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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306005948
Report Date: 01/09/2025
Date Signed: 01/10/2025 08:10:53 AM

Document Has Been Signed on 01/10/2025 08:10 AM - 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:AEGIS LIVING DANA POINTFACILITY NUMBER:
306005948
ADMINISTRATOR/
DIRECTOR:		NAZARETH, SHEILAFACILITY TYPE:
740
ADDRESS:26922 CAMINO DE ESTRELLATELEPHONE:
(949) 488-2650
CITY:DANA POINTSTATE: CAZIP CODE:
92624
CAPACITY: 76CENSUS: 63DATE:
01/09/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:20 AM
MET WITH:Eric MedorTIME VISIT/
INSPECTION COMPLETED:
04:15 PM
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Licensing Program Analysts (LPAs) Kimberly Lyman and Fred Arias conducted an unannounced visit to the facility. The purpose of today’s visit was to conduct the annual required inspection. LPAs were allowed entry into the facility and explained the reason for the visit.. Facility is licensed for 130 non-ambulatory residents of which 50 may be bedridden. The two-story facility houses Assisted Living (AL) and Memory Care (MC) apartments. The first floor houses 11 AL apartments, 19 MC apartments, three activity rooms/areas, med room, two common dining rooms, 1 private dining room, kitchen, sitting areas, staff offices, family room, spa, two common bathrooms and courtyard. The second floor houses 36 AL apartments, reading room, salon, and laundry room. There are 11 residents on hospice. LPAs along with Administrator (AD) Eric Medor toured the facility at 9:15 AM. All apartments have the necessary furnishings and private bathrooms. LPAs toured the physical plant, checked food service, and the first aid kit. Resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. Resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure and shower was free of mold/mildew. Water temperature measured between 104.7 degrees F and 117.5 degrees F in all restrooms. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked. LPAs checked medication room and medication carts and were found to be secured. Common areas were clean and clear of hazards, doorways were free of obstructions. Perishable and non-perishable food supply was checked and adequately stocked at time of visit. Kitchen appliances are operational during today's visit. LPAs observed the facility to be clean and sanitary. Toxins are secured. Smoke detectors and carbon monoxide detectors are tested monthly in house and fire/ sprinkler inspections were last conducted on 10/17/2024 by third-party SouthCoast fire and security. Fire extinguishers were fully charged. LPAs reviewed the infection control plan and emergency disaster plans and plans are complete. Facility conducts quarterly emergency drills with the last drill conducted on 11/13/2024. LPAs observed ample emergency food and water.
Continued ON LIC 809C DATED 1/09/2025
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Fred Arias
LICENSING EVALUATOR SIGNATURE: DATE: 01/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/09/2025
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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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: AEGIS LIVING DANA POINT
FACILITY NUMBER: 306005948
VISIT DATE: 01/09/2025
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 Outside grounds were toured. LPAs observed multiple outside patio areas. There is ample outdoor shaded seating for residents. Walkways around the facility were clear of hazards. There are no security bars or weapons on the premises. LPAs observed medication administration and storage. Medications are being administered per physician order.







Based on the observations made during today's visit, No deficiencies are being cited. Exit interview conducted and a copy of this report was left at the facility.
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Fred Arias
LICENSING EVALUATOR SIGNATURE:

DATE: 01/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/09/2025
LIC809 (FAS) - (06/04)
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