Licensing and administration
Cited in 2 reports, with 2 deficiencies in total.
SADDLEBACK FMJ III ELDERLY CARE HOME
24252 GRASS STREET, Lake Forest CA 92630
6 bedsLatest official report Jan 27, 2026Licensed
Additional info
- Telephone
- (949) 916-2382
- Licensee
- JIMENEZ, MARIA I.
- Administrator
- MARIA I. JIMENEZ
- Contact
- MARIA I. JIMENEZ
- License first date
- Jan 27, 2006
- License effective date
- Jan 27, 2006
- District office
- ORANGE COUNTY RO · (714) 703-2840
- Regional office
- 22
- Clients served
- 935 - ELDERLY
Summary
The available records show 3 Type A and 4 Type B deficiencies for this facility.
- Most recent inspection
- Jan 27, 2026
- Most recent deficiency
- Jan 27, 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 5 reports for this facility: 5 inspections, 0 complaint investigations, and 0 licensing or administrative records.
Those records contain 3 Type A and 4 Type B deficiencies.
0 deficiencies have explicit official correction or clearance evidence in the loaded records.
- Official inspections
- 5
- Recorded deficiencies
- 7
- Type A deficiencies
- 3
- Type B deficiencies
- 4
- Substantiated complaints
- 0
- Repeated topics
- 1
More than the typical 4
1 in the last 12 months
Well above the typical 1
2 in the last 12 months
Most this size have none
0 in the last 12 months
More than the typical 1
2 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.
Official report history
All preserved reports from the most recent to the oldest, sortable by report type.
Inspection
Basic services and supervisionType B
- Official classification
- Type B
- Official code
- 87466
- Regulation authority
- CCR
What the official deficiency says
The licensee shall ensure that residents are regularly observed for changes in physical, mental, emotional and social functioning and that appropriate assistance is provided when such observation reveals unmet needs. When changes such as unusual weight gains or losses or deterioration of mental ability or a physical health condition are observed, the licensee shall ensure that such changes are documented and brought to the attention of the resident's physician and the resident's responsible person, if any. 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 due to no clients having any weight records readly available for review which poses potential health risk to persons in care.
Official plan of correction
POC Due Date: 02/03/2026 Plan of Correction Administrator agrees to weigh and document the weights of each resident, and send proof to LPA via email by POC due date.
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 record review, the licensee did not comply with the section cited above in three out of three staff not having a valid CPR/First aid certificate which poses a potential health and safety risk to persons in care.
Official plan of correction
POC Due Date: 02/03/2026 Plan of Correction Administrator agrees to schedule all staff to complete CPR/First aid certification, and to send proof of completion to LPA by POC due date.
Plan of correction recorded
Correction not verified in available records
Inspection
No deficiencies recorded in this report
Inspection
Licensing and administrationType A
- Official classification
- Type A
- 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 and record review, the licensee did not comply with the section cited above in which poses an immediate health, safety or personal rights risk to persons in care. Administrator Maria Jimenez notified LPA that the facility currently does not have liability insurance.
Official plan of correction
POC Due Date: 01/16/2025 Plan of Correction AD agreed to write and submit a written plan for getting liability insurance to LPA by POC date via fax or email. AD agreed to provide proof of liability insurance within a week and submit it to LPA via email or fax.
Plan of correction recorded
Correction not verified in available records
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 comply with the section cited above in which poses an immediate health, safety or personal rights risk to persons in care. LPA observed six chemicals stored in an unlocked staff bathroom upstairs. LPA observed the door leading to the attached garage was unlocked at time of visit. LPA observed chemicals and toxins stored in the garage. LPA observed three toxins stored in an unlocked cabinet in the resident bathroom one. LPA observed one toxin stored in an unlocked cabinet in resident bathroom two.
Official plan of correction
POC Due Date: 01/22/2025 Plan of Correction Caregiver staff immediately removed all toxins and chemicals during the visit. Toxins now inaccessible. In addition a proof of training conducted by the facility adminsitrator to all staff will be provided to LPA via email or fax by the due date.
Plan of correction recorded
Correction not verified in available records
Fire safety and emergency preparednessType A
- Official classification
- Type A
- 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 in which poses an immediate health, safety or personal rights risk to persons in care. LPA observed that the facility has no record of conducting an emergency disaster drill in the last quarter or any previous quarter.
Official plan of correction
POC Due Date: 01/16/2025 Plan of Correction AD agreed to conduct an in house training by POC date. AD will provide the training to LPA via email or fax by POC 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 licensee did not comply with the section cited above in which poses a potential health, safety or personal rights risk to persons in care. LPA observed that 3 out of the 5 burners on the gas stove do not work. During a tour of the exterior portion of the facility, LPA observed a pipe, construction materials, and two buckets left unattended by the covered patio. LPA also observed boxes of trash, a vacuum, a bucket, and concrete blocks on the sidesouth of the facility. LPA observed a ladder left unattended by the shed.
Official plan of correction
POC Due Date: 01/29/2025 Plan of Correction AD agreed to clear all the hazards and obstructions in the exterior portion of the facility by POC date. LPA will conduct a follow up visit to ensure hazards and obstructions are cleared.
Plan of correction recorded
Correction not verified in available records
Background checksType B
- Official classification
- Type B
- Official code
- 87355(e)(3)
- Regulation authority
- CCR
What the official deficiency says
(e) 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: (3) Request a transfer of a criminal record clearance as specified in Section 87355(c) or 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 in which poses a potential health, safety or personal rights risk to persons in care. Per file review, LPA observed that Staff #2 is not background associated to the facility. Per file review, Staff #2 started working at the facility on 07/06/2004. Per review of Guardian associations, Staff #2 was seperated from the facility on 02/21/2017 and has not been associated to the facility since. Per file review, LPA observed that Staff #3 is not background associated to the facility. Per file review, Staff #3 started working at the facility on 02/27/2024. Per review of Guardian associations, Staff #3 has never been background associated to the facility.
Official plan of correction
POC Due Date: 01/22/2025 Plan of Correction AD agreed to associate via Guardian Staff #2 and Staff #3 by POC date.
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