Ankerton Suite

Type of visit: Required - 1 Year

On June 18, 2026, Licensing Program Analyst (LPA) Garlli Tat conducted an unannounced visit to the facility for the purpose of a required annual inspection. LPA explained the purpose for the visit and was greeted and granted entry by staff on duty. During the visit, staff on duty contacted the facility administrator (AD) Camille Santos about the visit. For this visit, there are two staff members on duty, both of which are background cleared and associated. AD later arrived to assist with the inspection. The PUB475 ‘See Something, Say Something’ poster was observed to be located near the front entrance. LPA observed that Camille Santos has a valid Administrator's certificate which expires on May 6, 2028. The facility is a Residential Care facility for the Elderly (RCFE) licensed for six residents, six of which may be non-ambulatory, one of which may be bedridden, and a hospice waiver for six. LPA toured the interior and exterior portions of the facility with AD. For this visit, there are a total of six non-ambulatory residents in care, one of which is on hospice, and none are bedridden. The facility is a single story home. There are a total of six bedrooms, four of which are private resident bedrooms, one is a shared bedroom, and one is a staff bedroom. LPA toured each bedroom with the AD and observed that bedrooms were provided with furniture in good repair, clean linens, adequate storage space, and free of any hazards. LPA observed the staff room is kept locked and inaccessible to residents in care. Smoke and carbon monoxide detectors as well as auditory exit alarms were tested and operational. There are a total of three bathrooms for residents and staff. Continued on LIC 809-C. Bathrooms were observed to be in good repair, toilets and faucets were operational and showers were equipped with grab bars and non-skid floor mats. Water temperature in the bathrooms were measured to be between 105.2 and 109.5 degrees Fahrenheit. Facility met the minimum two-day perishable and seven-day non-perishable food supplies. Sharp items and knives were locked in a kitchen sink and inaccessible to residents in care. Fire extinguisher was charged and located in the dining room. LPA observed all the required postings in the dining room. LPA observed the facility conducted their last emergency disaster drill on March 1, 2026. Facility had back-up emergency food and water supply, located in the garage. LPA observed that the First Aid kit had all the required components. Medications were observed to be locked in a medication cabinet in the dining room, inaccessible to residents in care. Chemicals were observed to be locked in the kitchen. LPA observed the door leading to the attached two car garage is kept locked and inaccessible to residents in care. The garage is used for storage and laundry. For the exterior portion, LPA observed patio furniture under shading, and the grounds were free of any hazards or obstructions. There are two self-closing gates in the backyard that can be opened in case of an emergency. No bodies of water were observed. During this visit, six resident files and three staff files were reviewed. All staff are background cleared and associated with the facility. LPA reviewed residents’ medication and medication records and two resident interviews were conducted. The facility has valid liability insurance that expires on July 31, 2026. Based on today's observations, there are no deficiencies being cited. An exit interview was conducted with Camille Santos. This report was reviewed with the administrator and a copy was provided at the end of the visit.the state’s words, verbatim · CDSS document, Jun 18, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Celine Rodriguez conducted an unannounced visit to the facility for the purpose of conducting the required annual inspection. LPA Rodriguez was greeted and granted entry by staff on duty, who contacted facility administrator (AD) Camille Santos about visit. For this visit, there are a total of 6 resident in care, of which all 6 are on hospice and 1 is bedridden. For this visit, AD Camille Santos and Tristan Lingat were present. LPA Rodriguez observed the administrator certificates for Camille Santos expires on May 6, 2026, Fregil Jimenez expires on August 24, 2025 and Tristan Lingat expires on October 16, 2025. LPA Rodriguez observed that the PUB475 "See Something, Say Something" poster was posted at the entrance of the facility. The facility has a total of 6 bedrooms, of which 1 is designated for staff, 1 shared resident room, and 4 private resident rooms. LPA Rodriguez 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. Facility was observed to have 3 bathrooms, of which were observed to be in good repair, and toilets were operational. Smoke and carbon monoxide detector and auditory exit alarms were tested and operational. Hot water was measured at 112.8 degrees Fahrenheit. LPA Rodriguez observed that the facility had a two-day supply of perishables and a seven-day supply of non-perishable food. LPA Rodriguez observed hallways were free of obstructions. For the exterior portion, LPA Rodriguez observed patio furniture under shading, and the grounds were free of any hazards. There are 2 gates in the backyard, which both were self-closing and self-latching. No bodies of water were observed. LPA Rodriguez observed that the facility has fire extinguishers that were charged, mounted and located in the kitchen with a maintenance tag dated for 2025. Sharp items, and medications were observed to be in a locked drawer located in the kitchen. Cleaning supplies were observed to be locked cabinet located in the kitchen and garage. LPA Rodriguez observed the Emergency and Disaster Plan posted in the kitchen, and that the facility has emergency supplies located in the garage. LPA Rodriguez reviewed all six resident files. LPA Rodriguez reviewed staff files, and observed that current staff members are cleared and associated to the facility. For today's visit no deficiencies were issued per Title 22 Division 6 of the California Code of Regulations. No citations were issued. An exit interview was conducted with AD Santos and Lingat. A copy of this report was explained and provided during the visit.the state’s words, verbatim · CDSS document, Jun 5, 2025

Type of visit: Case Management - Other

On this day, Licensing Program Analysts (LPAs) Kevin Saborit-Guasch and Samer Haddadin made an unannounced visit to the facility to conduct a case management visit. LPAs were greeted and granted entry by facility caregiving staff after introducing themselves and stating the purpose of the visit. Administrator Camille Santos and licensee Tristan Lingat were notified of the visit via telephone and arrived later to assist. LPAs initially came to the licensed location to conduct an annual visit for license #306005497. However, this license has been inactive since the initial licensing of the present licensed location on June 12, 2024. License 306005497 was verified to be inactive through interviews, review of resident and staff records along with a telephone call to former licensee Ignatius Rusli. There are currently six residents in care, five of which are receiving hospice care. The current license is observed to be posted. Current administrator certificates are also present on the premises. Upon reviewing two resident records maintained at the facility, LPAs observed the admission agreement had not yet been updated to reflect the current license number. A Technical Assistance Advisory Note was issued. At this time, no 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 was provided to a facility representative.the state’s words, verbatim · CDSS document, Oct 10, 2024

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Joseph Alejandre conducted an announced visit to the facility to conduct the pre-licensing inspection. LPA met with Tristan LIngat and toured the facility. An initial application to operate a Residential Care Facility for the Elderly (RCFE) was submitted to CCL on October 2, 2023. The facility is to have a capacity of 6 nonambulatory, of which 1 can be bedridden (room 5 is the only designated bedridden room). Applicant has requested a hospice waiver for 6 residents. Facility phone number 949-328-9314. LPA observed the following. Structure: The facility is a one story house with an attached 2 car garage with 6 bedrooms, 3 bathrooms, dining room, a kitchen and a great room. There are 7 exits, one exit in each bedroom and the front door. There are no fireplaces. Air/Heating: Central air/heating system installed with a central panel to control entire house. Resident Bedrooms: There are 6 Resident Bedrooms and each bedroom is private. The bedrooms are spacious and will easily accommodate the residents' belongings. All resident rooms had the required furnishings. Bedrooms Staff: There are no staff bedrooms. Bathrooms: All bathrooms have a working toilet, wash basin and walk in shower. All bathrooms are clean and operational. Linens & Hygiene Supplies: Adequate supply of linen stored in bedrooms. Emergency Phone Numbers, Exit Plan & Menu: Posted & readily available for review an emergency disaster plan with means of exiting and emergency phone numbers listed. Menus posted and available. Menus prepared one week prior and listed for food served for one week. Food Service: There is a 2-day perishable and a 7-day non-perishable food supply on hand in the ktichen. Smoke Detectors/Carbon Monoxide Detectors: Smoke detectors/carbon monoxide detectors tested operational. The fire extinguisher in the dining room is fully charged. Appliances: There is one 5 gas burner stove which lights unassisted, 1 oven, 1 microwave, a refrigerator, dishwasher, washer, and dryer. All appliances are clean and operational. Toxins: All cleaning supplies and chemicals are stored in the garage. Water Temperature: Hot water was measured in all bathrooms. Hot water measured between 113.1 to 114.6 degrees Fahrenheit. Medications, First-Aid Kit & Book: The first aid kit is mounted on the dining room wall. The first aid book is kept on the dining room cabinet. The first aid kit has all the required elements. Medications will be stored in the cabinet in the dining room. The cabinet is kept locked. Resident & Staff Files: The Resident and Staff Records will be kept locked in the cabinet in the dining room. Reading Material, Games, Equipment & Materials: Games and reading material, are stored in the dining room cabinet. There is a large screen TV mounted in the great room. Garage: The garage is used for storage The chemicals, cleaning supplies and dangerous items are kept locked in cabinets in the garage. Backyard: The backyard has two shaded seating areas with tables and chairs. No bodies of water observed. There are two sheds in the backyard. Both sheds are kept locked and used for storage. The exit gate is latched and self closing. No obstacles or hazards observed in the backyard. Fire clearance: Fire Clearance approved by Orange County Fire Authority Inspector Kevin Chaney on October 17, 2023. Component III: Component three was completed with the applicant. The applicant has met all pre-licensing requirements. The facility is ready to be licensed. LPA will submit notification to CAB (Central Applications Bureau) in Sacramento for final review prior to license being issued. Applicant was informed today that the final approval will be processed/granted by CAB in Sacramento. An exit interview was conducted and a copy of this report was left with the applicant.the state’s words, verbatim · CDSS document, May 28, 2024

The state marks this report as 4 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.

Type of visit: Office

Facility Type: RCFE Application Type: CHOW Capacity: 6 Census (if any clients in care): 3 COMP II Participants: Tristan Lingat, Admin/Licensee Interview Method: Virtual interview (MS Teams) On 5/2/2024, applicant/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. Signed LIC 809 with copy of photo ID have been obtained. During COMP II, CAB analyst confirmed Applicant/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 readinessthe state’s words, verbatim · CDSS document, May 2, 2024