Inspection
No deficiencies recorded in this report
PACIFICA COTTAGE
25421 PACIFICA AVE, Mission Viejo CA 92691
6 bedsLatest official report Sep 2, 2025Licensed
Additional info
- Telephone
- (310) 251-2382
- Licensee
- GRAND PACIFICA SUN, LLC
- Administrator
- DADABHOY, MUQEET
- Contact
- DADABHOY, MUQEET
- License first date
- Sep 2, 2021
- License effective date
- Sep 2, 2021
- District office
- ORANGE COUNTY RO · (714) 703-2840
- Regional office
- 22
- Clients served
- 935 - ELDERLY
Summary
The available records show 1 Type A and 3 Type B deficiencies for this facility.
- Most recent inspection
- Sep 2, 2025
- Most recent deficiency
- Jun 4, 2024
1 later report, on Sep 2, 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 4 reports for this facility: 3 inspections, 0 complaint investigations, and 1 licensing or administrative record.
Those records contain 1 Type A and 3 Type B deficiencies.
0 deficiencies have explicit official correction or clearance evidence in the loaded records.
- Official inspections
- 3
- Recorded deficiencies
- 4
- Type A deficiencies
- 1
- Type B deficiencies
- 3
- Substantiated complaints
- 0
- Repeated topics
- 0
Fewer than the typical 4
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
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 LPA observation and interview, the licensee did not comply with the section cited above in which the facility did not maintain an approved fire clearance for the bedroom #4 exit door that converted into a wall with a window which poses an immediate health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 06/05/2024 Plan of Correction Licensee states they will submit a copy of the original and the new facility sketches indicating the changes and submit a check in the amount of $25.00 payable to California Department of Social Services. Licensee states they will provide a proof of a receipt to CCLD via email to edward.kim@dss.ca.gov by June 5, 2025.
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, record review, and interview, the licensee did not comply with the section cited above in 5 out of 6 staff members. LPA observed the record review with S2-S6 not having trainings for 2024. This poses a potential health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 06/12/2024 Plan of Correction Licensee states they will send the proof that S2-S6 have completed their trainings to CCLD via email to edward.kim@dss.ca.gov by June 12, 2024.
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 observation, record review, and interview, the licensee did not comply with the section cited above. LPA observed there was no written record of emgerncy/safety drill log at the facility. This poses a potential health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 06/12/2024 Plan of Correction Licensee states they will send the proof of completing an emergency/safety drill log to CCLD via email to edward.kim@dss.ca.gov by June 12, 2024. Licensee state they will make sure to do quarterly safety/emergency drills.
Plan of correction recorded
Correction not verified in available records
Inspection
Resident rightsType B
- Official classification
- Type B
- Official code
- 87468.2(a)(1)
- Regulation authority
- CCR
What the official deficiency says
(a) In addition to the rights listed in Section 87468.2, Personal Rights of Residents in All Facilities, residents in privately operated residential care facilities for the elderly shall have all of the following personal rights: (1) To have a reasonable level of personal privacy in accommodations, medical treatment, personal care and assistance, visits, communications, telephone conversations, use of the Internet, and meetings of resident and family groups. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation and interviews of staff and Administrator, the facility utilizes a camera in two out of six bedrooms and is not providing R1 and R2 a reasonable level of personal privacy which poses a potential Health, Safety, or Personal Rights risk to persons in care.
Official plan of correction
POC Due Date: 09/16/2022 Plan of Correction The cameras were removed during the visit, and licensee agrees to submit a night shift schedule of staff by POC due date to LPA via email.
Plan of correction recorded
Correction not verified in available records
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