Inspection
No deficiencies recorded in this report
GOOD SAMARITAN GUEST HOME IV
26972 VIA GRANDE, Mission Viejo CA 92691
6 bedsLatest official report Jun 9, 2026Licensed
Additional info
- Telephone
- (949) 367-1806
- Licensee
- CAMBIO, SUSAN AND LEONARDO
- Administrator
- CAMBIO, SUSAN & LEONARD
- Contact
- CAMBIO, SUSAN & LEONARD
- License first date
- Jun 10, 2002
- License effective date
- Jun 10, 2002
- District office
- ORANGE COUNTY RO · (714) 703-2840
- Regional office
- 22
- Clients served
- 935 - ELDERLY
Summary
The available records show 1 Type A and 2 Type B deficiencies for this facility.
- Most recent inspection
- Jun 9, 2026
- Most recent deficiency
- Jun 17, 2024
2 later reports, from May 30, 2025 through Jun 9, 2026, 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 4 reports for this facility: 4 inspections, 0 complaint investigations, and 0 licensing or administrative records.
Those records contain 1 Type A and 2 Type B deficiencies.
1 deficiencies have explicit official correction or clearance evidence in the loaded records.
- Official inspections
- 4
- Recorded deficiencies
- 3
- Type A deficiencies
- 1
- Type B deficiencies
- 2
- Substantiated complaints
- 0
- Repeated topics
- 0
About the same as most this size
1 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
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
No deficiencies recorded in this report
Inspection
Dementia careType A
- Official classification
- Type A
- Official code
- 87705(f)(2)
- Regulation authority
- CCR
What the official deficiency says
(f) The following shall be stored inaccessible to residents with dementia: (2) Over-the-counter medication, nutritional supplements or vitamins, alcohol, cigarettes, and toxic substances such as certain plants, gardening supplies, cleaning supplies and disinfectants. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation conducted during the facility visit, the licensee did not comply with the section cited above as bleach was observed to be present in an unsecured kitchen cabinet. This poses an immediate health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 06/18/2024 Plan of Correction Dangerous items were relocated during the visit. LPA provided consultation that magnetic locks could be used in the kitchen to secure dangerous items. Deficiency cleared during the visit.
Official record says corrected or clearedRecorded in report dated Jun 17, 2024
Plan of correction recorded
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 staff records reviewed, the licensee did not comply with the section cited above as one relieving caregiver was noted to be associated to a different facility operated by the licensee but not to the present location. Thich poses/posed a potential health, safety or personal rights risk to persons in care. Civil penalty assessed.
Official plan of correction
POC Due Date: 06/18/2024 Plan of Correction Licensee will ensure adequate transfer of a criminal record clearance for the relieving caregiver before the plan of corrections 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 interview and records reviewed, the licensee did not comply with the section cited above as drills are conducted but not documented.This poses/posed a potential health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 07/17/2024 Plan of Correction Licensee will proceed to document all upcoming fire drills and take into account the date, the type of emergency covered by the drill, and the names of staff participating in the drill. One completed and documented drill to be provided to LPA before the plan of corrections due date.
Plan of correction recorded
Correction not verified in available records
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