Sunny Coast Care Home

Type of visit: Required - 1 Year

On June 15, 2026, Licensing Program Analyst (LPA) Brandon Lopez made an unannounced visit to the facility to conduct the required annual inspection. LPA was greeted and granted entry into the facility by care giving staff after explaining the purpose for the visit. Administrator (AD) Aileen Pimentel was present and assisted on today's visit. LPA observed that Aileen Pimentel has a valid Administrator certificate which expires on November 14, 2026. The facility is a Residential Care Facility for the Elderly (RCFE) licensed for six non-ambulatory residents, of which one can be bedridden, and has a hospice waiver for six. The facility is a single story home which consist of five resident bedrooms, one of which is shared, four resident bathrooms, a living room, a dining room, a kitchen, and an attached two car garage. LPA, accompanied by the AD, conducted a tour of the interior portions of the facility. On today's visit, LPA observed five residents in care and two care giving staff present. LPA observed the See Something, Say Something poster (PUB 475) mounted on the wall by the entryway of the facility. LPA inspected the five resident bedrooms and observed them to be clear of any hazards. LPA observed resident bedrooms to have the required furnishings of a bed, a chair, a chest of drawers, and a lamp. LPA observed resident beds to have clean linens and blankets. LPA observed additional linens to be stored in hallway cabinets. LPA inspected the four resident bathrooms and observed them to be clean. Resident bathrooms were equipped with grab bars and non-skid floor mats. Faucets and toilets were operational. Hot water temperature measured between 106.1 and 109.5 degrees Fahrenheit. LPA observed the facility has a two day perishable and a seven day non-perishable food supply in the kitchen. LPA observed kitchen knives and sharps to be stored in a locked kitchen cabinet. CONTINUED ON LIC809-C LPA observed two fire extinguishers to be mounted in the facility which were observed to be charged and serviced as of March 9, 2026. LPA tested the wired smoke detectors and individual carbon monoxide detectors which tested operational. LPA observed the facility conducted their most recent emergency disaster drill on June 2, 2026. LPA observed the centrally stored medication to be kept in a locked closet. LPA observed there is also a first aid kit stored in the locked closet which has all the required components. LPA observed the facility has a three day emergency food and water supply stored in a cabinet located by the living room. LPA observed chemicals and toxins to be stored in a locked cabinets near the two car garage. LPA observed the door leading to the attached two car garage to be kept locked and inaccessible to residents in care. LPA observed the garage to be used for storage. LPA, accompanied by the AD, conducted a tour of the exterior portions of the facility. LPA observed the exterior to be clear of any obstructions or hazards. LPA observed a shaded outdoor seating area with furniture for resident use. LPA observed the perimeter gates of the facility to be self-latching and can be opened in an evacuation. There are no bodies of water on the premises. LPA reviewed all six resident files. All the required documentation were present and current in the resident files reviewed. LPA reviewed the residents' medication and medication administration records. LPA reviewed three staff files. All staff are background cleared and associated to the facility. 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 Administrator Aileen Pimentel and a copy of the report was provided to the facility at time of visit.the state’s words, verbatim · CDSS document, Jun 15, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Alvaro Ramirez, Jr. conducted an unannounced visit for the Required 1 Year Inspection. LPA explained the purpose of today’s visit, and was greeted and granted entry by Caregiver Maria Lucia Malungcut. Administrator Assistant Aileen Pimentel Tecson arrived shortly after. For today’s visit, LPA observed a total of five residents in care and three staff members on duty. LPA observed the Administrator's Certificate for facility Administrator (AD) Aileen Pimentel Tecson which expires on November, 14, 2026. LPA Ramirez toured the interior and exterior portions of the facility with Administrator Assistant. The facility is a one-story house and is licensed for six non-ambulatory residents, of which six may be on hospice and one bedridden. There are a total of five resident bedrooms. LPA Ramirez 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 three restrooms. Restrooms were observed to be in good repair, toilets were operational, and grab bars and non-skid floor mats were provided. Water temperature tested between 111.0-115.5 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 extinguishers were charged, mounted and one was located in the laundry room and one by the residents' bedroom hallway. Fire extinguishers were last service on March 5, 2025. CONTINUED ON LIC809-C.. LPA Ramirez observed the emergency disaster and evacuation plan, which is posted by the residents' bedroom hallway. LPA observed that the 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 Ramirez observed a shaded area, patio furniture, and the grounds were free of any hazards. There are two gates in the backyard, which both are self-closing and self-latching. No bodies of water were observed. LPA reviewed five resident files and three staff files. LPA interviewed residents and staff present. For today's visit no deficiencies were issued per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted with Administrator Assistant Tecson. A copy of this report was provided at the time of exit.the state’s words, verbatim · CDSS document, Jun 23, 2025

Allegation investigated: Staff removed resident's oxygen resulting in death Staff yelled at a resident Staff did not ensure that residents' incontinence needs were met

On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility for the purpose of delivering findings into the investigation of the allegation listed above. LPA was greeted and granted entry by caregiving staff after introducing himself and stating the purpose of the visit. Administrator Eileen Tecson was notified by telephone and presented with the findings remotely. The initial complaint investigation visit was conducted alongside a health and safety check on September 16, 2024. A tour of the physical plant and review of resident records was conducted along with an interview of the facility’s administrator via telephone. The complaint investigation was conducted by the Department as follows: Records were requested, obtained and reviewed, including: records for resident R1, R2, R3, R4 and R5 maintained at the facility (admission agreements, physician reports, physician orders for life-sustaining treatment when available, Identification and Emergency Information, pre-placement appraisal information, Appraisal/Needs and Services Plan, hospice plans of care when applicable). CONTINUED ON FORM LIC9099-C Unfounded Resident R1 was admitted to the facility on August 7, 2024. The physician report established upon admission and dated August 22nd, 2024 states a primary diagnosis of cerebrovascular disease and orders the use of a hospital bed, wheelchair, oxygen, nebulizer and suction machine. Per R1’s pre-placement appraisal information, R1 sustained a stroke in 2007 and was paralyzed on the left side, with “hemiplegia and hemiparesis following cerebral infarction”. Resident moved into the facility from a different licensed facility as a result of a need for a higher level of care. Hospice records obtained during the investigation show an admission with Acacia Hospice and Palliative Services dated August 14, 2024. Hospice admission assessment shows that the resident was “AAOX3, able to make needs known”. Following the admission onto hospice, R1 was seen at the facility by hospice staff on August 15, 16, 18, 21, 22, 23, 29, 30 and 31. Visit notes present in the hospice records reviewed during the investigation indicate that on August 23 2024, “Dorothea was calm and took her medication normally. Fell asleep shortly after taking medication”. On August 29, 2024, she received a bed bath and appear fine. Only concern from the nurse was that she appeared “thinner”. On August 30, 2024, a hospice visit was requested due to decreased responsiveness. “[R1] woke up to take her medicine and eat lunch however was “semi responsive to verbal stimuli. Oxygen on at 3L VIA NC SPO2 90% lungs sound CTA. HR Tachycardia fever noted of 100.4 degrees and no bowel movement for the past 2-3 days. Nurse provided a Ducolax suppository. Nurse gave orders to administer a Tylenol suppository if fever persisted and to take aspiration precautions”. R1 is then stated to have passed away peacefully on August 31, 2024. R1’s death certificate was obtained during the investigation and lists the immediate cause of death as “cardiac arrest lasting a matter of minutes“ and “unspecified cerebrovascular disease”. Regarding the allegation that Staff removed resident's oxygen resulting in death, the following has been concluded: Based on a review of resident records, hospice and hospital records, incident reports and interview conducted, R1’s indicated cause of death is “cardiac arrest lasting a matter of minutes“ and “unspecified cerebrovascular disease” with no mention of the potential consequences of being deprived of medical oxygen. Furthermore, the information obtained during the investigation does not match the elements of the allegation which indicated that R1 passed away on August 30, 2024 following the alleged removal of oxygen by staff on the same date. Hospice records additionally confirm the provision of oxygen on August 30, 2024. Hospice staff is documented to have been present at the time of R1’s passing at approximately 8am on August 31, 2024. Hospice records additionally confirm oxygen administration was overseen by hospice staff. Patient orders generated upon hospice admission on August 14, 2024 confirm the Oxygen to have been provided as needed for shortness of breath. CONTINUED ON FOR LIC9099-C CONTINUED FROM FORM LIC9099-C The evidence gathered therefore does not support the allegation. Regarding the allegation that Staff yelled at a resident, the following has been concluded: Based on observation conducted during multiple facility visits along with three separate witness interviews, no occurrence of yelling or inappropriate verbal conduct on behalf of staff could be evidenced. Multiple witnesses interviewed indicated that residents diagnosed with dementia occasionally screamed or expressed themselves loudly during their visits but denied ever witnessing or being told about members of staff reciprocating or yelling at the individuals in care. Regarding the allegation that Staff did not ensure that residents' incontinence needs were met, the following has been concluded: Based on observation conducted during multiple facility visits along with three separate witness interviews, no smells or odors could be evidenced during visits. Additionally witnesses confirmed that during their visits, both planned and unplanned, they had never witnessed their relatives needing overdue incontinence care or had noticed any odors that could be associated with poor management of incontinence by staff. As a result of this investigation, the allegations are found to be Unfounded, meaning that the allegations are false, could not have happened and/or are without a reasonable basis. An exit interview was conducted with Administrator and a copy of this report was provided to a facility representative after permission was given to caregiving staff to sign the present report.the state’s words, verbatim · CDSS document, Dec 12, 2024 · control 22-AS-20240913151522

Allegation investigated: Resident developed a pressure injury while in care due to staff neglect.

On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility for the purpose of delivering findings into the investigation of the allegation listed above. LPA was greeted and granted entry by facility after introducing himself and stating the purpose of the visit. Administrator Buller was notified and informed of the findings by telephone. The initial complaint investigation visit was conducted alongside a health and safety check on August 2, 2024. A tour of the physical plant and review of resident records was conducted along with an interview of the facility’s administrator. The complaint investigation was conducted by the Department as follows: Records were requested, obtained and reviewed, including: records for resident R1 maintained at the facility (admission agreement dated June 9, 2024, physician report dated June 9, 2024, physician orders for life-sustaining treatment, Identification and Emergency Information, pre-placement appraisal information, Appraisal/Needs and Services Plan, physician’s orders dated August 1, 2024, nephrology orders) and discharge documents from Fountain Valley Post Acute dated June 6, 2024. CONTINUED ON FORM LIC9099-C Unfounded CONTINUED FROM FORM LIC9099 Resident R1 was admitted to the facility on June 9, 2024, with a primary diagnosis of “Acute/Chronic respiratory failure, Chronic Obstructive Pulmonary Disease and atelectasis” and secondary diagnosis of “End stage renal disease [requiring] dialysis and congestive heart failure”, from Fountain Valley Post Acute with a prescription for ongoing dialysis twice weekly on Mondays and Fridays. R1 attended regular dialysis appointments while admitted at the facility. On June 25, 2024, dialysis care staff notified facility staff that R1’s had elevated potassium levels and recommended an assessment at the hospital. R1 was admitted to Orange Coast Memorial Hospital on that day and returned to the facility on July 3, 2024. Orange Coast Memorial Hospital admission records indicate the reason of admission to be “Abnormal Labs on Dialysis” and the admitting diagnosis is stated to be sepsis due to a urinary tract infection. Discharge notes from Orange Coast Memorial Hospital were reviewed and include an order for a placement under hospice. The list of concerns included shows the presence of an unstageable decubitus ulcer and heel ulcer at that time. Based on the multiple assessments reviewed, R1 did not present with pressure injuries of any stage prior to this hospitalization. Upon returning to the facility on July 3, 2024, the facility staff notified R1’s responsible party about newly occurred pressure injuries as confirmed by a dated typed report. Text conversations from the administrator to R1’s responsible party show a shared concern about dietary incompatibilities that were not followed during the hospital admission. Hospice admission with Collective Hospice Care was finalized on July 13, 2024, with regular wound care being provided as documented in the hospice notes. The hospice admission diagnosis is listed as “Acute on Chronic diastolic Congestive Heart Failure” with comorbidities listed as: “hyperlipidemia, hyperkalemia, End Stage Renal Disease on hemodialysis, unstageable decubitus ulcer, heel, COPD, CAD, anemia, encephalopathy, dementia, altered mental state(…)”. In addition to the admission visit on July 13, the Collective Hospice Care made visits on July 18, July 20, July 22, July 23, July 25 and July 27, 2024. On July 29, 2024, the licensee reported to the Department that R1 was discharged from hospice and sent out to the hospital directly from the dialysis center due to a suspicion of stroke. Upon discharge on August 3, 2024, the resident was admitted onto hospice again with a different provider, Valley Oaks Hospice as confirmed by a review of the plan of care and admission documents. CONTINUED ON LIC9099-C CONTINUED FROM FORM LIC9099-C The hospice diagnosis is listed as End Stage Renal Disease which is consistent with the initial hospice admission made in July 2024. R1 passed away from cardiac arrest on August 6, 2024. R1 had been unresponsive since August 4, 2024, and had been receiving comfort care from the hospice provider since. R1’s family member was notified and was present at bedside at the time of R1’s passing. Regarding the allegation that Resident developed a pressure injury while in care due to staff neglect, the following has been concluded: Based on a review of resident records, hospice and hospital records, incident reports and interviews conducted, LPA did not find sufficient evidence that the occurrence of R1’s pressure injuries was attributable to facility staff neglect and/or lack of care and supervision. There is no evidence of the injuries being present prior to a hospital admission period from June 25 to July 3, 2024. Once assessed to be present, the injuries were addressed via home health and hospice services being contracted and in charge of providing wound care. As a result of this investigation, the allegation is found to be Unfounded, meaning that the allegation is false, could not have happened and/or is without a reasonable basis. An exit interview was conducted with administrator Kathrina Buller via telephone and a copy of this report was provided to a facility representative.the state’s words, verbatim · CDSS document, Oct 30, 2024 · control 22-AS-20240801112858

Type of visit: Prelicensing

Licensing Program Analysts (LPA) Alvaro Ramirez, Jr. conducted an announced visit to the facility to conduct the pre-licensing inspection. LPA met with Applicant Katrina Buller and toured the facility. An application for Change of Ownership (CHOW) to operate a Residential Care Facility for the Elderly (RCFE) was submitted to Community Care Licensing (CCL) on February 14, 2024. The facility is to have a capacity of six, of which five can be nonambulatory and one bedridden. Facility phone number 714-749-6629. LPA observed the following. Structure: The facility is a one-story house with five resident bedrooms, three full size bathrooms, one half bathroom, a living room, a kitchen, a dining room, and an attached car garage. LPA observed the See Something, Say Something poster (PUB 475) in the facility mounted on the wall in the entranceway. There is a backyard with an exit gate on each side of the house. There is a shaded seating area and LPA did not observe any obstacles or hazards in the backyard. Air/Heating: Central air/heating system installed with a central panel to control entire house. Resident Bedrooms: There are five resident bedrooms. All resident bedrooms had the required furnishings. LPA observed all beds had linens and blankets. CONTINUED ON LIC809-C... Bathrooms: All bathrooms are clean and have working plumbing. Hot water measured between 108.3 and 109.5 degrees Fahrenheit. Linens & Hygiene Supplies: A supply of extra linen for each resident was stored in a closet by the resident's bedrooms hallway. Emergency Phone Numbers, Exit Plan & Menu: Posted & readily available for review an emergency disaster plan with means of exiting and emergency phone numbers listed. Menu was posted and available. Monthly menu available and posted by the resident's bedrooms hallway. Food Service: There are six residents living in the facility at this time. A supply of 2-day perishable and 7-day of non-perishable food was observed and will be maintained on hand. Smoke Detectors/Carbon Monoxide Detectors: Smoke detectors/carbon monoxide detectors are hardwired and tested operational. There is a fire extinguisher mounted on the wall by the laundry room and one by the resident's bedroom hallway. Appliances: There is one, four gas burner stove which lights unassisted, one oven, one microwave, a refrigerator, dishwasher, washer, and dryer. All appliances are clean and operational. Toxins: All and any toxic chemicals, cleaning solutions, laundry toxins and disinfectants are inaccessible to residents and will be stored in the laundry room. Water Temperature: Hot water was measured in all bathrooms. Hot water measured between 108.3 and 109.5 degrees Fahrenheit. Medications, First-Aid Kit & Book: The first aid kit and the first aid manual are stored in the closet by the resident's bedrooms hallway. The first aid kit has all the required elements. Medications will be stored in a locked cabinet by the resident's bedrooms hallway. Resident & Staff Files: The Resident and Staff Records will be kept in a locked cabinet by the resident's bedrooms hallway. Reading Material, Games, Equipment & Materials: Arts and craft and board games are stored in a cabinet by the main entrance. There is one large screen television in the living room. Fire clearance: Fire Clearance approved by a fire inspector of Orange County Fire Authority on April 04, 2024. Special conditions noted, "Hallway door located at entrance to bedrooms shall remain closed, maintaining sliding doors to slide open easily, keep exit doors free from obstructions." Component III: Conducted at the Pre-Licensing visit, information provided about how to operate the facility within compliance and reporting requirements. The applicant has met all pre-licensing requirements. LPA will submit notification to CAB in Sacramento for final review prior to license being issued. Applicant was informed today that the final approval will be processed by CAB (Central Applications Bureau) in Sacramento. Exit interview was conducted and a copy of this report was left with the applicantthe state’s words, verbatim · CDSS document, May 23, 2024