Watermark Laguna Niguel.

Licensing Program Analysts (LPAs) Ruth Martinez and Garlli Tat made an unannounced visit to conduct the required annual inspection. LPAs met with Ashley Davidson, Resident Care Director and explained the reason for the visit. LPAs and the Resident Care Director toured the facility. Facility is licensed for 55 ambulatory, 68 non-ambulatory, and 12 bedridden residents. Facility has an approved hospice waiver for 25 residents. Delayed egress approved for 1st floor. This facility consists of two main areas. The assisted living and the memory care which is on the 1st floor. Memory care unit protected by delayed egress exits. Facility is a three story building with 78 Assisted Living resident rooms and 38 Memory Care resident rooms. The facility also houses 2 courtyards, a living room on each floor, a bistro, 2 dining rooms, 2 community patios, Staff break room, a Med rooms on each floor and a parking structure. LPAs and Resident Care Director began the tour of the physical plant of the facility. LPAs observed the memory care has a secured perimeter and delayed egress. The delayed egress exits were tested and found to be operational. The memory care is on the first floor and has a dining area, activity room and outdoor patio with shaded seating. LPAs toured the resident rooms in memory care. The resident rooms toured had all the required furnishings. There is an activity room with puzzles and games along arts and crafts supplies. There is a Large screen TV mounted on the wall in the activity room. No obstacles or hazards observed in the memory care. LPAs and the Resident Care Director toured the assisted living which is on the second and third floors. LPAs observed each stairway has an emergency evacuation chair. LPA observed the kitchen is clean and organized. LPA observed a bistro adjacent to the main dining room where residents can obtain Continued on LIC809-C 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 26 27 28 29 30 31 32 different snacks and beverages selections than in the main dining area. The bistro offers snacks all day so residents may dine when convenient. LPA observed menus for both areas and the food offered is varied and healthful. Kitchen was inspected. Perishable and non-perishable food supply was checked and adequately stocked at time of visit. Maintenance records were observed in the main kitchen. The emergency food and water supply is stored in a storage room. LPA observed the refrigerators and freezer are at the required temperatures. 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. Several resident bathrooms were tested for water temperature in floors 1-3 and water temperature measured between 115.7 and 118.5 degrees F in tested bathrooms. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked. LPAs pushed the restroom call button in various resident rooms and response times were under five minutes. LPAs observed several residents who appeared clean, and happy. There are activity rooms with games and reading materials on the second and third floor. Each activity room has a large screen TV. The assisted living section has a courtyard on the first floor with shaded seating. No bodies of water observed. There is also shaded balconies on the second and third floor for assisted living residents. No obstacles or hazards observed in the assisted living section. Fire extinguishers are fully charged and mounted throughout the facility. Smoke detectors and sprinkler system are tested by an outside agency, and LPAs was provided with testing documentation, last testing was done July 25, 2025. LPA inspected that medication is centrally stored in a safe locked location; facility has a medication room on each floor. LPA observed and inspected medication carts that are used to dispense meds to residents and observed medication was labeled and stored inaccessible to residents in care, no discrepancies observed. LPAs reviewed 6 resident files, no discrepancies observed. LPA reviewed 5 staff files. All staff had the required training. No discrepancies observed. Staff members present are background cleared and associated to the facility. Based on the observations made during today’s visit, no deficiencies were noted today in the areas inspected per Title 22 Division 6 of the California Code of Regulations. This report was reviewed with the facility representative and a copy of this report was provided to the facility.

Licensing Program Analyst (LPA) Joseph Alejandre made an unannounced visit to conduct the required annual inspection. LPA met with Managing Director Lee Kaufmann and explained the reason for the visit. LPA and the Managing Director toured the facility. Facility is a three story building with 78 Assisted Living resident rooms and 38 Memory Care resident rooms. The facility also houses 2 courtyards, a living room on each floor, a bistro, 2 dining rooms, 2 community patios, Staff break room, a Med room on each floor and a parking structure. LPA observed the memory care has a secured perimeter and delayed egress. The delayed egress exits are operational. The memory care is on the first floor and has a dining area, activity room and outdoor patio with shaded seating. LPA toured the resident rooms in memory care. The resident rooms toured had all the required furnishings. The smoke detectors tested operational. There is an activity room with puzzles and games along arts and crafts supplies. There is a Large screen TV mounted on the wall in the activity room. No obstacles or hazards observed in the memory care. LPA the Managing Director toured the assisted living which is on the second and third floors. LPA observed each stairway has an emergency evacuation chair. LPA observed the kitchen is clean and organized. LPA observed a 2 day perishable and a 7 day non-perishable food supply on hand in the kitchen. The emergency food and water supply is stored in a storage room. LPA observed the refrigerators and freezer are at the required temperatures. The resident rooms inspected in assisted living have the required furnishings. Hot water measured 112.0 degrees Fahrenheit in resident bathrooms. All bathrooms inspected are clean and operational. There are activity rooms with games and reading materials on the second and third floor. Each activity room has a large screen TV. 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 26 27 28 29 30 31 32 The assisted living section has a courtyard on the first floor with shaded seating. No bodies of water observed. There is also shaded balconies on the second and third floor for assisted living residents. No obstacles or hazards observed in the assisted living section. The last emergency drill took place on July 9, 2024. LPA observed the medication are kept locked in the medication room on the second floor and in the medication room on the first floor in memory care. LPA reviewed 4 resident medications, no discrepancies observed. LPA reviewed 5 resident files, no discrepancies observed. LPA reviewed 5 staff files. All staff had the required training. No discrepancies observed. Staff members present are background cleared and associated to the facility. No deficiencies observed during the inspection. No deficiencies are being cited as a result of this visit. An exit interview was conducted and a copy of the report provided.

Licensing Program Analyst (LPA) Dwayne Mason Jr. made an announced visit to the facility for purpose of conducting a pre-licensing inspection. LPA arrived at the facility at 1:00pm and was greeted and granted entry by Administrator (AD) Christopher Tharpe. An application to operate a Residential Care Facility for Elderly (RCFE) for (135) capacity, (85) ambulatory, (68) non-ambulatory, and (12) bedridden clients was received by Community Care Licensing (CCL) on 05/30/2023. Facility is a three story building housing with 78 Assisted Living single-occupancy apartments and 32 Memory Care apartments. 6 of the Memory Care apartments are shared occupancy. The facility also houses 2 courtyards, a living room on each floor, a bistro, 2 dining rooms, 2 community patios, Staff break room, a Med room on each floor, nurse office on the 3 rd floor and a parking structure. Resident Apartments: LPA observed model apartments with all the required furnishings. Per the facility’s admission agreement, Residents are encouraged to furnish their rooms. If Residents are unable to furnish their rooms, facility will order furnishings as needed. Toxins: LPA observed chemicals, cleaning solutions, laundry toxins and disinfectants are inaccessible to residents and will be stored and locked in the kitchen and laundry rooms, Medications, First-Aid Kit & Book: Medication will be stored in locked cabinets in the Med Room on each floor. The first aid kits have all the required elements. Resident & Staff Files: Staff Records will be kept locked in the HR office on the 1 st floor. Resident Records will be locked in a dedicated closet on the 3 rd floor. 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 26 27 28 29 30 31 32 Fire Extinguisher: LPA observed three fire extinguishers to be fully charged as indicated by the arrow pointing in the green zone. LPA observed the service tags indicating the Fire Extinguishers were last serviced on January 6, 2023. Activities: The facility has activity materials that will be kept in the Activity Rooms on the second and third floors. Activity calendars were posted and available for review. Fire clearance: Was approved by a fire inspector of Orange County Fire Authority on 07/28/2023. Bathrooms: All bathrooms have working plumbing. Hot water in each unit measured between 105 and 120 degrees Fahrenheit. Emergency Phone Numbers, Exit Plan & Menu: Posted and available for review. Food Service: There is a supply of 7-day non-perishable food on hand. Smoke Detectors: Smoke detectors were observed to be dual Smoke & Carbon Monoxide detectors that are stationed throughout the facility. The dual detectors were tested and observed to be operational. The facility also has fire doors on each floor. Appliances: Kitchen appliances and laundry machines were observed to be operational. The AD was notified that the final application approval will be issued by the Centralized Applications Bureau in Sacramento. Exit interview was conducted and a copy of this report was provided to designated AD.

Facility Type: Residential Care Facility for the Elderly Application Type: Initial Capacity: 135 Census (if any clients in care): 0 COMP II Participants: Christopher Tharp, Michael Hughes Interview Method: Telephone interview On July 26, 2023, applicant/administrator participated in COMP II. Identification of the applicant and administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, applicant and administrator confirmed the understanding of the California Code Title 22 Regulations. Signed LIC 809 with copy of photo ID have been obtained. During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of following areas: 1. Facility operation: License type, client/resident populations, and program 2. Admission Policies 3. Staffing requirements & Training 4. Restricted/Prohibited Health Conditions 5. General provisions 6. Emergency Preparedness 7. Complaints & Reporting 8. Pre-licensing readiness