Luxxylive

Type of visit: Required - 1 Year

On July 29, 2026, at 12:00 PM, Licensing Program Analyst (LPA) Edward Kim conducted an unannounced required 1-Year annual visit using the CARE Inspection Tool. Upon arrival at the facility, LPA Kim met with Administrator (ADMIN) Veronica Cuevas and explained the purpose of the visit. ADMIN Cuevas could not stay for the visit and stated that Staff Najati Ghazzal could sign on behalf of the facility. The facility is licensed to have a capacity of six (6) nonambulatory residents and a hospice waiver for six (6) residents. LPA Kim observed the following. The facility is a one-story house with an attached 2-car garage with six (6) resident bedrooms, one (1) staff bedroom, three bathrooms, dining room, a kitchen, a living room, and two outdoor shaded area. LPA Kim toured inside and outside of the physical plant. There are no obstructions or bodies of water on the premises. All rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting was provided, storage for each resident’s personal belongings was observed. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. All bedrooms were inspected: Resident room 1, Resident Room 2, Resident Room 3, Resident Room 4, Resident Room 5, and Resident Room 6. Bathrooms were found to be within Title 22 regulations and were clean and operational.. The water temperature measured between 114.6 degrees F and 115.3 degrees F. A comfortable temperature of 74 degrees F was maintained in the facility. LPA Kim observed the facility to be sanitary and appropriately furnished at the time of visit. Storage areas for personal hygiene, cleaning supplies, toxins, and sharps objects were stored and not accessible to residents Evaluation Report Continues on LIC 809-C During the visit, LPA Kim observed the facility's infection control practices. LPA observed screening protocols for visitors, staff, and residents, and sanitizing stations in common areas. LPA observed the facility has a 30-day supply of Personal Protective Equipment (PPE). The kitchen was inspected and there is a two-day supply of perishable and seven-day supply of non-perishable food available and maintained properly. Emergency food, emergency water and emergency supplies are stored in the garage. All mandated inspection control posters were posted. The facility has smoke detectors and carbon monoxide detectors that were operable. The Certificate of Liability Insurance is effective from February 18, 2026 to February 18, 2027. The facility conducts Fire/Safety Drills quarterly and was last conducted on April 23, 2026. Two (2) fire extinguishers are mounted in the facility in the resident hallway and in the kitchen. A working telephone Facility phone number (949-333-5444) and tablet device dedicated to the residents both remain available. First Aid Kit contained all the necessary elements. LPA Kim conducted an audit of six (6) residents (R1-R6) files, and seven (7) staff (S1-S7) personnel files, and medication and medication administration records that were all in order and complete. LPA conducted interviews with three residents and three staff. There are no deficiencies cited during the visit. An exit interview was conducted, and a copy of this report and was provided to Staff Najati Ghazzal.the state’s words, verbatim · CDSS document, Jul 29, 2026

Type of visit: Case Management - Health Checks

On this day, Licensing Program Analyst (LPA) Andrea Mendivil made an unannounced visit in conjunction with a complaint visit for complaint control # 22-AS-20260205153135. . LPA Mendivil toured interior and exterior of facility. No imminent health and safety hazards were observed. Residents were observed throughout the facility to be well groomed. No deficiencies were cited during this visit. An exit interview was conducted and a copy of this report was provided.the state’s words, verbatim · CDSS document, Feb 6, 2026

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Celine Rodriguez conducted an announced pre-licensing visit and was greeted and granted entry by Facility Administrators (AD) - Veronica Cuevas and House Manager (HM) - Savvas Kudsi. LPA Rodriguez observed the Administrator's Certificate for Veronica Cuevas 1/17/2027. For this visit, there are 0 residents in care. LPA Rodriguez toured the facility with AD- Cuevas and HM- Savvas Kudsi. Structure: Facility is a single level structure. On 5/1/2025, The Orange County Fire Authority granted a fire clearance for a capacity of 6 residents (which 6 may be non-ambulatory, 2 may be on hospice and 0 may be bedridden). There are a total of 6 bedrooms, which all are private resident rooms, and 1 room designated as a gym for resident use. There are a total of 3 bathrooms of which 2 are full bathrooms and 1 half bathroom. There is is a garage that is utilized as a storage space. Bedrooms: All 6 bedrooms were provided with furniture in good repair, clean linens, adequate storage space, and kept hazard free. Bathrooms: The restrooms were observed to be in good repair, toilets were operational, and grab bars and non-skid floor mats were provided. Water temperature in restrooms were measured at 115.3 degrees Fahrenheit. Linens and Hygiene Supplies: Adequate supply of linens is stored in the bedrooms and in the garage. Posters, Emergency Phone Numbers, Exit Plan: The PUB475 "See Something, Say Something" and Long Term Care Ombudsman poster was posted at the entrance of the facility. Emergency disaster plan is posted at the entrance and is also located in the facility binder. Food Service and Menu: Facility met the minimum two-day perishable and seven-day non-perishable food supplies. Sharp items and knives were locked and inaccessible to the residents in care and located in a kitchen drawer. Facility had back-up emergency food and water supply located in the garage and in the kitchen. Smoke and Carbon Monoxide Detectors: Smoke and carbon monoxide detectors were tested and operational. Alarms: There are auditory alarms located on each door and pool gate were all were tested and operational. Fire Extinguisher: Fully charged, mounted, and located in the kitchen and in the hallways. Fire extinguishers were dated for 2025. Appliances: Stove is a four-burner induction stove, and there is single oven, dishwasher, refrigerator and freezer. Washer and dryer are located in the garage. Toxins: Inaccessible to residents and located in a locked cabinet in the garage. Medications, PPE First-Aid Kit and Manual: LPA Rodriguez observed that First Aid Kit had all the required components. Medications were locked in a cabinet located in the hallway. Facility had an adequate supply of PPE located in the garage. Backyard: LPA Rodriguez observed that there are 2 exit gates in the backyard on one side, of which are self-closing and self-latching. LPA Rodriguez observed that there is a pool located in the backyard, however is closed off by a 6ft fence, along with an auditory alarm that was observed to be operational. Resident and Staff Files: Records were kept in a locked cabinet located in the hallway. Recreational Activities: The facility has activities that commensurate with plan of operation. LPA Rodriguez reviewed the Component III with AD - Veronica Cuevas and HM - Savvas Kudsi. Per interviews, AD - Veronica Cuevas and HM - Savvas Kudsi stated that they are not planning to advertise for special dementia program for this facility as of this time. Prelicensing visit and Component III are now complete. LPA Rodriguez will provide copy of this report to Centralized Applications Bureau for review and final determination of the application. LPA Rodriguez conducted an exit interview with AD - Veronica Cuevas and HM - Savvas Kudsi and a copy of this report was provided to the facility.the state’s words, verbatim · CDSS document, Jul 21, 2025