Senior Care Records.

Facility Evaluation Report

Our Lady of Guadalupe Home, Lake Forest01/16/2025Licence 306005504

Capacity6
Census4
Date signed01/16/2025 04:48:52 PM
The inspector’s account

Licensing Program Analyst (LPA) Brandon Lopez 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) Cresencia Santiago was notified via telephone and later arrived to assist with the inspection. LPA observed Cresencia Santiago has a valid Administrator certificate which expires on September 17, 2025.

The facility is an Adult Resident Facility (ARF) licensed for six ambulatory clients. The facility is a single-story home with four client bedrooms, one staff room, two shared client bathrooms, a living room, a dining room, a kitchen, a laundry room, and an attached two car garage. LPA accompanied by the AD conducted a tour of the physical plant. On today's visit, LPA observed four clients in care and one caregiver staff present. LPA inspected the four client bedrooms, and they were observed to be free of any hazards. LPA observed the client bedrooms had the required furnishings of a bed, a chair, a chest of drawers, and a lamp. All client beds had clean linens and blankets. LPA observed additional linens are stored in a hallway closet. LPA inspected the two shared client bathrooms. Resident bathrooms are clean. Faucets and toilets were operational. Hot water temperature measured between 105.8 and 109.5 degrees Fahrenheit. LPA observed the facility has an emergency food and water supply stored in a hallway closet.

LPA observed the kitchen has a two-day perishable and seven-day nonperishable food supply on hand. LPA observed kitchen appliances to be clean and operational. The four burner gas stove lights unassisted. LPA observed kitchen knives are stored in a locked kitchen cabinet. LPA observed cleaning supplies are stored in a locked kitchen cabinet under the stove.

A fire extinguisher is located in a the kitchen, and it was observed the be charged and purchased on July 29, 2024. LPA tested the wired smoke detector/carbon monoxide detector which tested operational. LPA observed the facility conducted their last emergency disaster drill on December 7, 2024.The centrally stored medication is kept in a locked storage cabinet in the living room. CONTINUED ON LIC809-C

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction