Unsubstantiated. An exit interview was conducted and a copy of this report was discussed with and provided to facility representative.the state’s words, verbatim · CDSS document, May 6, 2024 · control 22-AS-20240322145707