Senior Care Records.

Facility Evaluation Report

Good Samaritan II, Mission Viejo07/02/2025Licence 306001028

Capacity6
Census3
Date signed07/02/2025 04:37:43 PM
Name of licensing program analystKevin Saborit-Guasch
Name of licensing program managerSheila Santos
The inspector’s account

On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility for the purpose of following up on the plan of corrections for the deficiencies issued during the annual visit conducted on June 9, 2025.

The certificate of liability insurance for the facility was provided by the licensee with an effective expiration date of 05/28/2026 as well as adequate coverage amounts corresponding to Title 22 requirements.

One of the two pending admission agreements was also provided and reviewed. The second one is still pending the return of the resident's responsible party who was out of the country for approximately two months and is scheduled to return in the coming weeks. The second admission agreement will be provided by the licensee at the earliest convenience. The deficiency will therefore be cleared once the second document is provided.

An exit interview was conducted and a copy of this report was provided to a facility representative.

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