Admission, assessment, and eviction
Cited in 3 reports, with 6 deficiencies in total.
FOUNTAIN OF YOUTH SENIOR LIVING
525 N CAROUSEL PLACE, Anaheim CA 92806
6 bedsLatest official report Aug 13, 2026Licensed
Additional info
- Telephone
- (657) 208-3199
- Licensee
- FOUNTAIN OF YOUTH SENIOR LIVING LLC
- Administrator
- JERRAR, MOE A.
- Contact
- JERRAR, MOE A.
- License first date
- Aug 29, 2023
- License effective date
- Aug 29, 2023
- District office
- ORANGE COUNTY RO · (714) 703-2840
- Regional office
- 22
- Clients served
- 935 - ELDERLY, 983 - RCFE / DEMENTIA, 985 - RCFE / HOSPICE
Summary
The available records show 3 Type A and 14 Type B deficiencies for this facility.
- Most recent inspection
- Aug 13, 2026
- Most recent deficiency
- Aug 13, 2026
No later report is available, so the records do not show what happened afterward.
What Type A and Type B mean
- Type A
- Violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
- Type B
- Violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care.
Both classifications are published by California CDSS and are shown as published. SeniorLivingFacts does not rename them or add a severity level of its own.
At a glance
Counts cover the five-year public record. Typical figures are the median for the 984 Orange County facilities licensed for 6 or fewer beds.
In the available public five-year record, CCLD published 7 reports for this facility: 3 inspections, 1 complaint investigation, and 3 licensing or administrative records.
Those records contain 3 Type A and 14 Type B deficiencies.
1 deficiencies have explicit official correction or clearance evidence in the loaded records.
- Official inspections
- 3
- Recorded deficiencies
- 17
- Type A deficiencies
- 3
- Type B deficiencies
- 14
- Substantiated complaints
- 0
- Repeated topics
- 2
Fewer than the typical 4
2 in the last 12 months
Well above the typical 1
11 in the last 12 months
Most this size have none
1 in the last 12 months
Well above the typical 1
10 in the last 12 months
Most this size also have none
0 in the last 12 months
Last 36 months
Repeated topics
Topics cited in more than one report during the last 36 months. A repeat may show a pattern worth asking about. Each date opens its report below.
Health conditions and treatments
Cited in 2 reports, with 2 deficiencies in total.
Official report history
All preserved reports from the most recent to the oldest, sortable by report type.
Inspection
Hazardous items and storageType A
- Official classification
- Type A
- Official code
- 87309(a)
- Regulation authority
- CCR
What the official deficiency says
(a) Except as specified in subsection (b), the licensee shall ensure that disinfectants, cleaning solutions, poisonous substances, knives, matches, tools, sharp objects, and other similar items which could pose a danger to residents are in locked storage and are not left unattended if outside the locked storage. This requirement is not met as evidenced by: Deficient Practice Statement Based on LPAs observation and interview the licensee did not comply with the section cited above in six of six residents which poses an immediate health and safety or personal risk to persons in care.
Official plan of correction
POC Due Date: 08/14/2026 Plan of Correction AD will send LPA pictures via email or text of repaired sharps drawer by POC due date.
Plan of correction recorded
Correction not verified in available records
Resident rightsType B
- Official classification
- Type B
- Official code
- 87468(b)
- Regulation authority
- CCR
What the official deficiency says
(b) At the time the admission agreement is signed, a resident and the resident's representative shall be personally advised of and given a copy of: This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA's observations and file review, the licensee did not comply with the section cited above in three of three resident files which poses a personal rights risk to persons in care.
Official plan of correction
POC Due Date: 09/11/2026 Plan of Correction AD will obtain signed admissions agreements for three of three resident files by POC due date and will email agreements to LPA.
Plan of correction recorded
Correction not verified in available records
Records and plan of operationType B
- Official classification
- Type B
- Official code
- 87506(b)(15)
- Regulation authority
- CCR
What the official deficiency says
(b) Each resident's record shall contain at least the following information: (15) The admission agreement and pre-admission appraisal, specified in Sections 87507, Admission Agreements and 87457, Pre-admission Appraisal. This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA's observations and file review, the licensee did not comply with the section cited above in three of three resident files which poses a personal rights risk to persons in care.
Official plan of correction
POC Due Date: 09/11/2026 Plan of Correction AD will provide re-appraisals and Appraisal Needs and Services Plans to LPA via email by POC due date.
Plan of correction recorded
Correction not verified in available records
Admission, assessment, and evictionType B
- Official classification
- Type B
- Official code
- 87458(a)
- Regulation authority
- CCR
What the official deficiency says
(a) Prior to a person's acceptance as a resident, the licensee shall obtain documentation of a medical assessment, signed by a licensed medical professional acting within the scope of their practice and made within the last year, to be kept in the resident's record. This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA's file review and interviews, the licensee did not comply with the section cited above in two of six residents which poses a potential health and safety risk to persons in care.
Official plan of correction
POC Due Date: 09/11/2026 Plan of Correction AD will obtain Medical Assessments for two of six residents by POC due date. AD will email LPA documentation.
Plan of correction recorded
Correction not verified in available records
Admission, assessment, and evictionType B
- Official classification
- Type B
- Official code
- 87463(a)
- Regulation authority
- CCR
What the official deficiency says
(a) The pre-admission appraisal, as specified in Section 87457, Pre-Admission Appraisal, shall be updated, in writing as frequently as necessary or once every 12 months, whichever occurs first, to note significant changes in condition, as defined in Section 87101, Definitions, and to keep the appraisal accurate. For the purposes of this section, the updated pre-admission appraisal shall be referred to as the reappraisal. This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA's file review and interviews, the licensee did not comply with the section cited above in two of six residents which poses a potential health and safety risk to persons in care.
Official plan of correction
POC Due Date: 09/11/2026 Plan of Correction AD will conduct re-appraisals for two of six residentsi in care. AD will email LPA by POC due date.
Plan of correction recorded
Correction not verified in available records
Fire safety and emergency preparednessType B
- Official classification
- Type B
- Official code
- 1569.695(c)
- Regulation authority
- HSC
What the official deficiency says
(c) A facility shall conduct a drill at least quarterly for each shift. The type of emergency covered in a drill shall vary from quarter to quarter, taking into account different emergency scenarios. An actual evacuation of residents is not required during a drill. While a facility may provide an opportunity for residents to participate in a drill, it shall not require any resident participation. Documentation of the drills shall include the date, the type of emergency covered by the drill, and the names of staff participating in the drill. This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA interview and record review the licensee did not comply with the section cited above in six of six residents which poses a potential health and safety risk to persons in care.
Official plan of correction
POC Due Date: 09/11/2026 Plan of Correction AD will provide quarterly fire drill with all staff and will email LPA documentation by POC due date.
Plan of correction recorded
Correction not verified in available records
Health conditions and treatmentsType B
- Official classification
- Type B
- Official code
- 87608(a)(5)(A)
- Regulation authority
- CCR
What the official deficiency says
(A) A bed rail that extends from the head half the length of the bed and used only for assistance with mobility shall be allowed. This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA observations and file review, the licensee did not comply with the section cited above in three of six residents which poses a potential health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 09/11/2026 Plan of Correction AD will obtain bed rail orders for three of six resident and will email LPA orders by POC due date.
Plan of correction recorded
Correction not verified in available records
Inspection
Food serviceType B
- Official classification
- Type B
- Official code
- 87555(b)(8)
- Regulation authority
- CCR
What the official deficiency says
(b) The following food service requirements shall apply: (8) All food shall be of good quality. Commercial foods shall be approved by appropriate federal, state and local authorities. Food in damaged containers shall not be accepted, used or retained. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, there were expired food items, mainly canned tomatoes (Hunt) and peanut butter (Skippy) which poses a potential health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 09/30/2025 Plan of Correction Licensee will dispose of expired food items and review pantry for expired food on a weekly basis. House manager disposed of peanut butter during the visit. Deficiency cleared.
Official record says corrected or clearedOn or before Sep 23, 2025
Plan of correction recorded
Admission, assessment, and evictionType B
- Official classification
- Type B
- Official code
- 87458(c)(1)
- Regulation authority
- CCR
What the official deficiency says
(c) The medical assessment shall include, but not be limited to: (1) A physical examination of the resident indicating the licensed medical professional's diagnosis or diagnoses and results of an examination for all of the following: This requirement is not met as evidenced by: Deficient Practice Statement Based on interview and record review, the licensee did not comply with the section cited above in one out of five persons which poses/posed a potential health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 09/30/2025 Plan of Correction Licensee will provide a copy of the Physician's Report for Resident 4.
Plan of correction recorded
Correction not verified in available records
Admission, assessment, and evictionType B
- Official classification
- Type B
- Official code
- 87463(h)(2)
- Regulation authority
- CCR
What the official deficiency says
(h) The licensee shall request that all residents receive an annual routine visit with a licensed medical professional once every twelve months, either in person or by video appointment. (2) Documentation of a resident's refusal to receive an annual routine visit, or if applicable, their representative's refusal on their behalf, shall be added to the resident's record. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, interview, and record review, the licensee did not provide documentation of resident's refuse to see a Primary Care Physician (PCP) which poses a potential health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 09/30/2025 Plan of Correction Licensee will provide a signed copy of documentation indicating resident's refusal to see a PCP and send it to CCLD by 09/30/2025.
Plan of correction recorded
Correction not verified in available records
Admission, assessment, and evictionType B
- Official classification
- Type B
- Official code
- 87507(c)
- Regulation authority
- CCR
What the official deficiency says
(c) Admission agreements shall be signed and dated, acknowledging the contents of the document, by the resident or the resident's representative, if any, and the licensee or the licensee's designated representative no later than seven days following admission. Attachments to the agreement may be utilized as long as they are also signed and dated as prescribed above. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation and record review, the licensee did not possess a signed Admission Agreement for Resident 1, which poses a potential health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 09/30/2025 Plan of Correction Licensee will provide CCLD a signed copy of the Admission Agreement for Fountain of Youth Senior Living by 09/30/25.
Plan of correction recorded
Correction not verified in available records
Inspection
Background checksType A
- Official classification
- Type A
- Official code
- 87355(e)(1)
- Regulation authority
- CCR
What the official deficiency says
CRIMINAL RECORD CLEARANCE. All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1569.17(b) shall prior to working, residing or volunteering in a licensed facility: This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, interviews, record review, the licensee did not comply with the section cited above in that Reliever, Guadalupe Meza Lopez, was hired approximately on 8/12/2024, has no fingerprint clearance & is not associated with the facility. Hiring staff without fingerprint clearance & association with the facility poses an immediate health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 08/16/2024 Plan of Correction House Manager understand that Staff Meza Lopez cannot work or be present at the facility until staff has fingerprint clearance & association is completed. Since staff has not been fingerprinted & cleared & was working as a Reliever since 8/12/2024, a Civil Penalty of $100.00 per day is being assessed.
Corrective action observedRecorded in report dated Aug 15, 2024
Plan of correction recorded
Facility condition and maintenanceType A
- Official classification
- Type A
- Official code
- 87307(a)(2)(B)
- Regulation authority
- CCR
What the official deficiency says
(a) Living accommodations and grounds shall be related to the facility's function. The facility shall be large enough to provide comfortable living accommodations and privacy for the residents, staff, and others who may reside in the facility. The following provisions shall apply: (2) Resident bedrooms shall be provided which meet, at a minimum, the following requirements: (B) No room commonly used for other purposes shall be used as a sleeping room for any resident. This includes any hall, stairway, unfinished attic, garage storage area, shed or similar detached building. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above in that there was a beds, dresser, table, and personal belongings in an outside structure that is to be used for storage. This poses a potential health, safety or personal rights risk to staff and persons in care. Facility did not obtain a Fire Clearance approval to use the shed for staff sleeping quarters. This poses an immediate Health & Safety risk to the staff and residents in care.
Official plan of correction
POC Due Date: 08/16/2024 Plan of Correction Facility will immediately stop staff from using the shed as a bedroom. Will remove all personal belongings from shed. Facility will not allow any individual to reside in a structure that is not fire cleared for occupancy. Shed shall only be used for storage unless a city code approval and fire clearance approval is obtained.
Plan of correction recorded
Correction not verified in available records
Health conditions and treatmentsType B
- Official classification
- Type B
- Official code
- 87608(a)(5)(B)
- Regulation authority
- CCR
What the official deficiency says
(5) Under no circumstances shall postural supports include tying, depriving, or limiting the use of a resident's hands or feet. (B) Bed rails that extend the entire length of the bed are prohibited except for residents who are currently receiving hospice care and have a hospice care plan that specifies the need for full bed rails. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, interview and record review the licensee did not comply with the section cited above in that Resident 4 has a full bed rail and is not receiving Hospice care, which poses an immediate health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 08/15/2024 Plan of Correction Staff to remove the full bed rail . Facility to obtain a physician's order for half-bed rail, if there is a need and keep in file. Facility to provide POC by 8/16/2024.
Plan of correction recorded
Correction not verified in available records
Staffing, personnel, and trainingType B
- Official classification
- Type B
- Official code
- 1569.625
- Regulation authority
- HSC
What the official deficiency says
Personnel Requirenments - Staff members of residential care facilities for the elderly who assist residents with personal activities of daily living to receive appropriate training which consists of 40 hours of training for new staff or 20 hrs annually for staff in specific areas. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, interviews, and record review, the licensee did not comply with the section cited above in that 4 out of 4 had no proof of training or needed their annual training, which poses/posed a potential health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 08/30/2024 Plan of Correction Licensee to ensure that Staff receive specific training as stated in Health & Safety 1569.625. Staff to read regulation cited and submit understanding of regulation to LPA on or before 08/30/2024. LPA will retrun to review staff files.
Plan of correction recorded
Correction not verified in available records
Staffing, personnel, and trainingType B
- Official classification
- Type B
- Official code
- 87411(c)(1)
- Regulation authority
- CCR
What the official deficiency says
Personnel Requirements-General. Staff shall receive First Aid training from persons qualified by such agencies as the American Red Cross. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, interviews, and record reviews, the licensee did not comply with the section cited above in that 4 out of 4 staff did not have First Aid and CPR training in file which poses/posed a potential health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 08/30/2024 Plan of Correction Facility will have Staff take classes on First Aid and CPR and will submit to Licensing a copjy of the certiifcates on or before 08/30/2024.
Plan of correction recorded
Correction not verified in available records
Admission, assessment, and evictionType B
- Official classification
- Type B
- Official code
- 87458(a)
- Regulation authority
- CCR
What the official deficiency says
(a) Prior to a person's acceptance as a resident, the licensee shall obtain and keep on file, documentation of a medical assessment, signed by a physician, made within the last year. The licensee shall be permitted to use the form LIC 602 (Rev. 9/89), Physician's Report, to obtain the medical assessment. This requirement is not met as evidenced by: Deficient Practice Statement Based on record reviews, the licensee did not comply with the section cited above in that 3 of 6 files reviewed, 2 were missing Physician's Report and one need to be updated due to diagnosis, which poses/posed a potential health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 08/30/2024 Plan of Correction Facility to obtain and/or update Physician's Reports and place in each respective file.
Plan of correction recorded
Correction not verified in available records
Complaint
Allegations0 substantiated · 2 unsubstantiated · 0 unfounded
No deficiencies recorded in this reportLicensing recordNot an inspection of the operating facility
No deficiencies recorded in this report
Licensing recordNot an inspection of the operating facility
No deficiencies recorded in this report
Licensing recordNot an inspection of the operating facility
No deficiencies recorded in this report
Source and limits
California Department of Social Services, Community Care Licensing Division. Public facility history is described by the source as a five-year window. Older records and previous-licensee history may require a regional-office request. Type 741 RCFE-CCRCs, nursing homes, and other care settings are excluded from this page.
Read the data methodology