Saddleback FMJ II Elderly Care Home

Type of visit: Required - 1 Year

On this day Licensing Program Analyst (LPA) Fred Arias made an unannounced visit to conduct a required annual visit. LPA was greeted and granted entry into the facility by staff and explained the reason for the visit. Facility is licensed for five non-ambulatory residents. Facility has an approved hospice waiver for four residents and the home currently has four residents, with no residents on hospice. Administrator (AD) Jose Jimenez arrived shortly to conduct facility tour. LPA along with AD toured the facility at 1:33 PM. LPA toured the physical plant, checked food service, and facility documentation. The two story home consists of three resident bedrooms, living room, dining room, kitchen, and two bathrooms and an attached garage on the first floor. The second floor consists of three bedrooms and a bathroom. No residents reside on the second floor. Resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. Resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure and shower was free of mold/mildew. Water temperature measured between 111.9 degrees F and 113.3 degrees F in all bathrooms. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked. Common areas were clean and clear of hazards. Auditory exit alarms were operational during today's visit. LPA toured the kitchen. Perishable and non-perishable food supply was checked and adequately stocked at time of visit. Kitchen appliances were operational during today's visit. Smoke detectors tested operational during today's visit. LPA reviewed the infection control and emergency disaster plans. Facility conducts quarterly emergency drills with the last drill conducted on 3/1/2026. Outside grounds were toured. There is shaded outdoor seating for residents. Exit gate is unlocked and operational. LPA observed the emergency food supply. First aid kit contained all required items including tweezers, scissors and thermometer. Facility conducts activities in the form of exercise and outings. LPA reviewed four resident files and two staff files. Resident files contained required documentation including admission agreements, physician reports, and TB testing. One out of four resident physician's report indicated Resident 4 (R4) is bedridden. Facility not licensed for bedridden residents. Staff files reviewed contained required documentation including required annual training, medical assessment/ TB, criminal record clearance and proof of CPR training. LPA reviewed medication storage and administration. Medications are stored in a locked cabinet. Medications are being administered per physician order. Based on the observations made during today’s visit, a deficiency is being cited per Title 22 Division 6 of the California Code of Regulations. This report was discussed with the facility representative and a copy was provided along with appeal rights.the state’s words, verbatim · CDSS document, Jun 23, 2026

The state marks this report as 7 pages; the online copy we transcribed has 4. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Jessica Cho arrived at the facility unannounced for the purpose of conducting the Required 1-Year annual evaluation using the CARE Inspection Tool. LPA was greeted and granted entry by Caregiver Clemencia Vaszquez followed by Administrator (Admin) Jose Jimenez after stating the reason for the visit. The administrator's certificate for Jose Jimenez expires on January 27, 2025. The following was observed during the inspection: This is a two story property located in a residential neighborhood. Facility operates within the conditions and limitations specified on the license. LPA observed three residents in care with no residents receiving hospice service. LPA observed two caregivers on duty and verified fingerprint clearance and association statuses. All common areas were inspected including the attached two car garage as well as the second floor which is occupied by the licensee which consists of three bedrooms and one bath. The first floor is designated for the residents which consists of three resident bedrooms and one and a half resident bathrooms. LPA observed the residents' bedrooms were appropriately furnished, beds and bedding supplies were in good condition, adequate lighting was provided, and sufficient storage space for each residents' personal belongings were observed. All bathrooms were found to be in compliance, clean, and operational. The hot water temperature measured at 106.1 and 106.5 degrees Fahrenheit in the resident bathrooms. Toxins, disinfectants, sharps, and medications were secured and inaccessible. LPA observed sufficient two-day supply of perishables and seven-day supply of non-perishable food. LPA toured the exterior portion of the facility. LPA observed the outdoor passageway is free of obstruction. The exit gate was operational and there were sufficient seating and shading. The fire extinguisher was mounted, charged, and serviced on January 27, 2025. The auditory devices and smoke/carbon monoxide detectors were tested and operational on both floors. LPA observed the emergency food/water and supplies centrally stored in the closet. Emergency drills were conducted quarterly accounting various emergency scenarios with the the last date on June 1, 2025. LPA observed the required 'See Something, Say Something' (PUB475) poster posted in the correct size in the entry way. LPA interviewed two out of three residents, audited three residents' files, and two personnel files in which no discrepancies were found. Medications were audited for three out of three residents. No discrepancies found. Based on the observations made during today's visit, no deficiency is being cited. An exit interview was conducted with Administrator Jose Jimenez, and a copy of this report was provided at exit.the state’s words, verbatim · CDSS document, Sep 16, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Jessica Cho arrived at the facility unannounced for the purpose of conducting the Required 1 Year Inspection. LPA Cho was greeted and granted entry by Caregiver Clemenciaa Ayala Vasquez followed by a second Caregiver in training, Zindy Carolina Pena Sarabia. Administrators (Admins) Jose and Maria Jimenez were not present as they were out of town. Admin Jose was advised of the visit by telephone at 9:33am. Facility Consultant Efrain Matheus arrived to assist with the inspection. The facility is a two-story structure located in a residential neighborhood. Facility is licensed to operate for five (5) non-ambulatory and maintains a hospice waiver of four (4). There is one (1) resident under hospice care during today's visit. LPA Cho toured the interior and exterior portions of the facility. There are a total of three resident bedrooms and two resident bathrooms on the first floor. The second floor is the residence of the Administrator's family. LPA observed the facility to be clean and sanitary. The resident rooms were provided with furniture in good repair, clean linens, adequate storage space, and kept free of of tripping hazards. Smoke/carbon monoxide detectors and auditory exit alarms were tested and operational. LPA observed bathrooms to be in good repair, provided with handrails and a non-skid floor mat. The hot water measured at 113.1 and 113.7 degrees Fahrenheit in the resident bathrooms. Facility met the two day perishable and seven day non-perishable food supply. LPA observed medications, toxins, and sharps were inaccessible to the residents in care. The fire extinguisher was purchased on 11/22/23. For the exterior portion, facility had sufficient seating and shading and the exit door was self-latching and self-closing. LPA observed the emergency disaster supplies including food/water in the garage. Facility did not maintain an emergency drill log. LPA observed the required "See Something, Say Something' (PUB475) posters. LPA conducted an audit of four residents' files and one staff file. LPA did not conduct a staff interview due staff being occupied. No resident interviews were conducted as residents were also occupied. Medications were audited for four residents. No discrepancies noted. LPA consulted the following: to ensure staff/volunteers/facility representative is fingerprint cleared and associated and to maintain a quarterly emergency drill log accounting for various emergency scenarios. Based on the observations made during today's visit, a deficiency is being cited as per Title 22 Division 6 Chapter 8 of the California Code of Regulations. An immediate civil penalty is being assessed. An Advisory Note (LIC9102) is being issued during the visit. An exit interview was conducted with Facility Consultant Efrain Matheus per the acknowledgement of Administrator Jose Jimenez, and a copy of this report including the LIC809C, LIC809D, LIC421BG, LIC811, and the appeal rights were provided during this visit.the state’s words, verbatim · CDSS document, Jun 17, 2024

The state marks this report as 4 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.