Orangewood Guest Home

Type of visit: Required - 1 Year

On today's date Licensing Program Analyst (LPA) William Vanegas made an unannounced visit for the purpose of conducting the required annual inspection. LPA was greeted and granted entry by Care Giver (CG) Remedios Baculong after explaining the purpose for the visit. Administrator (AD) Mindy Fajardo was notified via telephone, and arrived shortly after to assist with the inspection. LPA observed that Administrator (AD) Mindy Fajardo has a valid Administrator certificate which expires May 22, 2027. LPA Vanegas began a tour of the facility and the facility consist of the following. It is a single story house with four bedrooms, one of which is a staff bedroom, two bathrooms one of which is a staff and guest bathroom, the other is for resident use only, a living room, a dining room, a kitchen, a laundry room, and an attached two car garage. LPA Vanegas observed one resident in care, lounging in the respective common areas, and in their room. LPA Vanegas observed the kitchen area to be clean and free of any mildew and debris. LPA Vanegas observed sharp utensils to be locked away and inaccessible to residents in care. LPA Vanegas observed the refrigerator, gas stove, microwave and dishwasher all to test operational. LPA Vanegas observed a two day supply of perishable food, and a seven day supply of non-perishable food. LPA observed the See Something, Say Something poster (PUB 475) mounted on a wall by the entryway of the facility. LPA inspected all five resident bedrooms, and they were observed to be free of any hazards. LPA observed the resident bedrooms had the required furnishings such as a bed, a chair, chest of drawers, and a reading lamp. All resident beds had clean linens in good repair; meaning no strains or tares. LPA observed additional linens are stored in a hallway closet. LPA inspected both bathrooms. Resident bathrooms are clean. Bathrooms are equipped with grab bars, slip resistant floor mats, and a shower chair. Faucets and toilets were operational. Hot water temperature measured between 108.5 and 111.5 degrees Fahrenheit. CONTINUED ON LIC809C LPA Vanegas observed the outside of the facility to be clean and free of any obstructions blocking the emergency exits. LPA Vanegas observed for the backyard of the facility to be large enough to participate in outdoor activities upon resident request. LPA Vanegas observed an outdoor shaded sitting area, and enough activities to participate in upon resident request. LPA Vanegas observed all smoke detectors and carbon monoxide detectors to test operational. LPA Vanegas observed all fire extinguishers to be fully charged, and up to date. LPA Vanegas reviewed P&I with AD Mindy Fajardo all balances were up to date and documented accurately. LPA Vanegas reviewed five resident files, and five staff files. All files (Staff and Resident) had all required documents, staff training was up to date and documented. LPA Vanegas reviewed medications with AD Mindy, per LPA Vanegas review all medications are being administered per physicians orders, and are being documented accurately by facility staff. Based on the observations made during today's visit, no deficiencies are being cited per Title 22 of the California Code of Regulations. An exit interview was conducted with AD Mindy Fajardo and a copy of the report was provided to facility, additionally a copy of this report will be mailed to the facility as well.the state’s words, verbatim · CDSS document, Jan 16, 2026

Allegation investigated: Staff yelled at client Staff attempted to hit a client

Licensing Program Analyst (LPA) Rose Ruppert made an unannounced visit to deliver findings for a complaint received in our Regional Office on February 6, 2025. LPA was greeted and granted entry and explained the purpose of the visit. LPA met with both Administrators, Melissa Carbajal and Mindy Fajardo. A report was filed with our office where a vendor witnessed a facility staff member, who yelled at the client and attempted to hit the client. On February 5, 2025, at 7:50am, the client was being picked up for Day Program when the incident occurred. Based on LPA interviews with the eyewitness and two of two staff present in facility at time of incident, Staff #1 (S1) had reached for the client’s backpack and the client grabbed S1’s hand. Client is non-verbal and indicated she wanted the backpack on her back. S1 raised her voice to the client to, “Let go” and client complied. According to the two of two staff members and eyewitness, the incident was brief. The staff member, S1, then placed the back pack on client’s shoulders and the client left for Day Program. (Continued on LIC 9099-C) Unsubstantiated (Continued from LIC 9099) LPA interviewed four of four staff; including S1, the staff member directly involved, who all denied the allegations. LPA spoke with two clients, one involved in the incident, who is non-verbal, and the other, a verbal client. The verbal client stated the staff member does not yell at them and has never tried to hit residents. LPA engaged with the non-verbal client who smiled at LPA. LPA observed client to be oriented to time and place and used body language, such as hand gestures and nodding. Client understands questions asked by LPA and staff. When asked about staff member, S1, LPA observed the client to be relaxed, nodding head up and down and smiling. Documents obtained and reviewed include the Client’s: Identification and Emergency Information, Physician’s Report and Appraisal/ Needs and Services Plan. Additional documents obtained include the Register of Facility Clients and the facility sign-in/sign-out sheet; signed by the vendor on the day of the incident. Upon file review client is prone to have aggressive incidents per Individual Program Plan (IPP) dated February 24, 2024. LPA reviewed Staff #1’s file and there were no disciplinary actions on record. S1's staff training included Elder Abuse and mandated reporting from July 7, 2024. Two staff members were interviewed from the Day Program, who reported the allegations. The eyewitness stated the yelling, by S1, was not shouting, but a raised voice. The eyewitness stated S1 moved her hand from side-to-side, as if to swat the client’s hands. Eyewitness stated staff member raised her hand to client’s face and, again, moved her hand from side-to-side. No contact was made. Eyewitness stated S1 spoke to client, “Like a parent addressing a toddler” which witness felt was not professional. LPA spoke with the Regional Center of Orange County (RCOC) Quality Assurance Coordinator (QAC), who had also visited the facility on February 11, 2025. The RCOC QAC’s findings were inconclusive. A 9102-TV has been issued to request staff training on recognizing and mitigating client behaviors, as well as documenting behavioral incidents in client’s file. Although the above allegations may have happened there is not a preponderance of evidence to prove the alleged violations occurred; therefore, the allegations that: staff yelled at client and that staff attempted to hit client is unsubstantiated. An exit interview was conducted with Melissa Carbajal and Mindy Fajardo, Administrators, and a copy of this report and LIC 9102-TV was provided to the facility.the state’s words, verbatim · CDSS document, Feb 20, 2025 · control 22-AS-20250206160830

Type of visit: Case Management - Annual Continuation

On 01/08/2025 Licensing Program Analyst (LPA) William Vanegas made an unannounced visit to complete the annual visit that was started on 12/26/2024. Upon arrival LPA Vanegas was greeted and granted entry to the facility by Care Giver (CG) Ruben Carbajal. LPA Vanegas began to observe resident rooms and observed the following. All resident rooms are clean and sanitary, and have enough space to accommodate enough storage space and space to move freely throughout the rooms. LPA Vanegas observed all resident rooms to have the required furnishings such as a night stand, chest drawer, lamp, chairs, enough closet space to store personal belongings, and a bed with linens that are in good repair meaning no strains or tears. LPA Vanegas reviewed PNI with administrator Melissa Carbajal and everything added up to the correct balance that was documented. LPA Vanegas reviewed two staff files and five client files all staff files had the required documentation and required training. LPA Vanegas observed all client files to have the paperwork that is required and up to date documents were recorded. LPA Vanegas reviewed medications and per LPA Vanegas review medications are being centrally stored, locked and inaccessible to clients in care. Per LPA Vanegas review medications are being administered per physicians orders. LPA Vanegas interviewed one client and one staff member. LPA Vanegas observed first aid kit to have all required equipment such as bandages, adhesive tape, scissors, a thermometer, and tweezers. Based on the observations made during today’s inspection, deficiencies are not being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted, and a copy of this report was left at the facility.the state’s words, verbatim · CDSS document, Jan 8, 2025

Type of visit: Required - 1 Year

On 12/26/2024 Licensing Program Analyst (LPA) William Vanegas made and unannounced visit for the purposes of conducting an annual visit. Upon arrival LPA Vanegas was greeted and granted entrance by caregiver (CG) Ruben Carbajel. LPA Vanegas set up equipment and conducting a tour of the facility and observed the following. This is a one storied home that has four bedrooms, three of which are resident rooms and one staff room. This home has two bathrooms, one of which is a staff bathroom and another that is a resident bathroom. LPA observed kitchen area to be clean and free of debris. LPA observed a microwave, gas stove, and dish washer in kitchen all were tested and tested operational. LPA observed a washer and dryer to be operational. All toxins and detergents are locked away and out of resident reach. LPA Observed smoke detectors and carbon monoxide detectors to be operational. Fire Extinguishers were observed to be up to date and fully charged. LPA observed resident and staff bathrooms to be clean and free of mildew and debris. Water temperature tested from 114.6-116.8 Degrees F. Resident restrooms were observed to have grab bars and slip resistant matts. Water faucet and toilets were observed to be operational. LPA Vanegas observed the backyard of the facility to have a seated shading area with enough space to participate in outdoor activities. Emergency pathways were free of any obstructions, and side doors were observed to be unlocked. LPA Vanegas observed there to be a two day supply of perishable food and a seven day supply of non-persihable food and a sufficient amount of emergency water on hand for residents. LPA Vanegas advised that due to time constraints LPA would need to return to complete the annual visit. No deficiency's were cited on today's date. An exit interview was conducted and a copy of this report was left at the facilitythe state’s words, verbatim · CDSS document, Dec 26, 2024

Allegation investigated: Resident was hit by a facility staff.

Licensing Program Analyst (LPA) Jerome Haley made unannounced visit to investigation a complaint received July 31, 2024. LPA Haley was greeted by staff and explained the reason for the visit before entering the facility. The complaint investigation consisted of interviews with facility staff, residents, witnesses, and document review. Regarding the allegation: Resident was hit by a facility staff. 5 of 8 individuals interviewed denied the complaint allegation above. During interview with multiple individuals, it was revealed Resident 1 (R1) has a history making false statements and having emotional outburst. Staff 1 (S1) explained R1 has outburst at the day program and has had outburst with the bus driver as well. S1 provided progress notes for R1 that document several of R1’s outburst. During an interview with Resident 2 (R2), the resident explained they get along with R1, and mentioned R1 yells and screams sometimes. Continued on LIC9099C Unsubstantiated During an interview with Witness 1 (W1) it was revealed R1's behaviors are well documented and W1 has had discussions with the facility as well as R1's day program regarding these behaviors. A review of R1’s Individualized Program Plan (IPP) dated January 11, 2024, list challenging behaviors for R1 including disruptive social behavior, self-injurious behavior, emotional outburst, and special conditions or behaviors that include assaultive behaviors that could have resulted in serious bodily injury or death. Based on the information gathered during the investigation through interviews, the Department is unable to ascertain if the allegation occurred as reported. Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove or refute the alleged violation occurred; therefore, the allegation is deemed Unsubstantiated. An exit interview was conducted, and a copy of this report was provided..the state’s words, verbatim · CDSS document, Aug 8, 2024 · control 22-AS-20240731162025

Allegation investigated: Facility staff did not ensure resident's food was protected against vermin.

Licensing Program Analyst (LPA) Jerome Haley made unannounced visit to start the investigation for a complaint received May 17, 2024. LPA Haley was greeted by staff and explained the reason for the visit. The complaint investigation consisted of interviews with facility staff, witnesses, and observations made during the complaint visit. Regarding the allegation: Facility staff did not ensure resident's food was protected against vermin. 3 of 5 individuals interviewed support the complaint allegation above. During an interview with Witness 2 (W2), the witness denied there’s a problem with vermin in the facility and said the facility is always clean. Witness 3 (W3) said the facility is sparkling clean and you can see your reflection on the floor. During the visit, LPA visually inspected the facility, made several observations, and closely examined the cleanliness of the physical plant. During the inspection LPA Haley observed Client 1’s (C1) lunch box, lunch bag(s), and observed how clients’ lunches are prepared and packed. During the inspection several photos were taken. Continued on LIC9099C Unsubstantiated Based on the information gathered during the investigation through interviews and observations, the Department is unable to ascertain if the allegation occurred as reported. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove or refute the alleged violations occurred; therefore, the allegations is deemed Unsubstantiated.the state’s words, verbatim · CDSS document, May 22, 2024 · control 22-AS-20240517084014

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Dwayne Mason Jr. arrived at Orangewood Guest Home to conduct an unannounced Required 1 Year Inspection. LPA arrived at the facility at 8:30am, LPA was greeted and granted entry by Administrator (AD) Melissa Carbajal. The facility is a one-story home with three resident bedrooms, two bathrooms, living room, kitchen, dining room, backyard, one staff bedroom, one office and an attached one car garage. There are two exit gates on either side of the house. There is one shaded seating area in the backyard. LPA did not observe any hazards or obstacles in back yard. All resident bedrooms had the required furnishings. LPA observed all resident beds had linens and blankets. LPA observed all windows were screened. All and any toxic chemicals, cleaning solutions, laundry toxins and disinfectants are inaccessible to clients and will be stored and locked in cabinets in the kitchen and laundry room. Medication and Files are stored in a locked cabinet in the dining room. First aid kit is locked in a hallway cabinet. LPA reviewed two out of four client files and medication. LPA reviewed three staff files. The clients were away at day program or appointments. The two fire extinguishers are fully charged as indicated by the arrow pointing in the green zone. LPA observed service tags to indicate the extinguisher was last serviced on 10/10/23. The facility has books, puzzles, exercise equipment and electronics for activity use. The facility also conducts group outings each weekend. All bathrooms have working plumbing and designated hand washing posters. Hot water measured at 108.5 degrees Fahrenheit in the hallway bathroom, 107 degrees Fahrenheit in the bathroom inside bedroom 3. A supply of extra linen and hygiene supplies was stored in the hallway cabinets and garage. Emergency Phone Numbers, Exit Plan & Menu are posted and available for review. There is a 2-day supply of perishable food and 7-day supply of non-perishable food on hand. Smoke detectors and carbon monoxide detector tested operational. Stove with gas burners, oven, refrigerators, dish washer, microwave, washer and dryer are operational. Based on the observations made during today's visit, no deficiencies are being cited as per Title 22 Division 6 Chapter 2 of the California Code of Regulations. An exit interview was conducted with Administrator Melissa Carbajal, and a copy of this report was provided.the state’s words, verbatim · CDSS document, Oct 11, 2023