Seasons at Laguna - 3

Type of visit: Required - 1 Year

On May 8, 2026, Licensing Program Analyst (LPA) Garlli Tat conducted an unannounced visit to the facility for the purpose of a required annual inspection. LPA explained the purpose for the visit and was greeted and granted entry by staff on duty. During the visit, staff on duty contacted the facility administrator (AD) Maricel Guibilondo about the visit. For this visit, there are two staff members on duty, both of which are background cleared and associated. AD later arrived to assist with the inspection. The PUB475 ‘See Something, Say Something’ poster was observed to be located near the front entrance. LPA observed that Maricel Guibilondo has a pending renewal for Administrator certificate for April 30, 2026. The facility is a Residential Care facility for the Elderly (RCFE) licensed for six residents, six of which may be non-ambulatory, five of which may be bedridden, and a hospice waiver for five. LPA toured the interior and exterior portions of the facility with AD. For this visit, there are a total of four non-ambulatory residents in care, two of which are on hospice, and two are bedridden. The facility is a single story home. There are a total of seven bedrooms, six of which are private resident bedrooms, and one is a staff bedroom. LPA toured each bedroom with the AD and observed that bedrooms were provided with furniture in good repair, clean linens, adequate storage space, and free of any hazards. LPA observed the staff room is kept locked and inaccessible to residents in care. Smoke and carbon monoxide detectors as well as auditory exit alarms were tested and operational. There are a total of six bathrooms, five are for residents and one is for staff. Continued on LIC 809-C. Bathrooms were observed to be in good repair, toilets and faucets were operational and showers were equipped with grab bars and non-skid floor mats. Water temperature in the bathrooms were measured to be between 115.7 and 118.5 degrees Fahrenheit. Facility met the minimum two-day perishable and seven-day non-perishable food supplies. Sharp items and knives were locked in a kitchen cabinet and inaccessible to residents in care. Fire extinguisher was charged, mounted and located in the kitchen. Fire extinguisher was dated and tagged on September 15, 2025. LPA observed all the required postings in the front entrance. LPA observed the facility conducted their last emergency disaster drill on May 1, 2026. Facility had back-up emergency food and water supply, located in the kitchen and the garage. LPA observed that the First Aid kit had all the required components. Medications were observed to be locked in a medication room in the hallway, inaccessible to residents in care. Chemicals were observed to be locked underneath the kitchen sink. LPA observed the door leading to the attached two car garage is kept locked and inaccessible to residents in care. The garage is used for storage and laundry. For the exterior portion, LPA observed patio furniture under shading, and the grounds were free of any hazards or obstructions. There are two self-closing gates in the backyard that can be opened in case of an emergency. No bodies of water were observed. During this visit, six resident files and two staff files were reviewed. All staff are background cleared and associated with the facility. LPA reviewed residents’ medication and medication records and two resident interviews were conducted. Based on today's observations, there are no deficiencies being cited per Title 22 of the California Code of Regulations. An exit interview was conducted with the administrator. This report was reviewed with the administrator and a copy was provided at the end of the visit.the state’s words, verbatim · CDSS document, May 8, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Jessica Cho arrived unannounced for the purpose of conducting the Required 1-Year annual evaluation using the Care Inspection Tool. LPA was greeted and granted entry by Administrator/Caregiver Maricel Guibilondo and explained the reason for the visit. Administrator (Admin) Guibilondo holds a valid certificate expiring on November 12, 2025. The facility is a single story structure and is licensed to provide services for age range 60 and over for six non-ambulatory of which 5 may be bedridden. A waiver was granted to provide hospice services to five residents at one time. During today's visit, there are four residents under hospice care and two staff on duty. LPA toured the physical plant with Admin Guibilondo. Facility is clean and operational with the exception of the keypad lock on the garage door. LPA observed six resident bedrooms/bathrooms. There is one additional staff bedroom and bathroom. Resident bedrooms had all required furnishings. Bathrooms were found to be in compliance, clean, and operational. The hot water temperature measured at 118.4, 117.5, 119.8, 118.5, 120.0, and 119.6 degrees Fahrenheit in the resident bathrooms. All common areas were inspected including the attached two car garage. LPA reviewed the Emergency Disaster Plan (LIC610E) and observed sufficient emergency food and water in the garage and kitchen pantry, however not all disaster supplies were obtained as noted on the LIC610E. 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 available in the kitchen and garage. LPA toured the exterior portion of the facility. The outdoor passageway is free of obstruction. The exit gates were self-closing and self-latching. LPA observed sufficient seating and shading. The fire extinguisher was mounted and serviced on September 12, 2024. The auditory devices and dual functioning smoke/carbon monoxide detectors were tested and operational. One detector was removed in the hallway by the room of Resident #7 (R7). Emergency evacuation drills are not conducted quarterly. Last drill was conducted on February 1, 2024. The facility land line number, (949) 397-9099, was tested and remains available. The Complaint Poster, 'See Something, Say Something,' (PUB 475) was available in the correct size and posted in the entry way. LPA conducted a review of all residents and two staff files. Discrepancies observed in staff/resident files as the health screening for one staff and Tuberculosis (TB) tests in one out of two staff and two out out of five residents were not completed, a doctor's order for the hospital bed and full bed rail for one hospice resident was not present at the time of the file review for Resident #6 (R6). No interviews were conducted as all residents were sleeping, and one staff interview was conducted. Medications were audited in three out of five residents. No discrepancies observed. The following items were addressed with the Admin: to repair the key padlock on the garage door, to reattach the smoke detector in the hallway by R7's bedroom, to amend the LIC610E and obtain disaster supplies noted on the plan, to obtain bed rail order for R6, to complete Health Screening (LIC503) and TB test for Staff #2 (S2) as well as R3 and R4. Based on the observations made during today's visit, deficiencies are being cited and Advisory Notes (LIC9102s) are also being issued. An exit interview was conducted with Administrator/Caregiver Maricel Guibilondo, and a copy of this report including the LIC809C, LIC809D, LIC9102s, LIC811s, and the appeal rights were provided at the end of the visit.the state’s words, verbatim · CDSS document, May 13, 2025

The state marks this report as 9 pages; the online copy we transcribed has 4. You can request the full file from the county licensing office.

Type of visit: Case Management - Annual Continuation

Licensing Program Analyst (LPA) Amy Rodgers conducted an unannounced Annual Continuation inspection. LPA was greeted and allowed entry into the facility by care giver Joy Recio to whom LPA discussed the purpose of the visit. Later, Administrator/Licensee Maricel N. Guibilondo joined the visit. According to the facility’s license, the facility has a maximum capacity of six (6) non-ambulatory clients, of which five (5) can be bedridden. Facility also has a hospice waiver for 5. LPA, accompanied Licensee/Administrator Maricel N. Guibilondo , to continue the tour of the interior and exterior of the facility, and inspected each room. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Client bedrooms contained the required furnishings. Doors, windows, screens, toilets, and showers were in working order. Extra linens and hygiene supplies were present, as well as Personal Protective Equipment. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and client activities. The facility’s ambient internal temperature was compliant. Hot water temperature at taps accessible to clients were all compliant. No pools or bodies of water on the premises. There was at least 2 days of perishable food, and at least 7 days non-perishable food present, all safely stored. Cooking/dining equipment and utensils were present. There were no sharp objects, toxic chemicals/poisons, or open-faced heaters accessible to clients. LPA also conducted an inspection of the centrally stored medications today. They were properly stored and locked in medication room. Medication logs and medications reviewed were current and medications appear to be administered according to the label instructions. [Continued on 809-C] [Continued form 809] LPA conducted further interviews and per Administrator/Licensee Maricel N. Guibilondo, no firearms or ammunition are kept at the facility. Smoke alarms, carbon monoxide detectors, emergency lighting, and facility telephone were all working. Fire extinguisher(s) were serviced within the last 12 months. First aid kit was complete and readily accessible. Required licensing postings were observed in visible areas of the facility. LPA reviewed the theft and loss policy and procedures. Transportation procedures are compliant. LPA interviewed staff members and residents during the initial inspection on 8/9/2024 . LPA interviews did not raise any licensing concerns. Staff and resident records reviewed on 8/9/2024 verified that all staff and residents records are complete and compliant. Licensee presented proof of current liability insurance. LPA observed that residents were being treated with dignity by staff, and there were sufficient staff on duty to meet resident’s needs. Administrator’s certification is current. No deficiencies were observed or cited at the time of visit. An exit interview was conducted with Licensee/Administrator Maricel N. Guibilondo, to whom copies of this report, and the Licensee/Appeal Rights (LIC9058 03/22) were provided at the conclusion of the visit.the state’s words, verbatim · CDSS document, Aug 16, 2024

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Amy Rodgers conducted an unannounced visit to commence a Required Annual Inspection. The facility file was reviewed prior to the visit. LPA Rodgers were welcomed by, identified themselves to, and discussed the purpose of the visit with Administrator/Licensee Maricel N. Guibilondo. During today’s visit, LPA toured the facility, reviewed staff and client records, and interviewed staff and clients. No deficiencies were cited during today’s visit. Due to time constraints, a return visit on a subsequent day is needed to complete the annual inspection. An exit interview was conducted with the Administrator/Licensee Maricel N. Guibilondo whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided during the visit.the state’s words, verbatim · CDSS document, Aug 9, 2024