Orange Care Home

Type of visit: Collateral

Licensing Program Analyst (LPA) Alvaro Ramirez, Jr. made an unannounced collateral visit in conjunction with complaint 22-AS-20240917153624. LPA Ramirez was allowed entry into the facility and met with Caregiver Jessie Bustamante. LPA explained the purpose of the visit. On today's visit LPA Ramirez toured the facility and interviewed staff. Administrator agreed to email the following documents by close of business on Monday February 9, 2026: a copy of the the Physician Reports (LIC602s), staff trainings, and a copy of the AD certificate. An exit interview was conducted with Caregiver Bustamante and a copy of this report was provided at the time of exit.the state’s words, verbatim · CDSS document, Feb 6, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Ruth Martinez is conducting this unannounced visit for the purpose of completing an annual required inspection. LPA arrived at the facility and was greeted and granted entry by Fernando Villafranca, Administrator LPA explained the nature of the visit. There are six residents at the facility and there are three residents receiving hospice services currently. LPA accompanied by the Administrator began the tour of the inside and outside of the facility. LPA observed required department postings throughout the 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 storage in a spare refrigerator and freezer located in the garage. The facility is maintained at a comfortable temperature. LPA inspected that medication is centrally stored in a safe locked storage cabinet located in the kitchen. LPA reviewed medication and observed medication was labeled and stored inaccessible to residents in care. LPA inspected the bathroom. LPA measured the hot water temperature which measured 119.9 Fahrenheit degrees. All bathrooms observed to have a supply of soap, toilet paper and towels. Bathrooms are equipped with required safety measures such as non-skid mats and grab bars. Lighting is sufficient to ensure safety and comfort. The facility is equipped with sufficient hand hygiene, cleaning, and disinfecting supplies. LPA observed that toxic chemicals, cleaning solutions and disinfectants are stored in a locked underneath kitchen sink and locked in a storage cabinet in the garage. The facility has an available clean supply of linens. LPA inspected residents’ bedrooms which has sufficient lighting to ensure the safety and comfort. All bedrooms observed to have all required components. Storage Continued on LIC809-C space is provided for residents in their bedroom. Smoke/carbon monoxide detectors were tested and found to be operational. LPA toured the outside of the facility and observed outdoor passageways are free of obstructions. LPA observed there are shaded seating areas for residents’ enjoyment. LPA observed a swimming pool adjacent to the house with a fence around it. LPA observed the pool gate has a pad lock for inaccessibility and the entry door opens away from the pool. The pool has two entry ways and both were observed to be locked. The fence has a pad lock at the two gate doors. LPA measured the pool fence which measured 5.2 ft from base of the floor to the top of the fence and it was observed to enclose the entire pool area. LPA observed a fire extinguisher with service date August 8, 2025, in the kitchen. Fire drills are conducted every three months and LPA reviewed logs with last drill conducted on October 10, 2025. LPA began review of records. LPA reviewed three resident records. All the required documentation was present and current in the residents’ files reviewed. LPA reviewed three 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. It was observed Administrator has a current Administrator certificate. Based on the observations 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, Oct 29, 2025

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Alvaro Ramirez, Jr. conducted an announced visit to the facility to conduct the pre-licensing inspection. LPA met with Applicant Fernando Villafranca 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 July 29, 2024. The facility is to have a capacity of 6 residents, (0) ambulatory, (6) non-ambulatory and () bedridden residents. Waiver granted for Hospice Care for (6). Facility phone number is 657-223-6948 LPA observed the following. Structure: The facility is a one-story house with four resident bedrooms, one staff bedroom, one office, three 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 by entryway. There are two gates in the backyard, which both are self-closing and self-latching. 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 111.2-113.7 degrees Fahrenheit. Linens & Hygiene Supplies: A supply of extra linen for each resident was stored in the closet by the residents' bedroom hallway. 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 refrigerator. Food Service: There are five residents living in the facility at this time. A supply of 2-day perishable and 7-day of non-perishable food was observed and will be maintained on hand. Smoke Detectors/Carbon Monoxide Detectors: Smoke detectors/carbon monoxide detectors are hardwired and tested operational. Fire extinguishers were charged, mounted and one was located by the kitchen and one by the entryway. Appliances: There is one gas stove which lights unassisted, one oven, microwave, 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 111.2-113.7 degrees Fahrenheit. Medications, First-Aid Kit & Book: The first aid kit and the first aid manual are stored in a cabinet next to the dining room/kitchen. The first aid kit has all the required elements. Medications will be stored in locked cabinet next to dining room/kitchen. Resident & Staff Files: The Resident and Staff Records will be kept in a cabinet next to the dining room/kitchen. Reading Material, Games, Equipment & Materials: The activities plan include playing card games, bingo, gardening, cross word puzzles and going on walks. Fire clearance: Fire Clearance approved by a fire inspector of Orange City Fire Department on August 19, 2024. Special conditions noted, "Fire clearance approved under the above noted conditions." Component III: Conducted at the Pre-Licensing visit, information provided about how to operate the facility within compliance and reporting requirements. LPA advised Applicant to use the general email address: CCLASCPOrangeCountyRO@dss.ca.gov for inquiries and to submit incident reports. The applicant has met all pre-licensing requirements. 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 by CAB in Sacramento. Exit interview was conducted and a copy of this report was left with the applicantthe state’s words, verbatim · CDSS document, Oct 2, 2024