Orange Grove Senior Living

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Cynthia Tamayo arrived unannounced to conduct an annual inspection. LPA met with facility administrator Christine Torres (S1) and Teresa Autencio (S2) and explained the purpose of the visit. The facility is licensed for age range 60 and over with clearance for 3 ambulatory and 3 non-ambulatory residents. The administrator certificate for S1 is current (#7012851740) and will expire 10/23/2026. The current census was six residents and three staff LPA toured the physical plant was conducted with S1 to ensure residents’ health and safety and the facility is in compliance with Title 22 regulations. The following was observed: LPA toured the facility with Torres and inspected common areas, the kitchen, bedrooms, bathrooms, and backyard areas with S2. Furniture and furnishings were sufficient to meet the needs of six residents in care. The facility temperature was 75 degrees Fahrenheit, which is within the required range of 68 and 85 degrees. The facility's water temperature measured 113 degrees Fahrenheit, which is within the required range of 105 and 120 degrees. LPA observed three light fixtures needed light bulb replacement in two resident bedrooms, licensee stated they will replace all bulbs once they are need of replacement. LPA observed first aid supplies, a fully-charged and up-to-date fire extinguisher, and working carbon monoxide/smoke detectors. LPA observed a minimum 2-day supply of perishable food and a minimum 7-day supply of nonperishable food. LPA observed a locked cabinet for the storage of medication. LPA observed medications requiring refrigeration are stored in a locked lock box stored on top shelf of the refrigerator. LPA observed locking cabinets for the storage of cleaning solutions and knives. Outdoor activity areas that are easily accessible to residents, protected from traffic, and have adequate shady areas. Continued on 809-C LPA reviewed five resident files (R1-R5) and two staff files (S1-S2). LPA provided Licensee with LIC 311, licensee will ensure all required records are in resident/staff files are signed and dated. The following documents were collected by LPA Tamayo and will be added to the facility file: (1) LIC 610 Current Emergency Disaster Plan (2) Proof of Current Liability Insurance (3) LIC 500 Current Personnel Report (4) Administrator Certificate The following documents were requested to be submitted to LPA Tamayo by 11/4/25 at 5:00PM to cynthia.tamayo@dss.ca.gov: (1) LIC 309 Administrator Organization (2) LIC 308 Designation of Administrative Responsibility As a result of this annual visit, the facility is in compliance with Title 22 Regulation. An exit interview was conducted with S1, and a copy of these LIC 809 reports were provided to the facility.the state’s words, verbatim · CDSS document, Oct 29, 2025

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 Analysts (LPAs) Vincent Moleski and Holly Williams arrived unannounced to conduct an annual inspection. LPA Moleski and Williams met with facility administrator Christine Torres and explained the purpose of the visit. LPAs Moleski and Williams reviewed five resident files (R1-R5) and two staff files (S1-S2). LPAs Moleski and Williams toured the facility with Torres and inspected common areas, the kitchen, bedrooms, bathrooms, and backyard areas. Furniture and furnishings were sufficient to meet the needs of residents. The facility temperature was 75 degrees Fahrenheit, which is within the required range of 68 and 85 degrees. The facility's water temperature measured 107.7 degrees Fahrenheit, which is within the required range of 105 and 120 degrees. LPAs Moleski and Williams observed first aid supplies, a fully-charged and up-to-date fire extinguisher, and working carbon monoxide/smoke detectors. LPAs Moleski and Williams observed a minimum 2-day supply of perishable food and a minimum 7-day supply of nonperishable food. LPAs Moleski and Williams observed a locked cabinet for the storage of medication. LPAs Moleski and Williams observed insulin needles in the refrigerator in boxes on top of a safe. Additionally, the safe, which contained more medications, was closed but it opened freely because the licensee did not scramble the lock. LPAs Moleski and Williams observed locking cabinets for the storage of cleaning solutions and knives. LPAs Moleski and Williams interviewed one staff member (S1) and three residents (R3, R5-R6). This facility is being cited per 22 CCR Section 87465(h)(2). An exit interview was held with Torres. Appeal rights and a copy of this report was emailed to Torres.the state’s words, verbatim · CDSS document, Sep 30, 2024

Type of visit: POC

Licensing Program Analysts (LPA) Pang Lee arrived at the facility on 11/02/2023 at 8:05 AM to conduct an unannounced Plan of Correction (POC) visit. LPA Lee met with direct care staff, Teresa Autencio and explained the purpose of the visit. The purpose of this visit is to follow-up on a plan of corrections that was due on 10/23//2023. During today's visit, LPA Lee reviewed residents and staff files to ensure all deficiencies previously cited have been corrected. Based upon this inspection, the LPAs observed the following: I. Deficiency cited under Title 22 Regulation 87412(a) has been cleared. The Licensee complied with the terms of the POC by POC due date 10/23/2023. A POC letter was generated and provided to the licensee. 2. Deficiency cited under Title 22 Regulation 87506(a) has been cleared. The licensee complied with the terms of the POC by POC due date 10/23/2023. A POC letter was generated and provided to the licensee. An exit interview was held, and a copy of this report, LIC 809, was given to the facility at the end of the visit.the state’s words, verbatim · CDSS document, Nov 2, 2023