Inspection
No deficiencies recorded in this report
LAKE FOREST COUNTRY HOME #2
25231 MAMMOTH CIRCLE, Lake Forest CA 92630
6 bedsLatest official report Aug 26, 2025Licensed
Additional info
- Telephone
- (949) 472-3811
- Licensee
- RIVAS, CARMEN T.
- Administrator
- RIVAS, CARMEN T.
- Contact
- RIVAS, CARMEN T.
- License first date
- Sep 5, 1996
- License effective date
- Sep 5, 1996
- District office
- ORANGE COUNTY RO · (714) 703-2840
- Regional office
- 22
- Clients served
- 983 - RCFE / DEMENTIA
Summary
The available records show 2 Type A and 2 Type B deficiencies for this facility.
- Most recent inspection
- Aug 26, 2025
- Most recent deficiency
- Sep 27, 2024
1 later report, on Aug 26, 2025, recorded no deficiencies, though the records do not say whether they were follow-ups.
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: 7 inspections, 0 complaint investigations, and 0 licensing or administrative records.
Those records contain 2 Type A and 2 Type B deficiencies.
0 deficiencies have explicit official correction or clearance evidence in the loaded records.
- Official inspections
- 7
- Recorded deficiencies
- 4
- Type A deficiencies
- 2
- Type B deficiencies
- 2
- Substantiated complaints
- 0
- Repeated topics
- 0
More than the typical 4
0 in the last 12 months
More than the typical 1
0 in the last 12 months
Most this size have none
0 in the last 12 months
More than the typical 1
0 in the last 12 months
Most this size also have none
0 in the last 12 months
Last 36 months
No inspection in the last 12 months, so a zero above means no record rather than a clean visit.
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
Licensing and administrationType B
- Official classification
- Type B
- Official code
- 1569.319(a)
- Regulation authority
- HSC
What the official deficiency says
(a) A licensee of a facility that has internet service shall provide at least one internet access device, such as a computer, smart phone, tablet, or other device, that can support real-time interactive applications, is equipped with videoconferencing technology, including microphone and camera functions, and is dedicated for resident use. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation and interviews, the licensee did not comply with the section cited above which poses a potential health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 10/11/2024 Plan of Correction Licensee to provide one internet access device and email LPA proof by POC 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 record review, the licensee did not comply with the section cited above which poses a potential health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 10/04/2024 Plan of Correction Licensee to email proof to LPA by POC due date.
Plan of correction recorded
Correction not verified in available records
Not classified in the sourceType A
- Official classification
- Type A
- Official code
- 87407(e)
- Regulation authority
- CCR
What the official deficiency says
This requirement is not met as evidenced by: 87407 Administrator Recertification Requirements (e) To apply for recertification after the expiration date of the certificate, but within four (4) years of the certificate expiration date, the certificate holder shall submit to the Department’s Administrator Certification Section: (1) A completed Application for Administrator Certification form LIC 9214. (2) Evidence of completion of the required continuing education hours as specified in Section 87407(a), or 87407(g), if applicable. The total number of hours required for recertification shall be determined by computing the number of continuing education hours the certificate holder would have been required to complete if they had remained certified. The date of computation shall be the date application for renewal is received by the Department's Administrator Certification Section. (3) Payment of a non-refundable delinquency fee equal to three times the one hundred dollar ($100) renewal fee, or three hundred dollars ($300). (4) A copy of the front and back of his/her current nursing home wallet license, or equivalent, if the applicant is a current Nursing Home Administrator. Deficient Practice Statement Based on nterview, the licensee did not comply with the section cited above which poses an immediate health, safety or personal rights risk to persons in care. Based on observation of not observing an Administrator Certificate posted, and interview with facility administrator who stated that certificate expired in February 2022, no renewal fee has been submitted
Official plan of correction
POC Due Date: 10/11/2024 Plan of Correction Licensee will submit the proof on or by 10/11/2024 to Community Care Licensing (CCL) and inform the assigned Licensing Program Analyst (LPA) of the needed materials to show that certificate renewal is in the process.
Plan of correction recorded
Correction not verified in available records
Inspection
No deficiencies recorded in this report
Inspection
No deficiencies recorded in this report
Inspection
Not classified in the sourceType A
- Official classification
- Type A
- Official code
- 87407(e)
- Regulation authority
- CCR
What the official deficiency says
87407 (e) Administrator Certification Requirements This requirement is not met as evidenced by: (e) To apply for recertification after the expiration date of the certificate, but within four (4) years of the certificate expiration date, the certificate holder shall submit to the Department's Administrator Certification Section: (1) A completed Application for Administrator Certification form LIC 9214 (2) Evidence of completion of the required continuing education hours as specified in section 87407(a) or 87407(g), if applicable. The total number of hours required to complete if they had remained certified. The date of computation shall be the date application for renewal is recieved by the Department's Administrator Certification Section. (3) Payment of a non-refundable delinquency fee equal to three times the one hundred dollar ($100) renewal fee, or three hundred dollars ($300). (4) A copy of the front and back of his/her current nursing home wallet license, or equivalent, if the applicant is a current Nursing Home Administrator. Deficient Practice Statement Based on observation of not observing an Administrator Certificate posted, and interview with facility administrator via phone who stated that certificate expired in February 2022, no renewal fee has been submitted, and disclosing the knowledge about the expired certificate, the licensee did not comply with the section cited above which poses an immediate health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 08/18/2022 Plan of Correction Licensee will submit the proof on or by 8/18/2022 to Community Care Licensing (CCL) and inform the assigned Licensing Program Analyst (LPA) of the needed materials to show that certificate renewal is in the process. NOTE: Due to Administrator not being able to be present to sign report, consent was provided for staff on duty to sign on her behalf. Citation was read via phone to Administrator who acknowledged and agreed to comply with the items discussed.
Plan of correction recorded
Correction not verified in available records
Inspection
No deficiencies recorded in this report
Inspection
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