Dalton Residential Care

Type of visit: Required - 1 Year

On this day Licensing Program Analyst (LPA) Fred Arias made an unannounced visit to conduct a required annual visit. LPA was greeted and granted entry into the facility by staff and explained the reason for the visit. Facility is licensed for six non-ambulatory residents of which one may be bedridden. Facility has an approved hospice waiver for six residents and the home currently has six residents, with two residents on hospice. Licensee (LI) Kevin Dinh arrived shortly to conduct facility tour. LPA along with LI toured the facility at 9:10 AM. LPA toured the physical plant, checked food service, and facility documentation. The home consists of four resident bedrooms, living room, dining room, and kitchen, two bathrooms and an attached garage. Resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. Resident bathroom was checked. Toilet and water faucet worked properly, grab bars were secure and shower was free of mold/mildew. Water temperature measured 111.7 degrees F. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked. Common areas were clean and clear of hazards. Auditory exit alarms were operational during today's visit. LPA toured the kitchen and observed sharps locked in a drawer during today's visit. Perishable and non-perishable food supply was checked and adequately stocked at time of visit. Kitchen appliances were operational during today's visit. Smoke detectors tested operational during today's visit. Fire extinguishers were fully charged. LPA reviewed the infection control and emergency disaster plans. Facility conducts quarterly emergency drills with the last drill conducted on 4/4/2026. Outside grounds were toured. Walkways around the home were clear of hazards. There is shaded outdoor seating for residents. Exit gates are unlocked and operational. LPA observed the emergency food and water supply. First aid kit contained all required items including tweezers, scissors and thermometer. LPA reviewed six resident files and two staff files. All resident files contained required documentation including admission agreements, physician reports, and resident appraisals. Staff files reviewed contained required documentation including required annual training, medical assessment/ TB, criminal record clearance and proof of CPR training. LPA reviewed medication storage and administration. Medications are stored in a locked closet. Medications are being administered per physician order. Based on the observations made during today’s visit, no deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. This report was discussed with the facility representative and a copy was provided.the state’s words, verbatim · CDSS document, May 26, 2026

The state marks this report as 5 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Michael Tea conducted an unannounced visit. The purpose of today’s visit was to conduct the Annual Required inspection. At around 1:30 PM, LPA Tea was greeted and granted entry into the facility by Licensee (LE) Kevin Dinh and explained the reason for the visit. Facility is licensed for six non-ambulatory residents, with an approved hospice waiver for six, and one maybe bedridden in Room #3. Currently there are no residents in care during today's visit. The licensee hopes to have residents for the facility during this year once the facility is approved for the Assisted Living Waiver (ALW) program. LPA Tea along with the LE Dinh toured the facility. LPA toured the physical plant, checked the first aid kit. The facility is a one-story home that consists of four resident bedrooms, two private, two shared, two full bathrooms, living room, family room, dining area, kitchen and garage. LPA observed smoke detectors/carbon monoxide in common areas and bedrooms to be operational. Resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. Resident bathrooms were checked. Toilets and water faucets worked properly. The grab bars were secure, and shower was free of mold/mildew. Water temperature measured around 107.9 Fahrenheit degrees. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked at time of visit. Common areas were clean and clear of hazards, doorways were free of obstructions. First aid kit had all the required elements including dressing, bandages, tweezers, thermometer, and scissors. Kitchen was inspected. Kitchen appliances are operational during today's visit. Sharps are locked and stored in a secured drawer in the kitchen. LPA also observed toxin substances inaccessible to residents in care, locked and secured underneath the sink. The fire extinguisher is fully charged in the kitchen area. LPA toured the outside grounds and there is ample seating with shade. Backyard has a nice garden with different plants and fruit trees. There are two exit gates that are self-latching and operational on both sides of the house. Continuation of the annual report on LIC809-C Emergency food is in a closet by the front entry way. Emergency water is in the garage and the emergency supplies are in the medication closet. No resident files were reviewed, and interviews were not conducted as there are no residents living at the facility. There were no health and safety concerns observed during today's visit. Based on the observation 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 Licensee Kevin Dinh and a copy of this report LIC809, 809-C was read and provided to the facilitythe state’s words, verbatim · CDSS document, May 21, 2025

Type of visit: Prelicensing

Licensing Program Analysts (LPA) Alvaro Ramirez, Jr. conducted an announced visit to the facility to conduct the pre-licensing inspection. LPA met with Applicant Kevin Dinh and toured the facility. An initial application to operate a Residential Care Facility for the Elderly (RCFE) was submitted to Community Care Licensing (CCL) on October 01, 2023. The facility is to have a capacity of 6, of which 5 can be nonambulatory and 1 bedridden. Facility phone number 714-300-4540. LPA observed the following. Structure: The facility is a one-story house with four resident bedrooms, two full size bathrooms, a living room, a kitchen, a dining room, and an attached car garage. LPA observed the See Something, Say Something poster (PUB 475) in the facility mounted on the wall in the entranceway. There is a backyard with an exit gate on each side of the house. There is a shaded seating area and LPA did not observe any obstacles or hazards in the backyard. Air/Heating: Central air/heating system installed with a central panel to control entire house. Resident Bedrooms: There are four Resident bedrooms. All resident bedrooms had the required furnishings. LPA observed all beds had linens and blankets. CONTINUED ON LIC809-C... Bathrooms: All bathrooms are clean and have working plumbing. Hot water measured between 106.1 and 109.7 degrees Fahrenheit. Linens & Hygiene Supplies: A supply of extra linen was stored in the closet of each resident bedroom. 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. Monthly menu available and posted in the kitchen refrigerator. Food Service: There are no residents living in the facility at this time. There is 7-day non-perishable food supply on hand. Smoke Detectors/Carbon Monoxide Detectors: Smoke detectors/carbon monoxide detectors are hardwired and tested operational. There is a fire extinguisher mounted on the wall by the dining room. Appliances: There is one, four gas burner stove which lights unassisted, one oven, microwave oven mounted above the stove, a refrigerator, dishwasher, washer, and dryer. All appliances are clean and operational. Toxins: All and any toxic chemicals, cleaning solutions, laundry toxins and disinfectants are inaccessible to residents and will be stored in the garage. Water Temperature: Hot water was measured in all bathrooms. Hot water measured between 106.1 and 109.7 degrees Fahrenheit. Medications, First-Aid Kit & Book: The first aid kit and the first aid manual are stored in the closet next to the kitchen. The first aid kit has all the required elements. Medications will be stored in locked cabinet next to kitchen. Resident & Staff Files: The Resident and Staff Records will be kept in a locked cabinet next to the kitchen. Reading Material, Games, Equipment & Materials: Arts and craft, board games and movies are stored in the living room cabinet. There is one large screen television mounted in the living room and one in the dining room. Fire clearance: Fire Clearance approved by a fire inspector of Orange County Fire Authority on 12/12/23. Special conditions noted, "Bedrooms 1,2 and 4 Approved for Nonambulatory" and "Bedroom 3 approved for Bedridden and Nonambulatory" Component III: Component three waived during visit. Applicant is Licensee/Administrator of other licensed facilities. Applicant was reminded that it is required to notify LPA when admitting their first resident. This notification may be done by phone, email or fax. The applicant has met all pre-licensing requirements. LPA will submit notification to CAB in Sacramento for final review prior to license being issued. Applicant was informed today that the final approval will be processed by CAB (Central Applications Bureau) in Sacramento. Exit interview was conducted and a copy of this report was left with the applicant.the state’s words, verbatim · CDSS document, May 3, 2024

Type of visit: Office

Facility Type: RCFE Application Type: Initial Capacity: 6 Interview Method: Telephone interview On 4/3/2024, 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, Apr 3, 2024