Laguna Woods

Type of visit: Required - 1 Year

On 3/17/2026, Licensing Program Analyst, Arvin Villanueva (LPA), arrived unannounced at this facility to conduct the annual inspection visit. LPA met with administrator, Jennylind Duran (AD), and stated the purpose of the visit. Overview: Facility is a one-story home located in a residential neighborhood. Facility is licensed to serve up to 6 elderly residents, up to 6 may be non-ambulatory. Hospice waiver for up to 6 residents. Facility does not manage residents’ cash resources. Facility does not have fire clearance for bedridden, delayed egress, and/or locked interior/exterior. Initial Observation: Present during today's visit were 6 residents in care with two staff on duty, S1 and AD. Physical Inspection: Areas inspected include, but not limited to, the kitchen, resident bedrooms, resident bathrooms, living and dining room and outdoor areas. LPA inspected resident 6 of 6 bedrooms and 2 of 2 bathrooms. All bedrooms are single occupancy. Room temperature was maintained at 71 degrees. The hot water temperature was measured at 117 degrees Fahrenheit. Fire extinguishers were observed in the kitchen and were serviced on 2/26/26. Smoke and carbon monoxide detectors were observed throughout. {1 of 2} In the kitchen, the facility maintained at least a seven-day supply of non-perishable foods and a two-day supply of perishable foods. The LPA also observed insulin medications stored inside a locked refrigerator located in the office. One additional freezer was observed in the kitchen. Medications, sharps, cleaning supplies, and other dangerous items were observed to be locked and not accessible to residents in care. Outdoor area was inspected. LPA observed a covered patio and outdoor furniture for residents’ use. Ramps, fence, and exit gate were observed to be in good repair at this time. Walkways and ramps were observed to be unobstructed. Record Reviews: Review of 3 of 6 resident files was conducted, including but not limited to, review of Admission Agreement, Physician Reports, Needs and Services Plan, Centrally Stored Medication Record and Ambulatory Status. Advisory provided to obtain PRN Authorization for each resident. Medication reviews were conducted for 2 residents. Review of 3 staff files included but not limited to background clearance, first aid/CPR certification, and training. Emergency Procedures Plan and Infection Control Plan were reviewed. Facility conducts quarterly disaster drills; last drill was conducted on 1/7/2026. Advisory provided to review their plans at least annually. First aid kit, located in the kitchen, was reviewed and found to be complete. Documents Requested: LPA requested a copy of updated Liability Insurance Certificate, Resident Roster, LIC610, LIC500, and LIC308 to be emailed to arvin.villanueva@dss.ca.gov. Per the California Code of Regulations, Title 22, Division 6, Chapter1 & 6, no deficiencies were cited. Advisories were provided. Exit interview was conducted. A copy of the report was provided upon exit. {2 of 2}the state’s words, verbatim · CDSS document, Mar 17, 2026

The state marks this report as 13 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) Victoria Brown arrived unannounced on 2/14/25 at 9:00am to conduct a Required - 1 Year inspection visit. LPA met with Karen Casila, Caregiver and Jennylind Duran, Administrator and explained the purpose of the visit. The facility is licensed for a capacity of 6 non-ambulatory residents of which 6 may receive hospice care services in rooms 1-6. LPA observed residents participating in individual activities during this visit. Administrator certificate expires 5/3/26. There is 1 person receiving hospice services during this visit. The facility conducted a fire/disaster drill on 1/16/25 that was logged. LPA toured and inspected the physical plant inside and outside to ensure there are no safety hazards to residents. LPA observed kitchen, dining area, bedrooms and bathrooms, storage areas, laundry and lighting throughout the facility. LPA observed supplies of nonperishable foods for a minimum of one week and perishable foods for a minimum of two days maintained on the premises. The temperature inside the facility was observed to be at 72*F which is within the required range of 68-85*F. The hot water temperature was measured at 114.7 *F which is within the required range of 105-120*F. LPA observed fire extinguisher(s), smoke and carbon monoxide detectors, and central heating and air in the facility. LPA observed staff assisting residents with medication pass after which the centrally stored medications area was found to be locked and inaccessible to residents. The first aid kit contained the required items such as sterile dressings, bandages, adhesive tape, scissors, tweezers, thermometers, antiseptic solution and guide. LPA reviewed files of 2 residents and 2 staff. Upon a file review the following items were discussed to be submitted with any changes annually: Licensing fees-Current Criminal Record Clearances LIS536-Current Administrative Organization LIC309-Current Designation of Administrative Responsibility LIC308-Submit Personnel Report LIC500-Submit Affidavit Regarding Client/Resident Cash Resources LIC400-NA Surety Bond LIC402-NA Facility Floor Plan/Plot Plan LIC999-Current Fire Clearance (consistent with terms and limitations of license)-NA Qualifications of Administrator/Facility Manager-Submit Articles of Incorporation/Organization, Constitution and bylaws-NA Partnership Agreement-NA Control of Property-Submit Emergency Disaster Plan LIC610-Submit Plan of Operation (Restricted Health Care Plan)-NA Admission Policies and Procedures-NA Health Screening Report-Facility Personnel LIC503-NA Bacteriological Analysis of Private Water Supply-NA In-service Training Program-NA Medication Procedures-NA Transportation Procedures-NA Job Description/Personnel Policies-NA Exemptions/Waivers and Exceptions-Current First aid/CPR certificates-Current Liability Insurance-(if applicable)Submit Infection Control Plan-Submit Per California Code of Regulations (CCRs) - Title 22, Division 6, Chapter 8, no deficiencies are being cited during this visit. Exit interview held. A copy of todays’ report provided.the state’s words, verbatim · CDSS document, Feb 14, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Christina Valerio arrived unannounced to the facility to conduct an annual required inspection. LPA met with facility staff Rose, and explained the purpose of the visit. LPA contacted facility designated staff Jennylind Duran via cell phone to notify of the visit. Staff Jennylind later met with LPA Valerio. LPA Valerio and facility staff Bonifacio toured the facility to ensure compliance with Title 22 regulations. LPA observed 6 bedrooms, 5 of which were occupied. All bedrooms were furnished with a bed, night stand, lamp, dresser, and a chair. Resident restrooms were observed to be clean, organized, and free from odors. The bathroom water delivered hot water between the regulatory range of 105.0*F - 120.0*F. Restrooms were fully stocked with toilet paper, wipes, hand sanitizer, hand soap, grab bars, and a trash can. Common areas were observed to be clean with no obstructions to walk ways. LPA observed staff cleaning the bathroom, cleaning the kitchen, and assisting residents. Residents were in the kitchen eating lunch, watching television, in their room, or out on an outing. The facility was observed to have medications locked and inaccessible to residents in care. LPA observed supplies of nonperishable foods for a minimum of one week and perishable foods for a minimum of two days maintained on the premises. The first aid kit was fully stocked. Fire extinguishers, Smoke detectors, and carbon monoxide detectors were observed to be within compliance with fire safety. LPA Valerio observed three (3) resident files and three (3) personnel files. All files were observed to be up to date. Staff had required training. LPA requested the following documentation to be sent to LPA Valerio via fax or e-mail: LIC 500, LIC 308, LIC 610D, Liability Insurance, and copy of Administrator Certificate Per California Code of Regulation (CCR) - Title 22, Division 6, Chapter 8, no deficiencies were observed during today's visit. An exit interview was held, and a copy of the report was provided.the state’s words, verbatim · CDSS document, Feb 12, 2024

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Christina Valerio arrived unannounced to the facility to conduct a case management visit. LPA met with facility staff, and explained the purpose of the visit. LPA was later met by designated facility manager Jennylind Duran On 12/13/23, the facility faxed a Death Report for Resident 1 to the Office of the Day Fax Line. On 12/18/23, LPA Valerio contacted the facility to request additional documentation. LPA left a voicemail; however, did not receive a call back. LPA Valerio requested and reviewed facility files for Resident 1, which included R1's Admission Agreement, LIC 602, Appraisal/Needs and Service Plan, and supportive documentation. LPA Valerio and staff Jennylind toured the facility. No health or safety concerns observed. Per California Code of Regulations (CCR) - Title 22, no deficiencies were observed. An exit interview was held, and a copy of the report was provided.the state’s words, verbatim · CDSS document, Dec 20, 2023