306000961-4-16-2026-22-AS-WVAS-DT7RM6-20260416130812

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 306000961
Report Date: 04/16/2026
Date Signed: 04/16/2026 01:08:27 PM

Document Has Been Signed on 04/16/2026 01:08 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

FACILITY NAME:	WALNUT VILLAGE		FACILITY NUMBER:	306000961
ADMINISTRATOR/ DIRECTOR:	DEBORAH INFIELD		FACILITY TYPE:	741
ADDRESS:	891 WALNUT STREET		TELEPHONE:	(714) 776-7150
CITY:	ANAHEIM	STATE: CA	ZIP CODE:	92802
CAPACITY: 334		CENSUS: 189	DATE:	04/16/2026
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	08:00 AM
MET WITH:	Debbie Infield (Executive Director)		TIME VISIT/ INSPECTION COMPLETED:	01:30 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On today's date Licensing Program Analyst (LPA) William Vanegas made an unannounced visit for the purposes of conducting an annual inspection. Upon arrival LPA was greeted by front desk reception staff. LPA explained the purpose of the visit, and Executive Director (ED) Deborah Infield was notified via telephone and arrived shortly after to assist with the annual inspection. LPA accompanied with ED conducted a tour of the facility and observed the following. ED has a valid Administrator certificate valid from February 25, 2026 through February 24, 2028. The facility is a gated community with a total of 189 residents. There are three storied apartment buildings, along with individual independent living cottages inside the gated community. The facility includes an independent living unit, assisted living unit, and a memory care unit. The facility is approved for delayed egress doors in the memory care unit and they tested operational. The facility is equipped with evacuation chairs at the top of each stairwell. The facility includes an art studio, a theater room, a large pool and sauna, a hair salon, a bistro, a sensory room, a boccie ball court, gym, putting green, two dinning room venues, and underground parking for residents, and guest parking through out the property. LPA observed the main kitchen area to be clean and free of any mildew and debris. LPA observed the kitchen area to be inaccessible to residents in care, and for the kitchen area to have a gas stove walk in refrigerator and freezer. All appeared to be in good repair and tested operational. All sharps were observed to be inaccessible to residents in care. LPA observed facility to have a two day supply of perishable food and a seven day supply of non-perishable food along with a sufficient amount of emergency water on hand for all residents in care. CONTINUED ON LIC809C

NAME OF LICENSING PROGRAM MANAGER: Kevin Saborit-Guasch
NAME OF LICENSING PROGRAM ANALYST: William Vanegas
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 04/16/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/16/2026

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are 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 deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

FACILITY NAME: WALNUT VILLAGE	FACILITY NUMBER: 306000961
	VISIT DATE: 04/16/2026

NARRATIVE

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LPA observed a water fountain in the main courtyard, how ever the water fountain does not have a large body of water. LPA toured the inside of resident rooms and observed rooms that were toured to have all required furnishings such as a chest of drawers, a reading lamp, a bed, cleaning linens in good repair meaning no strains or tares, and enough storage space for residents to store away their personal belongings. LPA observed there to be several different floor plans, that meet the requirements of title 22 chapter 8 division 6 of the California Code of Regulations. Additionally resident units have a full kitchen area, and a common area available to residents in care. Resident unit bathrooms were observed to be clean and free of any mildew and debris, resident bathrooms had required items including a shower chair, grab bars, and slip resistant floor matts. Hot water temperature in resident bathrooms tested between 113.4 and 121.3 degrees Fahrenheit.

LPA observed quarterly testing log for facility smoke detectors and carbon monoxide detectors tested operational on last inspection date of May 14, 2025. Inspection was conducted by Anaheim Fire Department. All smoke detectors and carbon monoxide detectors were observed to be in good repair. LPA observed fire extinguishers to be fully charged and up to date. LPA observed all required postings to be posted in the mail room; a food menu is made available to residents in care weekly, and the activity calendar is posted in a visible area for residents to take advantage of available activities for residents in care.

LPA Reviewed ten resident files and ten staff files all files (staff and resident) had all required documents. LPA reviewed medications with Medtech staff and ED. LPA observed all medications to be documented correctly and per LPA review medications are being administered per physicians orders. Based on observations made during today's inspection no deficiencies will be issued per title 22 chapter 8 division 6 of the California Code of Regulations. An exit interview was conducted with ED and a copy of this report was provided to the facility, additionally a copy of this report will be mailed to the facility.

NAME OF LICENSING PROGRAM MANAGER: Kevin Saborit-Guasch
NAME OF LICENSING PROGRAM ANALYST: William Vanegas
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 04/16/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/16/2026

LIC809 (FAS) - (06/04)

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