COUNTRY GARDENS TERRACE, INC.

1103 SALVADOR STREET, Costa Mesa CA 92626

Facility 306006152 · RESIDENTIAL CARE ELDERLY (740)

6 bedsLatest official report Jul 2, 2026Licensed

Additional info
Licensee
COUNTRY GARDENS TERRACE, INC.
Administrator
CATACUTAN, JEAN
Contact
CATACUTAN, JEAN
License first date
Jul 26, 2022
License effective date
Jul 26, 2022
District office
ORANGE COUNTY RO · (714) 703-2840
Regional office
22
Clients served
935 - ELDERLY

Summary

The available records show 2 Type A and 6 Type B deficiencies for this facility.

Most recent inspection
Jul 2, 2026
Most recent deficiency
Jul 2, 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: 4 inspections, 0 complaint investigations, and 3 licensing or administrative records.

Those records contain 2 Type A and 6 Type B deficiencies.

0 deficiencies have explicit official correction or clearance evidence in the loaded records.

Official inspections
4

About the same as most this size

1 in the last 12 months

Recorded deficiencies
8

Well above the typical 1

3 in the last 12 months

Type A deficiencies
2

Most this size have none

2 in the last 12 months

Type B deficiencies
6

Well above the typical 1

1 in the last 12 months

Substantiated complaints
0

Most this size also have none

0 in the last 12 months

Repeated topics
0

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.

No topic repeats in the last 36 months

No deficiency topic appears in more than one report during that window. This does not establish that nothing repeated earlier in the five-year record, and it is not a statement about current conditions.

Official report history

All preserved reports from the most recent to the oldest, sortable by report type.

Inspection
Fire safety and emergency preparednessType A
Official classification
Type A
Official code
87202(a)
Regulation authority
CCR

What the official deficiency says

(a) All facilities shall maintain a fire clearance approved by the city, county, or city and county fire department or district providing fire protection services, or the State Fire Marshal. Prior to accepting or retaining any of the following types of persons, the applicant or licensee shall notify the licensing agency and obtain an appropriate fire clearance approved by the city, county, or city and county fire department or district providing fire protection services, or the State Fire Marshal: This requirement is not met as evidenced by: Deficient Practice Statement Based on observation and record review, the licensee did not comply with the section cited above which poses an immediate health, safety or personal rights risk to persons in care. LPAs observed that Resident #2 (R2) Medical Assessment dated April 9, 2026, states that R2 is bedridden and confirmed that R2 is bedridden due to R2 being unable to reposition herself on her own. The facility's fire clearance does not allow them to retain a bedridden resident.

Official plan of correction

POC Due Date: 07/03/2026 Plan of Correction The Designee stated that the facility will submit a request to update their fire clearance to allow them to retain a bedridden resident. The Designee stated that he will provide LPA a written request, an updated LIC200, and an updated facility sketch, via email or fax by POC due date,

Plan of correction recorded
Correction not verified in available records
View official report
Health conditions and treatmentsType A
Official classification
Type A
Official code
87615(a)
Regulation authority
CCR

What the official deficiency says

(a) Persons who require health services for or have a health condition including, but not limited to, those specified below shall not be admitted or retained in a residential care facility for the elderly: This requirement is not met as evidenced by: Deficient Practice Statement Based on observation and record review, the licensee did not comply with the section cited above which poses an immediate health, safety or personal rights risk to persons in care. During a file review, LPAs observed that Resident #3 (R3) currently had a gastrostomy tube. LPAs also observed that R3 is currently not receiving hospice services. During the visit, LPAs observed and verified that R3 currently has a gastrostomy tube in place.

Official plan of correction

POC Due Date: 07/03/2026 Plan of Correction The Designee stated that the facility will submit an exception request for the resident requesting for the facility to retain the resident with a prohibited health condition. The Designee stated that he will provide LPA the written request via email or fax by POC due date.

Plan of correction recorded
Correction not verified in available records
View official report
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 observation and record review, the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care. LPAs observed the facility did not conduct an emergency disaster drill last quarter. LPAs observed the facility conducted their last emergency disaster drill on January 7, 2026.

Official plan of correction

POC Due Date: 07/13/2026 Plan of Correction The Designee stated that he will conduct an emergency disaster drill with all facility staff. The Designee agreed to provide LPA proof of the disaster drill training via email or fax by POC due date.

Plan of correction recorded
Correction not verified in available records
View official report
Inspection
Facility condition and maintenanceType B
Official classification
Type B
Official code
87303(e)(2)
Regulation authority
CCR

What the official deficiency says

(e) Water supplies and plumbing fixtures shall be maintained as follows: (2) Faucets used by residents for personal care such as shaving and grooming shall deliver hot water. Hot water temperature controls shall be maintained to automatically regulate the temperature of hot water used by residents to attain a temperature of not less than 105 degree F (41 degrees C) and not more than 120 degree F (49 degrees C). This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA observation, hot water temperature measured 103.2 degrees F which poses a potential health and safety risk to persons in care.

Official plan of correction

POC Due Date: 07/31/2025 Plan of Correction AD stated maintenace person will come and adjust water to fall within regulations. Water temperatures will be checked on daily from now on. LPA to return to verify water temperature.

Plan of correction recorded
Correction not verified in available records
View official report
Hazardous items and storageType B
Official classification
Type B
Official code
87309(a)(1)
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. (1) Disinfectants, cleaning solutions, and poisonous substances shall be stored in areas separate from food supplies as specified in Section 87555, General Food Service Requirements. This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA observation, cleaning solutions were in a cabinet unlocked in the garage accessible to residents which poses a potential health and safety risk to persons in care.

Official plan of correction

POC Due Date: 07/31/2025 Plan of Correction Staff locked cabinet during visit. AD stated they will perform an in service training and submit proof to LPA by POC due date.

Corrective action observedRecorded in report dated Jul 25, 2025
Plan of correction recorded
View official report
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 LPA observation, four expired cans of food were discovered in a hallway cabinet which posed a potential health and safety risk to persons in care.

Official plan of correction

POC Due Date: 07/31/2025 Plan of Correction Staff disposed the cans of expired food. AD to hold in service training and provide proof to LPA by POC due date.

Plan of correction recorded
Correction not verified in available records
View official report
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 record review, R13 is missing their admission agreement and R2 is missing their ID page, appraisals, and personal rights documents which poses a potential personal rights risk to persons in care.

Official plan of correction

POC Due Date: 07/31/2025 Plan of Correction AD stated she will email LPA documents by POC due date

Plan of correction recorded
Correction not verified in available records
View official report
Medication handling and storageType B
Official classification
Type B
Official code
87465(c)(2)
Regulation authority
CCR

What the official deficiency says

Once ordered by the physician the medication is given according to the physician's directions This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, medications for R2 are not being given according to the physician's orders which poses a potential health risk to persons in care.

Official plan of correction

POC Due Date: 07/31/2025 Plan of Correction AD stated will receive updated physician's orders, update centrally stored medication record, and provide proof to LPA by POC due date.

Plan of correction recorded
Correction not verified in available records
View official 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
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