Fire safety and emergency preparedness
Cited in 2 reports, with 4 deficiencies in total.
CONCORDIA GUEST HOME - 3
1065 SAN ANTONIO AVENUE, Fullerton CA 92835
4 bedsLatest official report Jun 23, 2026Licensed
Additional info
- Telephone
- (714) 990-5952
- Licensee
- VELASCO, CONCORDIA
- Administrator
- MICHAEL O. ROACH
- Contact
- MICHAEL O. ROACH
- License first date
- Jun 21, 2005
- License effective date
- Jun 21, 2005
- District office
- ORANGE COUNTY RO · (714) 703-2840
- Regional office
- 22
- Clients served
- 985 - RCFE / HOSPICE
Summary
The available records show 7 Type A and 16 Type B deficiencies for this facility.
- Most recent inspection
- Jun 23, 2026
- Most recent deficiency
- Jun 23, 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 4 reports for this facility: 4 inspections, 0 complaint investigations, and 0 licensing or administrative records.
Those records contain 7 Type A and 16 Type B deficiencies.
0 deficiencies have explicit official correction or clearance evidence in the loaded records.
- Official inspections
- 4
- Recorded deficiencies
- 23
- Type A deficiencies
- 7
- Type B deficiencies
- 16
- Substantiated complaints
- 0
- Repeated topics
- 4
About the same as most this size
1 in the last 12 months
Well above the typical 1
12 in the last 12 months
Most this size have none
3 in the last 12 months
Well above the typical 1
9 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.
Hazardous items and storage
Cited in 2 reports, with 2 deficiencies in total.
Licensing and administration
Cited in 2 reports, with 2 deficiencies in total.
Staffing, personnel, and training
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
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 admission, the facility has a lockable latch on the front door requiring a key to exit the front door which was previously used with a wandering resident and a pad lock was observed next to the eastern side exit, which poses an immediate safety risk to persons in care. CIVIL PENALTY ASSEESSED.
Official plan of correction
POC Due Date: 06/24/2026 Plan of Correction During the inspection, the licensee removed these locks and LPA confirmed.
Corrective action observedRecorded in report dated Jun 23, 2026
Plan of correction recorded
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 observation, the licensee did not ensure staff medications were inaccessible in the non-lockable staff bedroom, which poses an immediate health risk to residents in care.
Official plan of correction
POC Due Date: 06/24/2026 Plan of Correction During the inspection, the licensee secured these items and LPA confirmed.
Corrective action observedRecorded in report dated Jun 23, 2026
Plan of correction recorded
Health conditions and treatmentsType A
- Official classification
- Type A
- Official code
- 87608(a)(5)(B)
- Regulation authority
- CCR
What the official deficiency says
(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 and admission, R2 had a full bed rail and is not on hospice, which poses an immediate personal rights risk to persons in care.
Official plan of correction
POC Due Date: 06/24/2026 Plan of Correction During the inspection, the licensee reduced the bed rail to a half bed rail and LPA confirmed.
Plan of correction recorded
Correction not verified in available records
Health conditions and treatmentsType B
- Official classification
- Type B
- Official code
- 87470(c)
- Regulation authority
- CCR
What the official deficiency says
(c) An Infection Control Plan shall be developed by the licensee and shall be included in the Plan of Operation required by Section 87208. This requirement is not met as evidenced by: Deficient Practice Statement Based on documents, the facility does not have an infection control plan, which poses a potential health risk to persons in care.
Official plan of correction
POC Due Date: 07/21/2026 Plan of Correction Licensee stated they will review Provider Information Notice (PIN) 22-18-ASC, as well as related PINs, and submit the Infection Control Plan to LPA by POC due date.
Plan of correction recorded
Correction not verified in available records
Facility condition and maintenanceType B
- Official classification
- Type B
- Official code
- 87303(a)
- Regulation authority
- CCR
What the official deficiency says
(a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the fire extinguisher has no documentation that it was purchased or serviced within the last year, which poses a potential safety risk to persons in care.
Official plan of correction
POC Due Date: 07/21/2026 Plan of Correction Licensee stated they will purchase a new fire extinguisher or have this one serviced and submit proof to LPA by POC due date.
Plan of correction recorded
Correction not verified in available records
Facility condition and maintenanceType B
- Official classification
- Type B
- Official code
- 87303(e)(2)
- Regulation authority
- CCR
What the official deficiency says
(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 observations, the common bathroom faucet tested at 128 degrees F, which poses a potential safety risk to persons in care.
Official plan of correction
POC Due Date: 07/21/2026 Plan of Correction During the inspection, the licensee adjusted the temperature and LPA confirmed.
Plan of correction recorded
Correction not verified in available records
Staffing, personnel, and trainingType B
- Official classification
- Type B
- Official code
- 87411(f)
- Regulation authority
- CCR
What the official deficiency says
(f) All personnel, including the licensee and administrator, shall be in good health, and physically and mentally capable of performing assigned tasks. Good physical health shall be verified by a health screening, including a chest x-ray or an intradermal test, performed by a physician not more than six (6) months prior to or seven (7) days after employment or licensure. A report shall be made of each screening, signed by the examining physician. The report shall indicate whether the person is physically qualified to perform the duties to be assigned, and whether he/she has any health condition that would create a hazard to him/herself, other staff members or residents. A signed statement shall be obtained from each volunteer affirming that he/she is in good health.Personnel with evidence of physical illness or emotional instability that poses a significant threat to the well-being of residents shall be relieved of their duties. This requirement is not met as evidenced by: Deficient Practice Statement Based on documents, S3 does not have a health screening, which poses a potential safety risk to persons in care.
Official plan of correction
POC Due Date: 07/21/2026 Plan of Correction Licensee stated they will obtain a health screening including TB test for S3 and submit proof to 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
- 1569.69(b)
- Regulation authority
- HSC
What the official deficiency says
(b) Each employee who received training and passed the examination required in paragraph (5) of subdivision (a), and who continues to assist with the self-administration of medicines, shall also complete eight hours of in-service training on medication-related issues in each succeeding 12-month period. This requirement is not met as evidenced by: Deficient Practice Statement Based on documents and admission, S2 and S3 administer medications but have not received 8 hours of medication training in the last year, which poses a potential health risk to persons in care.
Official plan of correction
POC Due Date: 07/21/2026 Plan of Correction Licensee stated they will complete the medication training for these staff and submit proof to LPA by POC due date.
Plan of correction recorded
Correction not verified in available records
Medical and dental careType B
- Official classification
- Type B
- Official code
- 87465(e)
- Regulation authority
- CCR
What the official deficiency says
(e) For every prescription and nonprescription PRN medication for which the licensee provides assistance there shall be a signed, dated written order from a physician on a prescription blank, maintained in the resident's file, and a label on the medication. Both the physician's order and the label shall contain at least all of the following information. This requirement is not met as evidenced by: Deficient Practice Statement Based on observations and admission, the facility does not have doctor's orders for R2's vitamin D3, B complex and cranberry supplements which the facility has been administering to R2, which poses a potential health risk to persons in care.
Official plan of correction
POC Due Date: 07/21/2026 Plan of Correction Licensee stated they will stop giving R2 these supplements, obtain a doctor's order before resuming, and submit proof to LPA 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(c)(7)
- Regulation authority
- CCR
What the official deficiency says
(c) The medical assessment shall include, but not be limited to: (7) A description of any known behavioral expression as defined in Section 87101, Definitions. This requirement is not met as evidenced by: Deficient Practice Statement Based on documents, the physician's report for R2 is on the old form and the physician's report for R3 is on the incorrect form and both are missing required information, including behavioral expressions, which poses a potential safety risk to persons in care.
Official plan of correction
POC Due Date: 07/21/2026 Plan of Correction Licensee stated they will obtain new physician's reports for these residents on the new form and ensure they are complete with diagnoses and TB results and submit proof to LPA 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
- 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 documents and admission, the appraisals for R1 and R2 are over a year old, which poses a potential safety risk to persons in care.
Official plan of correction
POC Due Date: 07/21/2026 Plan of Correction Licensee stated they will reappraise these residents and submit proof to 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 documents and admission, the licensee does not have documentation of emergency disaster drills, which poses a potential safety risk to persons in care.
Official plan of correction
POC Due Date: 07/21/2026 Plan of Correction Licensee stated they will conduct a drill immediate, submit proof to LPA by POC due date, and ensure emergency disaster drills are conducted quarterly moving forward.
Plan of correction recorded
Correction not verified in available records
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 observation and interview the licensee did not comply with the section cited above. LPA observed a bottle of Cascade and a bottle of Finish Jet Dry were left in an unlocked cabinent under the kitchen sink.This poses an immediate health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 06/05/2025 Plan of Correction Facility immediately placed the bottle of Cascade and bottle of Finish Jet Dry in a locked cabinet in the garage.
Plan of correction recorded
Correction not verified in available records
Licensing and administrationType B
- Official classification
- Type B
- Official code
- 1569.618(c)(3)
- Regulation authority
- HSC
What the official deficiency says
(c)The facility shall employ, and the administrator shall schedule, a sufficient number of staff members to do all of the following: (3) Ensure that at least one staff member who has cardiopulmonary resuscitation (CPR) training and first aid training is on duty and on the premises at all times. This paragraph shall not be construed to require staff to provide CPR. 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. LPA observed S1 did not have a valid CPR/First Aid certificate. The last CPR expired on May 4, 2025. This poses a potential health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 06/18/2025 Plan of Correction Licensee states they will have S1 have a current and valid CPR training certificate and send proof to CCLD via email to edward.kim@dss.ca.gov by POC due date June 18, 2025.
Plan of correction recorded
Correction not verified in available records
Resident rightsType B
- Official classification
- Type B
- Official code
- 87468(c)(2)(A)
- Regulation authority
- CCR
What the official deficiency says
(c) Licensees shall prominently post personal rights, nondiscrimination notice, and complaint information in areas accessible to residents, representatives, and the public. (2) Information on the appropriate reporting agency in case of a complaint or emergency, including procedures for filing confidential complaints, shall be posted as follows: (A) Licensees may use the Residential Care Facility for the Elderly (RCFE) Complaint Poster (PUB 475) .... A poster developed by the licensee shall contain the same content as the PUB 475. The poster that is posted shall be 20” x 26” in size and be posted in the main entryway of the facility. PUB 475 may be accessed, downloaded, and printed from the www.ccld.ca.gov website. 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. LPA observed a framed PUB475 See Something Say Something paper measured at 10.5 " x 14.5 " instead of the 20 " x 26 " requirement. This poses a potential health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 06/18/2025 Plan of Correction Licensee states they will provide the PUB475 20 " x 26 " See Something Sy Something poster and posted in the main entryway by submitting proof of completion to CCLD via email to edward.kim@dss.ca.gov by POC due date June 18, 2025.
Plan of correction recorded
Correction not verified in available records
Inspection
Dementia careType A
- Official classification
- Type A
- Official code
- 87705(f)(1)
- Regulation authority
- CCR
What the official deficiency says
(f) The following shall be stored inaccessible to residents with dementia: (1) Knives, matches, firearms, tools and other items that could constitute a danger to the resident(s). This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above. LPA took photos of gardening shear, saw, and large wrench tool lying on an outdoor table, cleaning supplies in the garage and kitchen (Kirkland Ultra Fresh Fabric liquid, Arm & Hammer detergent, Cloralen bleach, Great Value Fabric softener bottle, fabuloso, Cascade, and Finish Jet).This poses an immediate health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 06/11/2024 Plan of Correction Licensee states they will put a new lock and place items in the garage cabinet. They will send a picture of the POC correction to CCLD via email to edward.kim@dss.ca.gov by June 11, 2024.
Plan of correction recorded
Correction not verified in available records
Fire safety and emergency preparednessType A
- Official classification
- Type A
- Official code
- 87203
- Regulation authority
- CCR
What the official deficiency says
87203 All facilities shall be maintained in conformity with the regulations adopted by the State Fire Marshal for the protection of life and property against fire and panic. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above. LPA took photos of the fire extinguisher at the time of visit not having an inspection record or receipt that show it complies with regulations. This poses an immediate health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 06/11/2024 Plan of Correction Licensee states they will provide a receipt that is within 1 year and send photo of the POC correction to CCLD via email to edward.kim@dss.ca.gov by June 11, 2024.
Plan of correction recorded
Correction not verified in available records
Records and plan of operationType B
- Official classification
- Type B
- Official code
- 87208(a)
- Regulation authority
- CCR
What the official deficiency says
(a) Each facility shall have and maintain a current, written definitive plan of operation. The plan and related materials shall be on file in the facility and shall be submitted to the licensing agency with the license application. Any significant changes in the plan of operation which would affect the services to residents shall be submitted to the licensing agency for approval. The plan and related materials shall contain the following: This requirement is not met as evidenced by: Deficient Practice Statement Based on observation], the licensee did not comply with the section cited above. The Licensee did not have a plan of operation or an infection control plan available at the time of the visit. This poses a potential health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 06/17/2024 Plan of Correction Licensee states they will provide a copy of the Plan of Operation and Infection Control Plan to CCLD via email to edward.kim@dss.ca.gov by June 17, 2024.
Plan of correction recorded
Correction not verified in available records
Licensing and administrationType B
- Official classification
- Type B
- Official code
- 1569.605
- Regulation authority
- HSC
What the official deficiency says
On and after July 1, 2015, all residential care facilities for the elderly, except those facilities that are an integral part of a continuing care retirement community, shall maintain liability insurance covering injury to residents and guests in the amount of at least one million dollars ($1,000,000) per occurrence and three million dollars ($3,000,000) in the total annual aggregate, caused by the negligent acts or omissions to act of, or neglect by, the licensee or its employees. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above. At the time of the visit, the insurance was not available. This poses a potential health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 06/17/2024 Plan of Correction Licensee states they will provide a proof of insurance showing the coverage to CCLD via email to edward.kim@dss.ca.gov by June 17, 2024.
Plan of correction recorded
Correction not verified in available records
Staffing, personnel, and trainingType B
- Official classification
- Type B
- Official code
- 1569.625(b)(2)
- Regulation authority
- HSC
What the official deficiency says
(2) In addition to paragraph (1), training requirements shall also include an additional 20 hours annually, eight hours of which shall be dementia care training, as required by subdivision (a) of Section 1569.626, and four hours of which shall be specific to postural supports, restricted health conditions, and hospice care, as required by subdivision (a) of Section 1569.696. This training shall be administered on the job, or in a classroom setting, or both, and may include online training. 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. LPA observed at the time of visit the 20 hours annually, 8 hours for dementia care training were not available.This poses a potential health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 06/17/2024 Plan of Correction Licensee states they will send a copy of the training hours for 2024 for S1 and S2 to CCLD via email to edward.kim@dss.ca.gov by June 17, 2024.
Plan of correction recorded
Correction not verified in available records
Dementia careType B
- Official classification
- Type B
- Official code
- 87705(c)(5)
- Regulation authority
- CCR
What the official deficiency says
(c) Licensees who accept and retain residents with dementia shall be responsible for ensuring the following: (5) Each resident with dementia shall have an annual medical assessment as specified in Section 87458, Medical Assessment, and a reappraisal done at least annually, both of which shall include a reassessment of the resident's dementia care needs. 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. LPA observed on record review R2 did not have a Medical Assessment availabe at the time of visit and R2 had appraisal needs and service plan that was done on April 16, 2023.This poses a potential health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 06/17/2024 Plan of Correction Licensee states they will provide a Medical Assessment (Physician's Report for both residents) and an updated Appraisal Needs and Service plan to CCLD via email to edward.kim@dss.ca.gov by June 17, 2024.
Plan of correction recorded
Correction not verified in available records
Inspection
Medication handling and storageType A
- Official classification
- Type A
- Official code
- 87465(h)(1)(c)
- Regulation authority
- CCR
What the official deficiency says
Incidental Medical and Dental Care Services. Medications shall be centrally stored if, because of the physical arrangements in the facility and the conditions of other persons in the facility, the medications are determined to be a safety hazard to other residents. This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA's observation Licensee failed to properly lock R2's Insulin Kwik Pens injections in the kitchen refrigerator which poses an immediate risk to the health & safety of residents in care.
Official plan of correction
POC Due Date: 05/03/2022 Plan of Correction Licensee shall ensure that all medication is locked away and made inaccessible to the residents at all times. Should any medication require refrigeration a locked container shall house such medication; Proof of compliance shall be submitted to CCL by 5/3/2022. Will provide in-service training to staff and submit proof of training by 5/10/2022.
Plan of correction recorded
Correction not verified in available records
Not classified in the sourceType B
- Official classification
- Type B
- Official code
- 87407(a)
- Regulation authority
- CCR
What the official deficiency says
Administrators shall complete at least forty (40) classroom hours of continuing education during each two (2)-year certification period... This requirement is not met as evidenced by: Deficient Practice Statement Based on interview with Licensee Concordia Velasco, the licensee did not comply with the section cited above. Licensee stated her Administrator Certificate expired 2 or 3 years ago. This poses a potential health and safety risk to persons in care.
Official plan of correction
POC Due Date: 05/04/2022 Plan of Correction Licensee to forward proof of initiating the process to renew Administrator Certificate and/or forward documentation of assigned Administrator to LPA by 5/4/2022.
Plan of correction recorded
Correction not verified in available records
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