Orangevale Garden Senior Care Home

Type of visit: Post Licensing

Licensing Program Analyst (LPA) Talwinder Bains arrived at the facility unannounced to conduct post licensing inspection. LPA met with Administrator Chiwen Hildebrandt and explained the purpose of the visit. LPA and administrator conducted a tour of the facility. Areas toured include but not limited to resident bedrooms, resident bathrooms, kitchen, backyard and common areas. LPA reviewed two (2) staff files and three (3) residents files. Staff files were complete. During today's visit, the following deficiencies were observed: Incomplete/Missing residents records in residents files Chemicals left open /accessible to residents in care Deficiencies were observed and cited per Title 22, CCR Regulations as listed on LIC 809-D. Civil penalties shall be assessed if facility does not comply with POC requirements which were issued today. Exit interview conducted. Copy of this report and appeal rights were provided.the state’s words, verbatim · CDSS document, Sep 9, 2026

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87309(a) · Plan of correction due date: Sep 10, 2026

87309- (a) Disinfectants, cleaning solutions, poisons, firearms and other items which could pose a danger if readily available to clients shall be stored where inaccessible to clients.....This requirement is not met as evidenced by: LPA observed that facility's staff left cabinet open in laundry area which has disinfectants, cleaning solutions and paint/chemicals left open in common room which were accessible to residents and poses a immediate health and safety risks to residents in care.the state’s words, verbatim · CDSS document, Sep 9, 2026

Plan of correction: The Licensee will send the letter of understanding of this regulation and will train staff regarding this regulation and will send training documents to CCL. POC due date - 9/10/26.

From the deficiency page — Deficiency type: Type B · Section cited: CCR87506(b) · Plan of correction due date: Sep 30, 2026

87506-(b) Each resident's record shall contain at least the following information: This requirement is not met as evidenced by: Based on records reviews, the licensee did not comply with the section cited above in residents files , R1,R2,R3 have missing/icomplete documents which poses a potential health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Sep 9, 2026

Plan of correction: The licensee shall compile and retain complete residents records for all residents that are accepted or retained in the facility per this Regulation. Send proof of correction of missing information in residents records by 9/30/26.

Type of visit: Prelicensing

On 12/17/25, Licensing Program Analyst (LPA) Talwinder Bains met with Applicant, Chiwen Hildebrandt to conduct a unannounced Pre- Licensing visit. The facility has a fire clearance for five (5) non-ambulatory/ambulatory for all bedrooms and one (1) bedridden resident for room #1 only as dated 11/19/25 . Facility has two (2) residents at this time. LPA conducted an inspection of the care home to ensure compliance with Title 22 regulations. LPA inspected 4 bedrooms for residents, 2 bathrooms, common area, family room, kitchen, laundry room ,garage and outdoor area. LPA observed facility to be properly furnished, including appropriate bedding and lighting in the facility . Bathrooms were in sanitary condition and properly maintained. LPA checked the kitchen area for the ability to prepare and store food. LPA observed cleaning products and other toxins to be locked away. LPA observed the area used for medications to be locked and inaccessible to residents. LPA observed smoke detectors and carbon monoxide detectors at the care home to be operational. Fire extinguisher and first aid kit are maintained and ready for emergency use. Water temperature was observed at 112 degrees F. A working telephone has been set up for residents use. Facility has completed all pending items as discussed during 12/02/25 Pre-licensing visit and there were no concerns noted during today's visit for those areas. Pre-licensing passed and Component III (RCFE) was completed during this visit. Facility has satisfied all requirements in accordance to Title 22, California Code of Regulations. Application is pending and LPA will forward findings to the Centralized Application Bureau (CAB) for final review and approval. CAB will further contact applicant on final status of application. A copy of this report was provided to the facility. Exit interview conducted.the state’s words, verbatim · CDSS document, Dec 17, 2025

Type of visit: Prelicensing

On 12/02/25, Licensing Program Analyst (LPA) Talwinder Bains arrived at the facility to conduct pre-licensing inspection . LPA met with applicant, Chiwen Hildebrandt and explained the purpose of the visit. The applicant will complete following items in order to complete the pre-licensing visit; Please have all required posters placed in a conspicuous place. Required posters include Rights of Resident Councils; Bill of Rights and Personal Rights; Complaint Poster and Ombudsman's poster. Facility shall lock all areas where chemicals, sharp objects will be stored so it will be inaccessible to residents. Medications closet will be locked and inaccessible to residents. Facility will comply with required fire and disaster drills per requirement. Facility will ensure that all residents rooms have required furniture per requirements. Several topics were discussed during this visit. The license is not being approved this date due to these pending items. Applicant was advised to review Title 22 Regulations to ensure that facility will be ready for pre-licensing visit for future date. No deficiencies are being cited as a result of the inspection. Technical assistance was provided. LPA will contact Centralized Applications with a current status update and also once the follow-up inspection has been completed. LPA will continue the pre-licensing inspection at another date. Exit interview was conducted. A copy of the report was provided to applicant.the state’s words, verbatim · CDSS document, Dec 2, 2025

The state marks this report as 4 pages; the online copy we transcribed has 2. You can request the full file from the county licensing office.

Type of visit: Office

Facility Type: RCFE Application Type: INITIAL Capacity: 6 Census (if any clients in care): 0 Method: Telephone call with CAB COMP II Participants: Hildebrandt, Chiwen On 11/21/2025, the applicant/administrator participated in COMP II at CAB via telephone call with analyst at CAB. Identification of the applicant and administrator was verified by confirming driver’s license number. During COMP II, applicant and administrator confirmed the understanding of Title 22. Component II was successfully completed. Applicant and administrator were advised to email/fax signed LIC 809 with copy of photo ID to CAB. During COMP II, CAB analyst confirmed Applicant/Administrator’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, Nov 21, 2025