Giada's House

Type of visit: Required - 1 Year

On this day, Licensing Program Analyst (LPA) Ruth Martinez made an unannounced visit to the facility to conduct the required annual inspection. LPA was greeted and granted entry by caregiver. Administrator Guadalupe De Veau was notified via telephone and arrived shortly afterwards to assist with the visit. LPA and facility staff toured the outside of the facility. LPA observed an shaded outdoor seating area with furniture for resident use. There are self-latching gates on both sides of the property and the routes are free of clutter and obstructions. There are no bodies of water on the premises. Four residents reside at this facility; LPA was informed residents were out in the community. LPA accompanied with staff began the tour of the inside and outside of the facility. LPA observed required department postings posted on the wall of 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 the spare refrigerator, freezer and pantry located in garage. The facility is maintained at a comfortable temperature. LPA inspected that medication are centrally stored in a safe locked storage cabinet located in the kitchen room. LPA reviewed medication and observed medication was labeled and stored inaccessible to residents in care. LPA inspected the bathroom and LPA measured the hot water temperature which measured 117.3 Fahrenheit degrees. All bathrooms observed to have a supply of soap, toilet paper and towels. The facility is equipped with sufficient hand hygiene, cleaning, and disinfecting supplies. LPA observed that toxic chemicals, cleaning solutions and disinfectants are stored locked underneath kitchen sink and in the garage. The facility has an available clean supply of linens. LPA inspected resident bedrooms which has sufficient lighting to ensure safety and comfort. All bedrooms observed to have all required components. Storage space is provided for clients in their bedroom. Smoke detectors were tested and found to be operational. LPA observed a fire extinguisher with service date of October 17, 2025, in kitchen/office. Fire drills conducted every three months, and LPA verified last Fire Drill was conducted on June 6, 2026. LPA toured the outside of the facility and observed outdoor passageways are free of obstructions. LPA observed there is shaded seating areas for residents’ enjoyment. LPA began reviewing records. LPA reviewed two resident records. All the required documentation was present and reviewed in residents’ files. The facility P&I records were reviewed. LPA observed that an individual log is maintained for each client. All monies are accounted for and attached receipts for record keeping. LPA reviewed two employee records. All employees present have a criminal record clearance and are associated to the facility. LPA observed records reviewed have a current First Aid certificate. 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 the Administrator, and a copy of this report was provided to the facility.the state’s words, verbatim · CDSS document, Jun 18, 2026

Allegation investigated: Staff made inappropriate physical contact with a client

On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility for the purpose of investigating the allegation listed above. LPA was greeted and granted entry by facility staff after introducing himself, stating the purpose of the visit and listing the allegation under review. Administrator Guadalupe De Veau was notified of the visit via telephone and arrived later to assist. During the visit, LPA conducted three client interviews, three staff interviews and one witness interview via telephone. Client records for all three individuals were requested and reviewed during the visit. LPA accompanied by staff also toured the premises. All staff members present are verified to be background cleared and associated to the licensed location in Guardian. CONTINUED ON FORM LIC9099-C Unsubstantiated CONTINUED FROM FORM LIC9099 Regarding the allegation that Staff made inappropriate physical contact with a client, the following has been concluded: It is alleged that a male individual named Paul [no last name provided] spanked client C1 at the facility. Per a review of the facility's roster and interviews conducted, there are no male individuals by that name currently associated with the facility. There is only one male staff member (S1) whose name is different and only provides relief caregiving on an occasional basis. A male relative of staff member S2 is also described as occasionally visiting the facility, however all statements gathered confirmed this individual is not associated in providing care and supervision to the clients in care. Two of the three clients interviewed denied ever observing or having any knowledge of inappropriate contact or spanking occurring at the facility. A third interview was inconclusive in providing detailed information. An additional interview with the Regional Center of Orange County Service Coordinator assigned to the three facility clients denied any concerns related to the allegation. Based on the evidence gathered, the allegation is determined to be Unsubstantiated, meaning that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove or refute the alleged violation occurred. An exit interview was conducted and a copy of this report was provided to a facility representative.the state’s words, verbatim · CDSS document, Dec 2, 2025 · control 22-AS-20251126121011

Type of visit: Required - 1 Year

On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility to conduct the required annual inspection. Upon LPA's arrival, caregiving staff was absent due to a medical appointment. Administrator Guadalupe De Veau was notified via telephone and arrived shortly afterwards to assist with the visit. There are currently three residents in care, none of which are receiving hospice care at this time. All three residents attend day program and are observed to be away during the present visit. No interviews were therefore conducted at this time. LPA accompanied by administrator toured the physical plant. The facility is a one-story house with an attached garage. The facility has four private bedrooms along with one locked staff room and a sunroom. Bedrooms appear clean and sanitary. No postural supports are observed to be in use on the premises. All resident bedrooms have the required furnishings. Bathrooms appear clean and sanitary and are equipped with grab bars and slip mats. Hot water temperature measured at 114F and 115F in two separate bathrooms equipped with faucets used for personal grooming. LPA observed the kitchen has a minimum two (2) day perishable and seven (7) day non-perishable food supply. Sharp items, cleaning supplies and the medication central storage are verified to be secured. CONTINUED ON FORM LIC809-C CONTINUED FROM LIC809 The wall-mounted fire extinguisher is charged, with up-to-date maintenance tag attached. LPA tested the smoke and carbon monoxide detectors which were found to be operational. The garage is inaccessible to residents and used for storage of food and supplies. The laundry room is accessible from the kitchen and office area however laundry supplies are confirmed to be inaccessible. LPA and facility staff toured the outside of the facility. LPA observed an shaded outdoor seating area with furniture for resident use. A large umbrella is stated to be scheduled for removal since it has been damaged. Consultation provided. There are self-latching gates on both sides of the property and the routes of egress are free of clutter and obstructions. There are no bodies of water on the premises. Facility does not utilize locked perimeters or delayed egress. LPA reviewed three resident records which included all necessary components. Facility is awaiting updates from Regional Center of Orange County for admission agreements as well as Purchase of Service Authorizations, some of which are still issued to the formerly licensed facility at this time. Consultation provided. Personal and incidental funds reviewed with no discrepancies found. LPA reviewed resident medication records and prescription orders for all residents with no discrepancies observed. Oxygen is not in use. LPA reviewed staff records for two staff members currently scheduled. Administrator has a current CPR certificate on file, however the caregiver scheduled has an expired certificate since February 2025. Type B citation issued. Annual training on file. Disaster drills are conducted three times a year with proof of attendance provided. Consultation provided. Both staff members present are background cleared and associated to the licensed location. Based on the observations made during today’s visit, one type B deficiency is being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted and a copy of this report along with appeal rights were provided to a facility representative.the state’s words, verbatim · CDSS document, May 30, 2025

The state marks this report as 9 pages; the online copy we transcribed has 4. You can request the full file from the county licensing office.

Type of visit: Prelicensing

On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made a scheduled visit to the facility for the purpose of conducting a pre-licensing inspection. LPA was greeted and granted entry by Guadalupe De Veau, administrator. An initial application for a license to operate as a Residential Care Facility for the Elderly was received by the Department on January 11, 2024 for a capacity of four non-ambulatory clients. This is a change of ownership with 3 residents already in care. The facility receives residents placed by the Regional Center of Orange County as aging clients with developmental disabilities. LPA accompanied by administrator toured the physical plant. Facility is a one-level home with a frontyard, backyard and attached garage. There are four individual bedrooms. Each of the bedrooms include all necessary components of furnishing including a light, chair, storage space for personal items and a full-size bed as well as a supply of linen and bedsheets. There are three bathrooms on the premises, two of which are designated for use by the residents. Water temperature was measured to be within acceptable range. Common living spaces are present and a computer connected to the internet is present for the use of the clients in care. Facility is clean, sanitary and free of odors in all areas inspected. Kitchen equipment is present and operating as required. Sharp items and cleaning supplies are confirmed to be secured. A sufficient supply of perishable and non-perishable food is present as required by Title 22 Regulations. The centrally stored medication storage is located in a secure cupboard. The garage is also used for additional storage of food and activity items, along with emergency and back-up supplies. Staff and client records were reviewed and confirmed to include all necessary components. CONTINUED ON FORM LIC809-D CONTINUED FROM FORM LIC809 The fire clearance has been obtained and provided to the Department before the pre-licensing visit. Combined smoke and carbon monoxide detectors are observed throughout the facility and confirmed to be functional. LPA and licensee toured the outside of the facility and observed it to be free of obstructions. A shaded area is present in the back of the house and is equipped with outdoor furniture for the enjoyment of residents and visitors. The perimeter gates present on both sides of the house are self-latching and can easily be opened in an evacuation. There are no bodies of water on the premises. No items of non-compliance were identified during today's visit. Component III was waived as the prospective licensee has already been acting as the current facility administrator for over a year. This report was reviewed with facility representative and a copy of this report was emailed to the prospective licensee before the conclusion of the visit.the state’s words, verbatim · CDSS document, May 31, 2024

Type of visit: Office

Facility Type: RCFE Application Type: CHOW Capacity: 4 Census : 3 Method: Telephone call with CAB COMP II Participants: Guadalupe De Veau (Administrator/Licensee) & Tammy Edwards (Analyst). Administrator/Licensee participated in COMP II via telephone call with CAB analyst. Identification of the Administrator/Licensee was verified by confirming driver’s license number. During COMP II, Administrator/Licensee confirmed the understanding of Title 22. Component II was successfully completed. Administrator/Licensee was advised to email signed LIC 809 with copy of photo ID to CAB. During COMP II, CAB analyst confirmed Administrator/Licensee'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 30, 2024