Select Senior Care III

Type of visit: Required - 1 Year

On March 6, 2026, 2:00 PM, Licensing Program Analyst (LPA) Edward Kim conducted an unannounced required 1-Year annual visit using the CARE Inspection Tool. Upon arrival at the facility, LPA Kim met with Administrator Daniel Datcu and explained the purpose of the visit. The facility is licensed to operate for six (6) nonambulatory residents and has a hospice waiver for four (4) residents. The facility is a single-story structure located in a residential neighborhood. It consists of the following: six (6) resident bedrooms, one (1) staff bedroom, four (4) bathrooms, living area, dining area, kitchen, fountain in the backyard, shed in the backyard, outdoor covered patio in the backyard, front patio has two chairs and table, and an attached two car garage. LPA Kim toured inside and outside of the physical plant. There were no obstructions in the facility. All rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting was provided, storage for each resident's personal belongings was observed. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. The Resident’s rooms were inspected: Resident Room 1, Resident Room 2, Resident Room 3, Resident Room 4, Resident Room 5, and Resident Room 6. Bathrooms were found to be clean and operational. The water temperature measured at 116.5 degrees F to 117.0 degrees F. A comfortable temperature of 76 degrees F was maintained in the facility. LPA Kim observed the facility to be appropriately furnished at the time of visit. Storage areas for personal hygiene and sharps objects were stored and not accessible to residents. LPA observed a gallon of Dawn Professional Manual Pot and Pan Detergent and Weiman Stainless Steel Cleaner and Polish aerosol can in an unlocked cabinet under the kitchen sink. Evaluation Report Continues on LIC 809-C The kitchen was inspected and there is a two-day supply of perishable and seven-day supply of non-perishable food both were available and maintained properly. Emergency food, emergency water, and emergency supplies are stored in the garage. The facility has one (1) fire extinguisher that is charged and mounted on the wall next to the dining room and was last inspected on July 11, 2025. During the visit, LPA Kim observed the facility's infection control practices, plan of operation, and screening protocols for visitors, staff, and residents. LPA observed the facility has a 30-day supply of Personal Protective Equipment (PPE). All mandated inspection control posters were posted. The smoke detectors and carbon monoxide detectors were operable. A working telephone (714-756-2341) and video teleconferencing laptop dedicated to the residents both remain available. Last emergency drill was conducted on February 15, 2026 and is conducted monthly. First aid kit is maintained and contains all the necessary elements. Evidence of Liability Insurance is effective March 21, 2025, and expires March 21, 2026. LPA Kim conducted an audit of resident files (R1-R5), staff files (S1-S5), and medication and medication administration record that were all in order and complete. LPA Kim conducted interviews with four residents and two staff. A deficiency was cited during this visit per Title 22 Division 6 Chapter 8. LPA observed a gallon of Dawn Pot and Pan Detergent and Weiman Stainless Steel Cleaner and Polish aerosol can in an unlocked cabinet under the kitchen sink. Staff removed Dawn detergent and Weiman Stainless Steel Cleaner and polish aerosol can in a locked area in the garage. An exit interview was conducted, and a copy of this report, LIC809D, and appeal rights were provided to Administrator Daniel Datcu.the state’s words, verbatim · CDSS document, Mar 6, 2026

Type of visit: Required - 1 Year

On May 14, 2025, at 1:45 PM, Licensing Program Analyst (LPA) Edward Kim conducted an unannounced required 1-Year annual visit using the CARE Inspection Tool. Upon arrival at the facility, LPA Kim was greeted and granted entry by Caregiver (CG) Cinthya Gomez. Administrator (AD) Daniel Datcu arrived at the facility around 2:25 PM and LPA Kim explained the purpose of the visit. The facility is licensed to operate for six (6) nonambulatory residents, and has a hospice waiver for four (4) residents. The facility is a single-story structure located in a residential neighborhood. It consists of the following: six (6) resident bedrooms, one (1) staff bedroom, four (4) bathrooms, living area, dining area, kitchen, fountain in the backyard, shed in the backyard, outdoor covered patio in the backyard, front patio has two chairs and table, and an attached two car garage. LPA Kim toured inside and outside of the physical plant with ADMIN Datcu. There were no obstructions in the facility. All rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting was provided, storage for each resident's personal belongings was observed. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. The Resident’s rooms were inspected: Resident Room 1, Resident Room 2, Resident Room 3, Resident Room 4, Resident Room 5, and Resident Room 6. Bathrooms were found to be within Title 22 regulations and were clean and operational. The water temperature measured at 113.1 degrees F to 115.0 degrees F. A comfortable temperature of 76 degrees F was maintained in the facility. Evaluation Report Continues on LIC 809-C LPA Kim observed the facility to be appropriately furnished at the time of visit. Storage areas for personal hygiene, cleaning supplies, toxins, and sharps objects were stored and not accessible to residents. The kitchen was inspected and there is a two-day supply of perishable and seven-day supply of non-perishable food both were available and maintained properly. Emergency food, emergency water, and emergency supplies are stored in the garage. The facility has one (1) fire extinguisher that is charged and mounted on the wall next to the dining room and was last inspected on July 18, 2024. During the visit, LPA Kim observed the facility's infection control practices, plan of operation, and screening protocols for visitors, staff, and residents. LPA observed the facility has a 30-day supply of Personal Protective Equipment (PPE). All mandated inspection control posters were posted. PUB475 measured at 11”x17” instead of 20”x26”. The smoke detectors and carbon monoxide detectors were operable. A working telephone (714-756-2341) and video teleconferencing laptop dedicated to the residents both remain available. Last emergency drill was conducted on May 5, 2025 and is conducted monthly.. First aid kit is maintained and contains all the necessary elements. Evidence of Liability Insurance is effective March 21, 2025, and expires March 21, 2026. LPA Kim conducted an audit of resident files (R1-R6), staff files (S1-S7), and medication and medication administration record. LPA Kim conducted two (2) resident interviews. No deficiencies were cited during this visit per Title 22 Division 6 Chapter 8. A technical violation was issued during the visit in regards to PUB475 measuring at 11” x 17”. An exit interview was conducted, and a copy of this report and was provided to Administrator Daniel Datcu.the state’s words, verbatim · CDSS document, May 14, 2025

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.

Type of visit: Required - 1 Year

On 6/13/2024, Licensing Program Analyst (LPA) Jenifer Tirre conducted an unannounced required visit using the CARE Inspection Tool. LPA was greeted by staff and granted entry after stating the purpose of the visit. Administrator (AD) Daniel Datcu was present to assist with the facility inspection on today's date. The facility is licensed for six (6) non-ambulatory residents with approved hospice waiver for four (4) residents. Currently, there are two(2) Hospice residents present during today’s visit. This is a single story with a two-car garage facility. The facility has seven bedrooms, six resident rooms, one caregiver room and four bathrooms. At around 1:30PM, LPA conducted a tour of the physical plant accompanied by Administrator Datcu, and the following was observed: There were no bodies of water on the premises. All rooms were inspected. Beds and bedding supplies were in operational condition, lighting was provided, and storage for the client's personal belongings was observed. Bed linens, comforters, and bath towels were available during the visit. Bathrooms were operational with water temperature measured at 105.6 degrees F. A comfortable temperature of 76 degrees F. was maintained in the facility. LPA observed the facility to be furnished at the time of the visit. Storage areas for personal hygiene, toxins and sharps objects were stored and not accessible to residents. The kitchen was inspected, and sufficient perishable and non-perishable food was maintained adequately. Facility has two fire extinguishers, mounted and charged. A review of the Medication Records Administration (MAR) was conducted, and LPA observed the records are in compliance. CONT ON 809C During the visit, LPA observed the facility's infection control practices. LPA observed screening protocols for visitors, staff, and residents, and sanitizing stations in common areas and restrooms. LPA observed the facility has a 30-day supply of Personal Protective Equipment (PPE). All mandated inspection control posters were posted. LPA observed First Aid Kit was maintained. A working landline phone was operational. The last fire drill was conducted on March 19, 2024. The facility had operational smoke and carbon monoxide detectors in bedrooms and common areas. The facility has current liability insurance on file effective 3/21/24 - 3/21/25. The facility is current on Community Care Licensing annual dues. A review of four residents (R1-R4) service files and three staff (S1-S3) personnel files revealed to be complete. The facility has the administrator's certification on file for Daniel Datcu No deficiencies during this inspection visit. An exit interview was conducted with Administrator, and a copy of the report was provided.the state’s words, verbatim · CDSS document, Jun 13, 2024