New Home Senior Care 4

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Alvaro Ramirez, Jr. conducted an unannounced visit for the Required 1 Year Inspection. LPA explained the purpose of today’s visit, and was greeted and granted entry by Caregiver Chenee Brutas. Administrator (AD) John Bardon arrived shortly after. For today’s visit, LPA observed a total of five residents in care and two staff members on duty. LPA observed the Administrator's Certificate for facility AD John Bardon which expires on May, 13, 2027. LPA Ramirez toured the interior and exterior portions of the facility with AD Bardon. The facility is a single level structure and is licensed for six non-ambulatory residents, of which six may be on hospice and zero bedridden. There are a total of six bedrooms, of which five are private resident bedrooms, and one private bedroom for staff. LPA Ramirez toured each bedroom in the facility and observed that bedrooms were provided with furniture in good repair, clean linens, adequate storage space, and kept free of tripping hazards. Smoke and carbon monoxide detector and auditory exit alarms were tested and operational. There are a total of four restrooms. Restrooms were observed to be in good repair, toilets were operational, and grab bars and non-skid floor mats were provided. Water temperature tested between 111.6-114.8 degrees Fahrenheit. Facility met the minimum two-day perishable and seven-day non-perishable food supplies. Sharp items and knives were locked and inaccessible to residents in care. Fire extinguisher was charged, and located by the kitchen. CONTINUED ON LIC809-C... LPA Ramirez observed the emergency disaster and evacuation plan, which is posted by the main entrance. Facility had back-up emergency food and water supply, located in the garage. LPA observed that First Aid Kit had all the required components. LPA observed that medications and toxins were locked and inaccessible to residents in care. Medications are locked in a cabinet by the dining room For the exterior portion, LPA Ramirez observed a shaded patio area with furniture, and the grounds were free of any hazards. There are two gates in the backyard, which are self-closing and self-latching. No bodies of water were observed. LPA reviewed six resident files and three staff files. LPA interviewed residents and staff present. For today's visit no deficiencies were issued per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted with AD Bardon. A copy of this report was provided at the time of exit.the state’s words, verbatim · CDSS document, Apr 27, 2026

Type of visit: Required - 1 Year

On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility to conduct the required annual inspection. LPA was greeted and granted entry by facility caregiving staff after introducing himself and stating the purpose of the visit. Administrator Brian Schott was notified and arrived later to assist with the visit. There are currently six residents in care, one of which is receiving hospice care. LPA observed residents relaxing in the facility's common living areas as well as in their respective bedrooms. LPA accompanied by facility staff toured the physical plant. The facility is a one-story house with a detached garage. The facility has one shared bedroom occupied by a couple and four private rooms in addition to one staff room. There are 3.5 bathrooms, 1.5 of which is en-suite to a bedroom. All showers are equipped with grab bars and slip mats. Bedrooms appeared clean and sanitary. There are full rails for postural support in use for three individual residents, however only one of the three was admitted onto hospice. Hospice plan of care reviewed. One type B deficiency issued. All resident bedrooms have the required furnishings. Bathrooms appear clean and sanitary. Hot water temperature measured at 118F in two of the bathrooms used for personal grooming and toileting care. LPA observed the kitchen has a minimum two (2) day perishable and seven (7) day non-perishable food supply. Sharp items and the medication central storage are stored securely along with most of the cleaning products. There are however multiple cleaning products left unsecured in and around the shared bathroom accessed from the dining room. CONTINUED ON FORM LIC809-C CONTINUED FROM FORM LIC809 Fire extinguishers are charged and mounted, with up-to-date maintenance documented on the attached tags. LPA tested the smoke and carbon monoxide detectors which were found to be operational. The attached garage is inaccessible to residents. LPA and facility staff toured the outside of the facility. LPA observed an shaded outdoor seating area with furniture for resident use. There are self-latching gates on each side of the property. Routes of egress are free of obstruction. There are no bodies of water on the premises. Facility does not utilize locked perimeters or delayed egress. LPA reviewed six resident records which included all necessary components, however two of the admission agreements on file were found to be missing either the administrator's or both the facility and resident representative signatures. Advisory note issued. LPA reviewed resident medication records and prescription orders with no discrepancies observed. Oxygen is currently in use with adequate signs displayed. There are no bedridden residents present on the premises. LPA reviewed staff records for three caregivers in staff. Records were found to be complete. Training and CPR/First aid training reviewed and up-to-date. All staff are background cleared and associated to the licensed location accurately. Disaster drills are conducted quarterly on average. Based on the observations made during today’s visit, two type B deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted and a copy of this report along with appeal rights was provided to a facility representative.the state’s words, verbatim · CDSS document, Apr 21, 2025

The state marks this report as 7 pages; the online copy we transcribed has 5. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit for the purpose of conducting a Required Annual Inspection. LPA was greeted and granted entry by facility caregiving staff after introducing himself and stating the reason of the visit. Administrator Fairlane Delosreyes was notified of the visit and arrived later to assist. During the inspection, LPA and administrator conducted a tour of the physical plant and observed the following: The facility is a one-story home with five resident bedrooms, one staff room and three bathrooms. All resident bedrooms had the required furnishings. LPA observed all beds had linens and blankets and an adequate additional supply is present. The backyard has a shaded area and the route of egress is free of clutter and obstructions. There are currently six residents in care at the facility, four of which are receiving hospice care. Residents are observed to be clean and appear well taken care of. Bathrooms faucets and toilets were operational. Water temperature was verified to be within acceptable range. LPA observed emergency disaster plan with means of exiting and emergency phone numbers listed and posted. LPA observed the facility has a 2-day supply of perishables and a 7-day supply of non-perishable food as required by regulations. Combined smoke and carbon monoxide detectors tested operational. There is a fire extinguisher present which was observed to be fully charged with up-to-date maintenance. Medication, sharp items and cleaning supplies were confirmed to be inaccessible throughout the physical plant. The staff room and laundry area were observed to be locked by facility staff. The medication central storage was also observed to be secure and reviewed for accuracy during the visit. LPA reviewed six resident files and three staff files. LPA conducted or attempted six resident and three staff interviews. Based on the observations made during today’s inspection, three type B deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted, and a copy of this report along with appeal rights was left at the facility.the state’s words, verbatim · CDSS document, Apr 17, 2024