Bardwells Pines Manor

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Yolanda Delgado arrived unannounced to conduct an annual inspection. Upon arrival LPA was greeted by facility staff and granted entry by Teresa Powell. LPA began inspection with introduction, visit purpose and provided the facility caregiver with LPA identification and business card. Resident record review began- Three (3) records were reviewed. LPA reviewed for admission agreement, medical assessment and TB test results, consent forms, identification and emergency information, appraisal needs and service plans, centrally stored medication/destruction records, safeguard for personal property/valuables, and personal rights notification. This facility is meeting documentation requirements. Employee records review began- Two (2) records were reviewed. LPA reviewed employee record for first aid certification, fingerprint clearance, personnel/job application, health screening and TB test results, criminal record statement, employee rights, training verification, and current administrator certification. CPR and requirements have been met. The facility employs enough staff to maintain cleanliness and meet the needs of the clients in care. Administrator certification is present and current 10/01/2026. Physical Plant and Safety of Environment/Operational Requirements- LPA toured the facility inside and outside. The home is maintained at a comfortable temperature for the clients. Lighting is sufficient for safety and comfort. Water temperature measured 117.0 degrees F. Laundry facilities and a locked cabinet is present for storing laundry soap and other chemicals. All outdoor and indoor passageways are free of obstruction. A locked area is provided for medications and sharp objects. LPA verified there is a telephone working at this location. (Continued from LIC809, Page 1) (Continued from LIC809, Page 1) Food Service- Food supply meets the one week supply of nonperishable and 2-day supply of perishables food on hand. A menu is posted, foods are dated to assure safety. Food prep areas are clean and organized. LPA made observation throughout the inspection process to assess if the facility remains in conformity with the State Fire Marshall regulations. The facility has not exceeded its capacity limitation, and the structure remains unchanged according to the approved floor plan. Smoke detectors and carbon monoxide detectors were tested and found to be operational. Fire extinguishers are tested or replaced annually and were last done so on 08/05/2025. The facility is conducting emergency disaster drills, last done on 09/18/2025. Corporation is active and in good standing. Based on the information received during this visit today, there is one (1) deficiency that is being cited per Title 22, Division 6 of The California Code of Regulations. This report, LIC809 D and Appeal Rights was reviewed with Teresa Powell and a copy provided at the time of the exit interview.the state’s words, verbatim · CDSS document, Oct 2, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPAs), Armando Perez and Ferrer Sabarias made an unannounced visit to the facility for the purpose of conducting a required annual inspection. The LPAs were granted entry by staff to conduct the inspection and met with administrator,Najeh Hamed. The LPA informed the Administrator of the purpose for the visit. The inspection included the following: The facility consists of five (5) bedrooms, three (3) bathrooms, a kitchen and dinning area, a living room area, a garage and laundry room, and a patio and yard with sufficient seating and space for activities. There are no bodies of water located on the property. According to Administrator, no weapons are stored in the home. All outdoor and indoor passageways are kept free of obstruction and are free of debris and other trash. There are grab bars for each toilet, bathtub and shower used by residents. Resident showers have non-skid mats present. LPAs began review of client records. Five (5) records were reviewed. LPAs reviewed for identification and emergency information, admission agreement, medical assessment, and TB test results, needs and service plans, placement, functional assessment, centrally stored medication/destruction records, safeguard for personal property/valuables, and personal rights notification. LPAs began review of employee records- Three (3) records were reviewed. LPAs reviewed employee records for first aid certification, criminal record clearance or an exemption, health screening and TB test results, employee rights, training verification, and current administrator certification; expiration date 10/01/2024.Administrator provided proof of payment and the pending status email. Payment was made on 07/26/24. LPAs observed facility kitchen had the ability to prepare food in clean environment and possessed equipment in good working condition. Food supply meets the requirement of one (1) week supply of nonperishable and two (2) day supply of perishables. Emergency food and water supply is present. There is a locked location for chemicals and sharps in the kitchen. Medications are centrally stored. There is a locked kitchen cabinet allocated for medication storage. Centrally stored medication and destruction logs are maintained. Medications reviewed appear to have been dispensed accurately. LPAs made observation throughout the inspection process to assess if the facility remains in conformity with the State Fire Marshall regulations. Smoke detectors and carbon monoxide detectors were tested and found to be operational. Fire extinguishers was recharged this year, 08/01/2024. The facility is conducting emergency disaster/fire drills quarterly; last done on 09/21/2024. Based on the information received during this visit today in the areas reviewed, there are no deficiency that are being cited per Title 22, Division 6 of The California Code of Regulations. This LIC 809 report was reviewed with the facility representative and a copy was provided.the state’s words, verbatim · CDSS document, Oct 8, 2024

Type of visit: Required - 1 Year

On 10/19/2023, Licensing Program Analyst (LPA) Chinwe Nwogene arrived unannounced at the facility to conduct an annual inspection. LPA Nwogene was greeted and granted entry by Caregiver, Teresa Powell who called the House Manager, Juana Shalabi. Juana arrived at the facility shortly after. Teresa Powell and Juana Shalabi were informed of the purpose of the visit. At the time of visit there was 2 staff and 7 residents present. LPA was informed by Teresa and Juana that facility has seven residents residing in the facility. Facility is operating above capacity. Citation and civil penalty will be issued. LPA toured the facility inside and out with Teresa. Tour included: Kitchen; LPA toured the kitchen and observed kitchen to be clean. Food is stored in a safe and healthful manner. Utensils and dishware are sufficient for the census. The refrigerator and stove are in working order. Sharps are stored in a locked kitchen drawer, available only to authorized individuals. Trash cans has tight-fitting lids. Fridge, freezer and all need appliances were present and shown to be in working condition and clean. Dining and Livingroom; LPA toured the dinning and Livingroom area. LPA observed area to be clean and furnitures in good condition. Temperature was 78 degrees Fahrenheit. Hallway; LPA toured the hallway and observed hallway to be clean with no pathway obstruction. LPA observed additional linens and hygiene items. LPA inspected the fire extinguisher and found it to be in compliance and record to be up to date. Smoke detector was tested and functioning properly. LPA observed facility has no Carbon monoxide. Citation will be issued. Medication; Medications were labeled and stored in separate bins inside of a locked medication cabinet and are distributed according to physician orders. The first aid kit was complete. Continue on LIC809-C Continued from LIC809. Bathroom; LPA toured two #2 out of #2 resident’s bathroom and observed bathroom to be clean and equipped with grab bar. There is also a good number of personal toiletries available for the residents in care. The hot water measured at 114 degrees Fahrenheit. Bedroom; LPA toured five #5 out of #5 residents bedroom and observed bedrooms to be clean and furnished according to regulation, which includes proper furniture, dressers, chairs and lighting. Facility has no Night lights. Citation will be issued. Garage; LPA tour the garage and observed garage to be clean. Laundry; Cleaning supplies are stored away in the laundry room, inaccessible to clients. Washing machine and dryer are all in good repair and sufficient for the census. Backyard; LPA toured the backyard and observed backyard to be clean and furnitures in good condition. The backyard was free from obstruction and the side gates remain unlocked. No bodies of water were observed. Food Services: There are seven days non-perishable and two days of perishable food supply present, and all food was properly stored and available to residents. Fridge and freezer are sufficient enough to accommodate the required perishable foods. Records: All required postings, were posted near the entryway and throughout the facility. The administrator certificate expired on 10/1/2022. LPA was informed Administrator already received the administrator certificate but is yet to print it out. LPA advised Juana to print out the administrator certificate and have it available in the facility. All staff present are confirmed as being associated with the facility. Two staff and three #3 residents' records were reviewed. One staff has no documentation of criminal record clearance, both staff has no health screening, both staff has no CPR, one staff has no proof of training, and two residents has no medical assessment. Facility has no infection control plan. Citations will be issued. Interview; two staff and three residents were interviewed. Therefore, based on the observations made during today’s visit, a civil penalty will be assessed, and nine #9 deficiencies will be cited per Title 22, Division 6 of the California Code of Regulations. See LIC 809D. An exit interview was conducted, and this reported was provided along with appeal rights to Juana Shalabi.the state’s words, verbatim · CDSS document, Oct 19, 2023