New Horizon Board and Care II

Type of visit: Annual/Required

Licensing Program Analyst (LPA) Christina Valerio arrived unannounced to the facility to conduct an annual required inspection. Due to technical difficulties with the system, the choice to pick Annual Required Visit was not an option. LPA Valerio clicked Case Management - Annual continuation; however, this visit will count towards the facility completing their annual inspection. LPA met with designated administrator Sharon Manalang, and explained the purpose of the visit. LPA and facility staff toured the physical plant to ensure compliance with Title 22 regulations. LPA observed the common areas, resident bedrooms, resident bathrooms, garage, and exterior area. Resident bedrooms were observed to be clean and free from debris or odors. Common areas were observed to be fully furnished, clean, and organized. Bathrooms were equipped with skid mats, hand rails, soap, paper towels, and a trash can with a lid. The hot water was measured at 105.8*degrees F, which is within the required regulatory range of 105.0*F - 120.0*F. A fire extinguisher, carbon monoxide detector, and smoke alarms were observed to be fully charged and in working condition. The facility had a minimum of 2 days of perishable food items and 7 days of non-perishable food items with an emergency food/water supply. No emergency exits were obstructed. Residents were observed watching television and in their room. Staff were assisting residents with phone calls, activities, and preparing dinner. LPA spoke to staff and residents during the visit. LPA spoke to residents and staff during the visit. LPA observed 3 resident files and 2 staff files. Resident files were complete and up to date. Staff files were complete and had required training/certifications. Per California Code of Regulations (CCR) - Title 22, Division 6, Chapter 8, no deficiencies were observed during today's visit. An exit interview was held, and a copy of the report was provided to facility staff.the state’s words, verbatim · CDSS document, Nov 6, 2023

Type of visit: POC

On 10/21/2022 at 9:05 am, Licensing Program Analyst (LPA) Tung Truong arrived at this facility unannounced to conduct a proof of correction (POC) visit in regard to deficiencies cited on 10/11/2022. LPA met with Assistant Administrator Sharon Perez and stated the purpose of today’s visit. LPA observed water temperature in the kitchen is 118.9 degrees Fahrenheit and bathroom sink is 117.6 degrees Fahrenheit. *Deficiency cited under Title 22 Regulation 87303(e)(2) – Cleared. Proof of correction was submitted on 10/12/2022. Licensee complied with the terms of the POC by POC due date. Facility was provided POC cleared letter. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, Oct 21, 2022

Type of visit: Required - 1 Year

On 10/11/22 at 9:00 am, Licensing Program Analyst (LPA) Tung Truong arrived at this facility unannounced to conduct an annual inspection visit. Prior to entering the facility, LPA Truong called and spoke to facility staff who confirmed no residents or staff have had any symptoms of COVID-19 in the last 10 days. LPA met with Assistant Administrator Sharon Perez and explained the purpose of the visit. Administrator holds current certification #6018430740 and expires on 7/14/2024. The facility is licensed to serve up to (6) six non-ambulatory residents. Approved hospice waiver for (4) four residents. There are currently three (3) residents who reside at this facility. LPA toured the facility with Assistant Administrator Sharon Perez on 10/11/22 at 9:20 am. LPA inspected the physical plant including but not limited to the common area, kitchen, dining area, resident bedrooms, resident bathrooms, laundry area, and outside courtyards of the facility to ensure compliance with Title 22 regulations. LPA observed the facility is clean and in good repair. LPA observed sufficient furniture and lighting throughout the facility. LPA observed bedrooms to be properly furnished, with appropriate bedding and lighting. The bathrooms were in sanitary condition and properly maintained. The hot water temperature was observed to be 132.2 degrees Fahrenheit, which is not within the required regulation of 105 to 120 degrees Fahrenheit. Facility thermostat observed at 75 degrees Fahrenheit. Food supply is adequate for 2-day perishable and 7-day nonperishable. LPA observed knives and toxins to be locked away and inaccessible to clients. Smoke and carbon detectors were in good repair. Fire extinguisher and first aid kit was up to date. LPA checked medication storage and found medication to be locked away and inaccessible to residents. LPA completed the infection control domain tool. Continued on 809-C The facility mitigation plan was submitted to CCLD, and it was approved on 4/13/2021. Facility has routine symptom screening checks for residents, staff, and visitors. The facility has a symptom check binder for staff, residents, and care staff. Hand Hygiene procedures have been implemented. Facility had Covid-19 posters throughout the facility, and the facility has implemented Covid-19 mitigation plan. Administrator was informed to send updated copies of the following documents to CCL within 15 days: (1) LIC308 Designation of Administrative Responsibility (2) LIC500 Personnel Report (3) Copy of Administrator Certificate (4) LIC610 Emergency Disaster Plan (5) Proof of Current Liability Insurance Per California Code of Regulations, Title 22, Division 6, Chapter 8, the following (1) deficiency is being cited. See 809-D for citation. Failure to correct the deficiency by the noted due date may result in a penalty being assessed. Exit interview conducted and copy of report provided. Appeal rights given.the state’s words, verbatim · CDSS document, Oct 11, 2022

Type of visit: Required - 1 Year

On 09/13/2021 at 11:10 AM, Licensing Program Analyst (LPA) Tung Truong arrived at this facility unannounced to conduct an annual inspection visit. Prior to entering the facility, LPA called to ensure that the facility does not have any positive COVID-19 cases. LPA met with Assistant Administrator Sharon Perez and explained the purpose of the visit. Administrator Suzanne Perez holds current certification #6018430740 and expires on 7/14/2022. The facility is licensed to serve up to (6) six non-ambulatory residents. Approved hospice waiver for (4) four residents. There are currently (3) three residents who reside at this facility. LPA toured the facility with Assistant Administrator Sharon Perez on 09/13/2021 at 11:20 AM. LPA inspected the physical plant including but not limited to the common area, kitchen, dining area, resident bedrooms; resident bathrooms, laundry area, and outside courtyards of the facility to ensure compliance with Title 22 regulations. LPA observed the facility is clean and in good repair. LPA observed sufficient furniture and lighting throughout the facility. LPA observed bedrooms to be properly furnished, with appropriate bedding and lighting. The bathrooms were in sanitary condition and properly maintained. The hot water temperature was observed to be 118.2 degrees Fahrenheit. Food supply is adequate for 2-day perishable and 7-day nonperishable. LPA observed knives and toxins to be locked away and inaccessible to residents. Smoke and carbon detectors were in good repair. Fire extinguisher and first aid kit was up to date. LPA checked medication storage and found medication to be locked away and inaccessible to clients. LPA also conducted the infection control domain tool. Report continued on 809-C The facility mitigation plan was submitted to CCLD, and it was approved on 4/13/2021. Facility has routine symptom screening checks for residents, staff, and visitors. The facility has a symptom check binder for staff, residents, and care staff. Hand Hygiene procedures have been implemented. Facility had Covid-19 posters throughout the facility, and the facility has implemented Covid-19 mitigation plan. Administrator was informed to send updated copies of the following documents to CCL within 15 days: (1) LIC308 Designation of Administrative Responsibility (2) LIC500 Personnel Report (3) Copy of Administrator Certificate (4) LIC610 Emergency Disaster Plan (5) Proof of Current Liability Insurance (6) LIC309 Administrative Organization Per California Code of Regulations, Title 22, no deficiencies were observed during this visit. Exit interview held with Assistant Administrator Sharon Perez and a copy of report given at the conclusion of the visit.the state’s words, verbatim · CDSS document, Sep 13, 2021