Saddleback Fmj III Elderly Care Home

Type of visit: Required - 1 Year

On today's date January 27, 2026 Licensing Program Analyst (LPA) Brandon William Vanegas made an unannounced visit to conduct the required annual inspection. LPA was greeted and granted entry by caregiver staff and explained the purpose for the visit. Administrator (AD) Maria Jimenez was notified via telephone and later arrived to assist with the inspection. LPA observed that Administrator Maria Jimenez has a valid Administrator certificate which expires on April 20, 2027. LPA Vanegas began a tour of the facility and observed the following, the facility is a two story home, and consists of six bedrooms three of which are resident bedrooms, and three of which are staff bedrooms, two resident bathrooms, a living room, a dining room, a kitchen, and an attached two car garage. The upstairs portion of the facility is designated for staff only. LPA accompanied by the AD conducted a tour of the physical plant. On today's visit, LPA observed six residents in care and two caregiver staff present. LPA observed the See Something, Say Something poster (PUB 475) mounted on a wall by the kitchen. The PUB 475 poster measured 20X26. LPA inspected the three 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 with clean linens in good repair; meaning no strains or tares, a chair, a chest of drawers, a reading lamp, and enough storage space to store personal belongings. LPA observed additional linens are stored in a hallway closet. LPA inspected the two shared bathrooms. Resident bathrooms are clean and free of mildew and debris. Bathrooms are equipped with grab bars and slip resistant floor mats. Water faucets and toilets tested operational. Hot water temperature measured between 110.3 and 116.4 degrees Fahrenheit. LPA inspected the staff bedroom which was observed to be locked. CONTINUED ON LIC809-C LPA Vanegas observed kitchen area to be clean and free of any mildew and debris. LPA observed a gas stove, microwave, refrigerator, dishwasher, washer, and dryer to all be in good repair, and tested operational. LPA Vanegas observed refrigerator to be at the appropriate temperature, and have a two day supply of perishable food and a seven day supply of non-perishable food. LPA Vanegas observed fire extinguisher in the kitchen area to be fully charged and recently purchased with receipt attached to it with a purchase date of November 25, 2025. LPA observed all smoke and carbon monoxide detectors to be operational. LPA Vanegas observed first aid kit to have all required items such as a thermometer, bandages, adhesive tape, scissors, tweezers, and a first aid manual. LPA reviewed six resident files, all six files were missing a weight record. Per LPA review of facility staff records three staff members had an expired CPR/First aid certification deficiencies were issued on today's date. taff had required annual training up to date and documents. LPA reviewed medication administration log and medications accompanied by AD, per LPA review all medications are being administered per physicians orders. LPA Vanegas conducted a tour of the outside of the facility, and observed the following. The backyard is free of any hazards or obstructions a long the exit routes. LPA observed a fully fenced pool with the fence measuring 5ft tall and bars 4 inches apart from one another. Side doors are self latching and unlocked. Based on observations made during today's inspection deficiencies will be issued. LPA Vanegas conducted an exit interview with AD Maria Jiminez and a copy of this report was provided to the facility.the state’s words, verbatim · CDSS document, Jan 27, 2026

Type of visit: Case Management - Deficiencies

Licensing Program Analyst (LPA) Brandon Lopez made an unannounced visit to the facility for the purpose of following up on a plan of correction for a deficiency cited during the annual visit conducted on 1/15/2025. LPA was greeted and granted entry by care giving staff and explained the purpose of the visit. Administrator (AD) Maria Jimenez was notified via telephone but was not available to assist with the inspection. During the annual inspection completed on 1/15/2025, LPA observed a pipe, construction materials, and two buckets left unattended by the outdoor covered patio. LPA observed a ladder left unattended by the shed. LPA also observed boxes of trash, a vacuum, a bucket, and concrete blocks on the side south of the exterior portion of the facility. On today’s visit, LPA observed that the pipe, the construction materials, and the two buckets that were observed by the outdoor covered patio had been removed. LPA observed that the ladder had been removed and is now stored in the locked two car garage. LPA observed that the boxes of trash, the vacuum, the bucket, and the concrete blocks that were observed on the side south of the facility had been removed. LPA observed that all obstructions and hazards that were observed on the annual inspection completed on 1/15/2025 have been removed. The plan of correction for the deficiency was cleared during today's visit. An exit interview was conducted with Caregiver staff Rosa Hernandez. Administrator Maria Jimenez notified LPA via telephone that Caregiver staff Rosa Hernandez was authorized to sign the report. A copy of this report, along with the plan of correction clearance letter was provided.the state’s words, verbatim · CDSS document, Feb 6, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Brandon Lopez and Licensing Program Manager (LPM) Sheila Santos made an unannounced visit to conduct the required annual inspection. LPA was greeted and granted entry by caregiver staff after explaining the purpose for the visit. Administrator (AD) Maria Jimenez was notified via telephone and later arrived to assist with the inspection. LPA observed that Administrator Maria Jimenez has a valid Administrator certificate which expires on April 20, 2025. The facility is a Residential Care Facility for the Elderly (RCFE) licensed for six non-ambulatory residents with a hospice waiver for two. The facility is a two story home with three resident bedrooms, two staff bedrooms, two resident bathrooms, a living room, a dining room, a kitchen, and an attached two car garage. The upstairs portion of the facility is designated for staff only. LPA and LPM, accompanied by the caregiver staff conducted a tour of the physical plant. On today's visit, LPA observed four residents in care and three caregiver staff present. LPA observed the See Something, Say Something poster (PUB 475) mounted on a wall by the kitchen. The PUB 475 poster measured 9 by 14 inches. LPA inspected the three resident bedrooms and they were observed to be free of any hazards. LPA observed the resident bedrooms had the required furnishings of a bed, a chair, a chest of drawers, and a lamp. Resident linens and blankets were clean. LPA observed additional linens are stored in a hallway closet. LPA inspected the two shared bathrooms. Resident bathrooms are clean. Bathrooms are equipped with grab bars and non skid floor mats. LPA observed that three toxins were stored in an unlocked cabinet in resident bathroom one. LPA observed that one toxin was located in an unlocked cabinet in resident bathroom two. Caregiver staff immediately removed the chemicals and locked it. Hot water temperature measured between 108.1 and 108.9 degrees Fahrenheit. LPA inspected the staff bedroom which was observed to be locked. LPA observed the upstairs staff bathroom to be unlocked. LPA observed six chemical products that were observed to be stored in the staff bathroom. Caregiver staff immediately removed the chemicals and locked it in the staff bedroom. CONTINUED ON LIC809-C LPA observed the kitchen has a two day perishable and seven day non perishable food supply on hand. LPA observed kitchen knives are stored in a locked kitchen cabinet. LPA observed cleaning supplies are stored in a locked kitchen cabinet under the sink. LPA observed that three out of the five burners on the gas stove are not in operation. A fire extinguisher is located in a hallway by the kitchen and it was observed the be charged but does not have a maintenance tag. LPA tested the individual smoke detectors/carbon monoxide detectors which tested operational. The centrally stored medication is kept in a locked cabinet by the kitchen. LPA observed the First Aid kit has all the required components but facility does not have a First Aid manual. The door leading to the attached garage was unlocked at the time of visit. The garage is used for storage and laundry. LPA observed chemicals and toxins to be stored in the garage. LPA observed the facility has an emergency food and water supply stored in the garage. LPA and LPM, accompanied by caregiver staff conducted a tour of the exterior portion of the facility. LPA observed one pipe, construction materials, three buckets, two trash boxes, and concrete blocks left unattended that may pose a safety issue. LPA observed one ladder was left unattended by the shed. Caregiver staff immediately removed the ladder and locked it in the garage. LPA observed a shaded seating area with furniture for resident use. There is a pool located in the exterior of the facility. The pool is inaccessible to residents and observed to be adequately fenced. LPA reviewed the four resident files. All the required documentation were present and current in the resident files reviewed. LPA reviewed four residents medication and medication records. LPA reviewed three staff files. LPA observed that Staff #2 (S2) and Staff #3 (S3) are not associated to the facility. Civil penalties assessed. LPA observed that the facility does not have any record of an emergency disaster drill in the last quarter. LPA observed the facility does not currently have liability insurance. Based on today's observations, the facility is being cited per Title 22 of the California Code of Regulations. An exit interview was conducted with Administrator Maria Jimenez. A copy of the report was explained and Appeal Rights were provided.the state’s words, verbatim · CDSS document, Jan 15, 2025

The state marks this report as 7 pages; the online copy we transcribed has 5. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Celine De Perio conducted an unannounced visit for the Required 1 Year Inspection. LPA was greeted and granted entry by staff on duty. LPA met with facility administrator (AD) Maria Jimenez and explained the purpose of today's visit. For today’s visit, LPA observed a total of 5 residents in care of which 0 are on hospice and 0 are bedridden and 3 staff members on duty. LPA observed the Administrator's Certificate for facility administrators Jose Jimenez which expires on 02/22/2024, and Maria Jimenez which expired on 04/20/2021, however, provided proof to LPA that renewal fee, and application was submitted on 01/20/2022, and renewal certificate is pending. The PUB475 "See Something, Say Something" poster was also observed to be posted in the kitchen. LPA toured the interior and exterior portions of the facility with AD Jimenez. The facility is a two level structure and is licensed for 6 non-ambulatory residents, of which 2 may be on hospice and 0 bedridden. There are a total of 5 bedrooms, of which the 3 downstairs bedrooms are for residents, and the 2 bedrooms located on the upper level, is designated for staff only. LPA observed that there are no residents residing on the upper level of the facility. LPA toured each bedroom in the facility and observed that bedrooms were provided with furniture in good repair, clean linens, adequate storage space, and kept free of tripping hazards. Smoke and carbon monoxide detector and auditory exit alarms were tested and operational. There are a total of 3 restrooms of which 1 is for staff and 2 are for residents. Restrooms were observed to be in good repair, toilets were operational, and grab bars and non-skid floor mats were provided. Water temperature in restrooms were measured to be at 109.9 degrees Fahrenheit. Facility met the minimum two-day perishable and seven-day non-perishable food supplies. Sharp items and knives were locked and inaccessible to residents in care. Fire extinguisher was charged, mounted and located in the kitchen. LPA observed the emergency disaster and evacuation plan, which is posted at the entrance of the facility. Facility had back-up emergency food and water supply, located in the garage. LPA observed that First Aid Kit had all the required components. LPA observed that medications and toxins were locked and inaccessible to residents in care. For the exterior portion, LPA observed patio furniture under shading, and the grounds were free of any hazards. LPA De Perio observed that the facility has a pool, and is made inaccessible to residents in care through a locked gate. For today's visit no deficiencies were issued per Title 22 Division 6 of the California Code of Regulations. No citations were issued. An exit interview was conducted with AD Jimenez. A copy of this report was provided and explained.the state’s words, verbatim · CDSS document, Jan 24, 2024