Fire safety and emergency preparedness
Cited in 3 reports, with 4 deficiencies in total.
ANNISSA GEM CARE
825 LILAC DRIVE, Placentia CA 92870
6 bedsLatest official report Jan 29, 2026Licensed
Additional info
- Telephone
- (714) 203-1702
- Licensee
- ANNISSA GEM CARE, LLC
- Administrator
- LIMPIADO, GIDEON
- Contact
- LIMPIADO, GIDEON
- License first date
- Jan 25, 2021
- License effective date
- Jan 25, 2021
- 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 11 Type B deficiencies for this facility.
- Most recent inspection
- Jan 29, 2026
- Most recent deficiency
- Jan 29, 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: 4 inspections, 1 complaint investigation, and 0 licensing or administrative records.
Those records contain 2 Type A and 11 Type B deficiencies.
0 deficiencies have explicit official correction or clearance evidence in the loaded records.
- Official inspections
- 4
- Recorded deficiencies
- 13
- Type A deficiencies
- 2
- Type B deficiencies
- 11
- Substantiated complaints
- 0
- Repeated topics
- 3
About the same as most this size
1 in the last 12 months
Well above the typical 1
4 in the last 12 months
Most this size have none
0 in the last 12 months
Well above the typical 1
4 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.
Staffing, personnel, and training
Cited in 2 reports, with 3 deficiencies in total.
Facility condition and maintenance
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
Staffing, personnel, and trainingType B
- Official classification
- Type B
- Official code
- 87412(a)
- Regulation authority
- CCR
What the official deficiency says
(a) The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee. Each personnel record shall contain the following information: This requirement is not met as evidenced by: Deficient Practice Statement Based on observation and staff interview, the licensee did not comply with the section cited above in one of three staff files which poses a potential health, safety and personal rights risk to persons in care.
Official plan of correction
POC Due Date: 02/27/2026 Plan of Correction Staff De Guzman stated a personnel record will be maintained for all staff and a copy provided to LPA via email by POC date.
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 record review, the licensee did not comply with the section cited above in three of three staff files which poses a potential health, safety and personal rights risk to persons in care.
Official plan of correction
POC Due Date: 02/27/2026 Plan of Correction Staff De Guzman stated staff will complete required training and a copy provided to LPA via email 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
- 1569.69(a)(2)
- Regulation authority
- HSC
What the official deficiency says
(a) Each residential care facility for the elderly licensed under this chapter shall ensure that each employee of the facility who assists residents with the self-administration of medications meets all of the following training requirements: (2) In facilities licensed to provide care for 15 or fewer persons, the employee shall complete 10 hours of initial training. This training shall consist of 6 hours of hands-on shadowing training, which shall be completed prior to assisting with the self-administration of medications, and 4 hours of other training or instruction, as described in subdivision (f), which shall be completed within the first two weeks of employment. 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 of three staff files which poses a potential health, safety or personal rights risk to persons in care.
Official plan of correction
POC Due Date: 02/27/2026 Plan of Correction Staff De Guzman stated required staff training will be completed and a copy provided to LPA via email by POC date.
Plan of correction recorded
Correction not verified in available records
Facility condition and maintenanceType B
- Official classification
- Type B
- Official code
- 87307(a)
- Regulation authority
- CCR
What the official deficiency says
(a) Living accommodations and grounds shall be related to the facility's function. The facility shall be large enough to provide comfortable living accommodations and privacy for the residents, staff, and others who may reside in the facility. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above as staff is currently residing in the garage which poses a potential safety and personal rights risk to persons in care.
Official plan of correction
POC Due Date: 02/27/2026 Plan of Correction Staff De Guzman stated staff would no longer reside in the garage and bed, made with linen and blankets, and staff's personal belongings, including clothing and toiletries would be removed and picture proof provided to LPA via email by POC date.
Plan of correction recorded
Correction not verified in available records
Inspection
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 record review, the licensee did not comply with the section cited above in two of two staff records, which poses a potential health, safety and personal rights risk to persons in care.
Official plan of correction
POC Due Date: 03/05/2025 Plan of Correction Staff DeGuzman stated staff training will be completed and proof provided to LPA via email 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
- 1569.69(a)(2)
- Regulation authority
- HSC
What the official deficiency says
(a) Each residential care facility for the elderly licensed under this chapter shall ensure that each employee of the facility who assists residents with the self-administration of medications meets all of the following training requirements: (2) In facilities licensed to provide care for 15 or fewer persons, the employee shall complete 10 hours of initial training. This training shall consist of 6 hours of hands-on shadowing training, which shall be completed prior to assisting with the self-administration of medications, and 4 hours of other training or instruction, as described in subdivision (f), which shall be completed within the first two weeks of employment. 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 two of two staff files which poses a potential health and safety risk to persons in care.
Official plan of correction
POC Due Date: 03/05/2025 Plan of Correction Staff DeGuzman stated staff training will be completed and proof provided to LPA via email by POC date.
Plan of correction recorded
Correction not verified in available records
Admission, assessment, and evictionType B
- Official classification
- Type B
- Official code
- 87458(c)(1)(A)
- Regulation authority
- CCR
What the official deficiency says
(c) The medical assessment shall include, but not be limited to: (1) A physical examination of the resident indicating the licensed medical professional's diagnosis or diagnoses and results of an examination for all of the following: (A) Communicable tuberculosis. 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 of four resident files which poses a potential health risk to persons in care.
Official plan of correction
POC Due Date: 03/05/2025 Plan of Correction Staff DeGuzman stated an examination for communicable tuberculosis for residents will be completed and proof provided to LPA via email by POC 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 record review, the licensee did not comply with the section cited above in four of four resident files, which poses a potential health, safety and personal rights risk to persons in care.
Official plan of correction
POC Due Date: 03/05/2025 Plan of Correction Staff DeGuzman stated pre-admission appraisals will be updated in writing and proof provided to LPA via email by POC date.
Plan of correction recorded
Correction not verified in available records
Admission, assessment, and evictionType B
- Official classification
- Type B
- Official code
- 87507(d)
- Regulation authority
- CCR
What the official deficiency says
(d) The licensee shall retain in the resident's file the original signed and dated admission agreement and all subsequent signed and dated modifications. This does not apply to rate increases which have specific notification requirements as specified in Health and Safety Code section 1569.655. 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 one of four resident files, which poses a potential personal rights risk to persons in care.
Official plan of correction
POC Due Date: 03/05/2025 Plan of Correction Staff DeGuzman stated a copy of original signed and dated admission agreement will be provided to LPA via email 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(b)
- Regulation authority
- HSC
What the official deficiency says
(b) A facility shall provide training on the plan to each staff member upon hire and annually thereafter. The training shall include staff responsibilities during an emergency or disaster. This requirement is not met as evidenced by: Deficient Practice Statement Based on staff interview and record review, the licensee did not comply with the section cited above in two of two staff files which poses a potential health and safety risk to persons in care.
Official plan of correction
POC Due Date: 03/05/2025 Plan of Correction Staff DeGuzman stated staff training will be completed and proof provided to LPA via email by POC date.
Plan of correction recorded
Correction not verified in available records
Health conditions and treatmentsType B
- Official classification
- Type B
- Official code
- 87608(a)(3)
- Regulation authority
- CCR
What the official deficiency says
(3) A written order from a physician indicating the need for the postural support shall be maintained in the resident’s record. The licensing agency shall be authorized to require other additional documentation if needed to verify the order. 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 four of four resident records which poses a potential safety and personal rights risk to persons in care.
Official plan of correction
POC Due Date: 03/05/2025 Plan of Correction Staff DeGuzman stated a written order from a physician indicating the need for the postural supports will be obtained and proof providded to LPA via email
Plan of correction recorded
Correction not verified in available records
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: Deficient Practice Statement This requirement was not met as evidence by based on observation it was observed the Adminitrator did not ensure the facility's Fir extingisher was serviced on March 05, 2020, which poses an immediate health and safety risk to the person in care.
Official plan of correction
POC Due Date: 05/11/2024 Plan of Correction Administrator reach out to have the fire extinguisher serviced the same date of inspection, and willl submit proof of correction through email by the assigned POC due date of 05/11/2024.
Plan of correction recorded
Correction not verified in available records
Facility condition and maintenanceType A
- Official classification
- Type A
- Official code
- 87303(e)(2)
- Regulation authority
- CCR
What the official deficiency says
(e) Water supplies and plumbing fixtures shall be maintained as follows: (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). Deficient Practice Statement This requirement was not met as evidence by based on observation, two out of two resident's bathrooms had hot water measured over 120 degree Fahrenheit which poses an immediate health and safety risk to the person in care,
Official plan of correction
POC Due Date: 05/11/2024 Plan of Correction During inspection, the house manager adjusted hot water. LPAs measured hot water to be between 105 and 120 degree Fahrenheit. POC was fulfilled during inspection.
Plan of correction recorded
Correction not verified in available records
Complaint
Allegations0 substantiated · 0 unsubstantiated · 1 unfounded
No deficiencies recorded in this reportInspection
No deficiencies recorded in this report
1 complaint has no published investigation report
The official record holds these complaints, but no investigation report was published for them. Their outcome is shown as the source recorded it.
- Jan 27, 2023 · Control 22-AS-20230120092507
Allegations0 substantiated · 0 unsubstantiated · 2 unfounded
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