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17582 MEDFORD AVE., Tustin CA 92780

Facility 306002292 · RESIDENTIAL CARE ELDERLY (740)

6 bedsLatest official report Apr 24, 2026Licensed

Additional info
Licensee
DORMIDO, LOUIE C.
Administrator
LOUIE DORMIDO
Contact
LOUIE DORMIDO
License first date
Apr 19, 2004
License effective date
Apr 19, 2004
District office
ORANGE COUNTY RO · (714) 703-2840
Regional office
22
Clients served
985 - RCFE / HOSPICE

Summary

The available records show 9 Type A and 3 Type B deficiencies for this facility.

Most recent inspection
Apr 24, 2026
Most recent deficiency
Apr 24, 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 4 reports for this facility: 4 inspections, 0 complaint investigations, and 0 licensing or administrative records.

Those records contain 9 Type A and 3 Type B deficiencies.

0 deficiencies have explicit official correction or clearance evidence in the loaded records.

Official inspections
4

About the same as most this size

1 in the last 12 months

Recorded deficiencies
12

Well above the typical 1

4 in the last 12 months

Type A deficiencies
9

Most this size have none

2 in the last 12 months

Type B deficiencies
3

More than the typical 1

2 in the last 12 months

Substantiated complaints
0

Most this size also have none

0 in the last 12 months

Repeated topics
3

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
Staffing, personnel, and trainingType A
Official classification
Type A
Official code
87411(f)
Regulation authority
CCR

What the official deficiency says

(f) All personnel, including the licensee and administrator, shall be in good health, and physically and mentally capable of performing assigned tasks. Good physical health shall be verified by a health screening, including a chest x-ray or an intradermal test, performed by a physician not more than six (6) months prior to or seven (7) days after employment or licensure. A report shall be made of each screening, signed by the examining physician. The report shall indicate whether the person is physically qualified to perform the duties to be assigned, and whether he/she has any health condition that would create a hazard to him/herself, other staff members or residents. A signed statement shall be obtained from each volunteer affirming that he/she is in good health.Personnel with evidence of physical illness or emotional instability that poses a significant threat to the well-being of residents shall be relieved of their duties. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation and records reviewed, the licensee did not comply with the cited above in 1 out of 2 staff did not have a LIC 503 Health Record. This poses an immediate health and safety risks to persons in care.

Official plan of correction

POC Due Date: 04/30/2026 Plan of Correction Administrator agreed to have staff complete a new TB test and provide proof to LPA by poc due date.

Plan of correction recorded
Correction not verified in available records
View official report
Medication handling and storageType A
Official classification
Type A
Official code
87465(h)(2)
Regulation authority
CCR

What the official deficiency says

(h) The following requirements shall apply to medications which are centrally stored: (2) Centrally stored medicines shall be kept in a safe and locked place that is not accessible to persons other than employees responsible for the supervision of the centrally stored medication. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation LPA observed pre poured medication in an unsecured kitchen drawer. This poses an immediate health and safety risks to persons in care. A civil penalty issued due to repeat violation.

Official plan of correction

POC Due Date: 04/25/2026 Plan of Correction Administrator corrected during visit.

Plan of correction recorded
Correction not verified in available records
View official report
Incident reportingType B
Official classification
Type B
Official code
87211(a)(1)
Regulation authority
CCR

What the official deficiency says

(1) A written report shall be submitted to the licensing agency and to the person responsible for the resident within seven days of the occurrence of any of the events specified in (A) through (D) below. This report shall include the resident's name, age, sex and date of admission; date and nature of event; attending physician's name, findings, and treatment, if any; and disposition of the case. This requirement is not met as evidenced by: Deficient Practice Statement Based on observations and records reviewed LPA observed Resident 1 and Resident 3 had hospital discharge paperwork and no incident report was provided to the Department. This poses a potential health and safety risk to persons in care.

Official plan of correction

POC Due Date: 05/07/2026 Plan of Correction Administrator will submit incident reports for R1 and R3 and will provide a list of issues that will need to be reported to CCLD and provide to LPA by POC due date.

Plan of correction recorded
Correction not verified in available records
View official report
Admission, assessment, and evictionType B
Official classification
Type B
Official code
87463(h)(1)
Regulation authority
CCR

What the official deficiency says

(h) The licensee shall request that all residents receive an annual routine visit with a licensed medical professional once every twelve months, either in person or by video appointment. (1) Documentation of the annual routine visit, such as a visit summary, shall be added to the resident's record. This requirement is not met as evidenced by: Deficient Practice Statement Based on records reviewed Residents 1 - 3 did not have an updated physician's report or documentation of an annual visit. This poses a potential health and safety risks to persons in care.

Official plan of correction

POC Due Date: 05/07/2026 Plan of Correction Administrator will obtain updated physicians reports for Resident 1 - 3 and provide proof to LPA by POC due date.

Plan of correction recorded
Correction not verified in available records
View official report
Inspection
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. LPA Mendivil observed unsecured cleaning supplies in unsecured cupboard under kitchen sink and unsecured garage. This poses an immediate risks to persons in care.

Official plan of correction

POC Due Date: 04/26/2025 Plan of Correction Administrator corrected during visit.

Plan of correction recorded
Correction not verified in available records
View official report
Health conditions and treatmentsType A
Official classification
Type A
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 observation and records reviewed, the licensee did not comply with the section cited above in 1 out of 1 resident. Administrator did not have physicians orders for half rails postural supports. This poses an immediate health and safety risk to persons in care.

Official plan of correction

POC Due Date: 04/30/2025 Plan of Correction Administrator removed half rails during visit. Administrator stated will provide proof of Physician's orders if resident requires half rails in the future.

Corrective action observedRecorded in report dated Apr 25, 2025
Plan of correction recorded
View official report
Food serviceType A
Official classification
Type A
Official code
87555(b)(8)
Regulation authority
CCR

What the official deficiency says

(b) The following food service requirements shall apply: (8) All food shall be of good quality. Commercial foods shall be approved by appropriate federal, state and local authorities. Food in damaged containers shall not be accepted, used or retained. This requirement is not met as evidenced by: Deficient Practice Statement Based on obseravation the licensee did not comply with the section cited above. LPA Mendivil observed Lipton Soup that expired on 05/07/2023 and Lasgna Pasta Sheets that expired on 01/15/2024. This poses an immediate health and safety risk to persons in care,

Official plan of correction

POC Due Date: 04/30/2025 Plan of Correction Administator threw away expired items and corrected during visit. Administrator will audit and label all items with expiration dates.

Plan of correction recorded
Correction not verified in available records
View official report
Staffing, personnel, and trainingType A
Official classification
Type A
Official code
1569.625(a)(2)
Regulation authority
HSC

What the official deficiency says

(a)In addition to any other requirement of this chapter, a residential care facility for the elderly shall have an emergency and disaster plan that shall include.. (2) Plans for the facility to be self-reliant for a period of not less than 72 hours immediately following any emergency or disaster, including, but not limited to, a short-term or long-term power failure. If the facility plans to shelter in place and one or more utilities, including water, sewer, gas, or electricity, is not available, the facility shall have a plan and supplies available to provide alternative resources during an outage. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation and interview with Administrator, the licensee did not comply with the section cited above. Administrator stated the facility did not have emergency food and water which poses an immediate health and safety risk to persons in care.

Official plan of correction

POC Due Date: 04/30/2025 Plan of Correction Administrator to purchase emergency food and water for 72 hour period.

Plan of correction recorded
Correction not verified in available records
View official report
Medication handling and storageType A
Official classification
Type A
Official code
87465(h)(2)
Regulation authority
CCR

What the official deficiency says

(h) The following requirements shall apply to medications which are centrally stored: (2) Centrally stored medicines shall be kept in a safe and locked place that is not accessible to persons other than employees responsible for the supervision of the centrally stored medication. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above. LPA Mendivil observed unsecured medication in a bag on medication cabinet, unsecured mediation cabinet and unsecure medications in kitchen cabinet This poses an immediate health and safety risk to persons in care.

Official plan of correction

POC Due Date: 04/26/2025 Plan of Correction Administrator corrected during visit.

Plan of correction recorded
Correction not verified in available records
View official report
Admission, assessment, and evictionType A
Official classification
Type A
Official code
87457(c)(1)(A)
Regulation authority
CCR

What the official deficiency says

(c) Prior to admission a determination of the prospective resident's suitability for admission shall be completed and shall include an appraisal of their individual service needs in comparison with the admission criteria specified in Section 87455, Acceptance and Retention Limitations. (1) The appraisal shall document, at a minimum: (A) An evaluation of the prospective resident's functional capabilities, mental condition, and social factors as specified in Sections 87459, Functional Capabilities and 87462, Social Factors. 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. LPA Mendivil observed incomplete Needs and Services Plans for 5 out of 5 residents which poses an immediate health and safety risk to persons in care.

Official plan of correction

POC Due Date: 05/09/2025 Plan of Correction Administrator to complete all 5 resident's records and provide proof to LPA by POC due date.

Plan of correction recorded
Correction not verified in available records
View official report
Inspection
Background checksType A
Official classification
Type A
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 LPA record review], the licensee did not comply with the section cited above in one out of five staff members which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 05/28/2024 Plan of Correction Licensee immediately faxed the Transfer Request to regional office to associate Administrator from facility next door, Lois Guest Home II, to Lois Guest Home.

Plan of correction recorded
Correction not verified in available records
View official report
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 LPA 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: 05/31/2024 Plan of Correction LIcensee and Administrator to conduct fire drill with staff and residents and send proof of drill to LPA by end of this quarter.

Plan of correction recorded
Correction not verified in available records
View official 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