Barr Senior Courtyard I

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Michael Tea conducted an unannounced visit. The purpose of today’s visit was to conduct the Annual Required inspection. LPA Tea was greeted and granted entry into the facility by caregiver staff and explained the reason for the visit. Licensee (LE) Ban Nguyen arrived shortly to assist with the visit. Facility is licensed for six non-ambulatory residents, of which one may be bedridden and with a hospice waiver for six. Currently there are six residents, of which one is on hospice during today's visit. LPA reviewed two staff files and six resident records. Resident and staff files contained all required documentation. Some completed forms need required signatures. Administrator Honglan Tran’s administrator certificate expires on July 30, 2026. The last disaster drill was conducted on December 1, 2025. LPA Tea along with the lead staff toured the facility. LPA toured the physical plant, checked food service, and the first aid kit. The facility is a single-story home that consists of 6 resident bedrooms, 1 caregiver room, 4 bathrooms, storage room, living room, dining room, kitchen, office area and garage. LPA observed smoke detectors/carbon monoxide in common areas and bedrooms are operational. 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 around 114.9 F degrees. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked at time of visit. Common areas were clean and clear of hazards; doorways were free of obstructions. First aid kit had all the required elements including dressing, bandages, tweezers, thermometer, and scissors. Kitchen was inspected. Perishable and non-perishable food supply was checked and adequately stocked at time of visit. LPA observed sharps locked in a kitchen drawer. LPA also observed toxin substances to be locked and inaccessible to clients in care secured (Annual Inspection continued on LIC809C) underneath the kitchen sink, garage and storage room. The fire extinguishers throughout the facility were fully charged. Kitchen appliances are operational during today's visit. LPA toured the outside grounds and there is ample seating with shade in front of the house. LPA observed emergency supplies and water in the garage. Facility provides activities based on resident interests and health conditions. The residents watch television, listen to music, play bingo, color, art and go for walks outside. There is also music therapy, and they love to sing. At the time of annual visit, residents were enjoying breakfast and visitors coming to see them. LPA reviewed medication storage and administration. Medications are stored in a locked cabinet in a staff area. Medications are being administered per physician order. LPA interviewed residents regarding their quality of care and spoke to staff present regarding care provided. Based on the observation 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 Licensee Ban Nguyen and a copy of this report LIC809, along with the 809-C, LIC858, and LIC859 were read and provided to the facility.the state’s words, verbatim · CDSS document, Dec 2, 2025

Allegation investigated: Staff did not ensure resident received sufficient food service Staff did not maintain complete records for resident Staff did not communicate with resident's authorized representative regarding care needs in a timely manner

Licensing Program Analyst (LPA) Kimberly Lyman conducted an unannounced complaint visit to continue the investigation into the above allegations. LPA was greeted and granted entry into the facility and explained the reason for the visit. During the course of the investigation, LPA toured the facility and interviewed staff as well as reviewed and obtained pertinent documentation such as physician report. Regarding the allegations that staff did not ensure resident received sufficient food service, staff did not maintain complete records for resident and staff did not communicate with resident's authorized representative regarding care needs in a timely manner, the investigation revealed the following: Garden Park Care Center discharge summary for Resident 1 (R1) dated 11/18/2024 indicates R1 is on a regular diet, pureed texture with moderately thickened liquids. Two out of two staff state resident was eating a pureed diet supplemented by protein shakes. LPA observed photos of pureed meals documented for the resident's family member. Two out of two staff deny feeding the resident protein shakes only. LPA observed residents eating breakfast during the visit and food served was appropriate. CONTINUED ON LIC 9099C DATED 10/21/2025 Unsubstantiated Physician order dated 10/20/2023 shows an order for a hospital bed. Staff state the bed and wheelchair were ordered through Dr Pham and Legacy Home Health and authorization was not made by the staff. LPA reviewed a discharge letter dated 07/18/2024 from Dr Pham terminating services due to inappropriate behavior from R1's family member. After the discharge, R1 went under a different physician for care. R1's family member was non-responsive to LPA. Two out of two staff confirm speaking with R1's family member constantly regarding care. LPA reviewed text messages between facility and R1's family regarding obtaining emergency services for the resident in December 2024. Based on interviews conducted and record review, LPA is unable to corroborate the allegations. Therefore, the allegations are deemed unsubstantiated, meaning that although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violations occurred. Exit interview conducted and a copy of this report was provided.the state’s words, verbatim · CDSS document, Oct 21, 2025 · control 22-AS-20250116094644

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Michael Tea conducted an unannounced visit. The purpose of today’s visit was to conduct the Annual Required inspection. LPA Tea was greeted and granted entry into the facility by caregiver Isabel Vargas and explained the reason for the visit. Licensee (LE) Ban Nguyen arrived shortly to assist with the visit. Facility is licensed for six non-ambulatory residents, of which one may be bedridden and with a hospice waiver for six. Currently there are five residents, of which two are on hospice during today's visit. LPA Tea reviewed five resident files and two staff files. There were discrepancies noted in the review of resident and staff files. Administrator Honglan Tran’s administrator certificate expires on July 30, 2026. LPA Tea along with the Administrator toured the facility at 2:19 PM. LPA toured the physical plant, checked food service, and the first aid kit. The facility is a single-story home that consists of 5 resident bedrooms, 1 caregiver room, 3 bathrooms, spare/storage room, living room, dining room, kitchen, office area and garage. LPA observed smoke detectors/carbon monoxide in common areas and bedrooms and are operational. 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 around 109 F degrees. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked at time of visit. Common areas were clean and clear of hazards, doorways were free of obstructions. First aid kit had all the required elements including tweezers, thermometer, and scissors. Kitchen was inspected. Perishable and non-perishable food supply was checked and adequately stocked at time of visit. LPA observed sharps locked in a kitchen drawer. LPA also observed toxin substances to be locked and inaccessible to clients in care secured underneath the kitchen sink. The fire extinguishers throughout the facility were fully charged. Kitchen appliances are operational during today's visit. Annual inspection continued on LIC809-C LPA toured the outside grounds and there is ample seating with shade in front of the house. LPA observed emergency supplies and water in the garage. Licensee had ordered emergency food already and will arrive shortly to the facility. Facility provides activities based on resident interests. The residents watch television, listen to music, play bingo, color, arts and go for walks outside. There is also music therapy, and they love to dance. At the time of annual visit, residents were seen watching television, walking around the front yard and doing word search puzzles. LPA reviewed medication storage and administration. Medications are stored in a locked cabinet in a staff area. Medications are being administered per physician order. LPA interviewed residents regarding their quality of care and spoke to staff present regarding care provided. The following deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted with Licensee Ban Nguyen and a copy of these reports were given to the facility along with a copy of the LIC 858; 859;809-D, 9102 and Appeal Rights.the state’s words, verbatim · CDSS document, Dec 9, 2024

The state marks this report as 5 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Claudia Gutierrez made an announced visit to the facility for purpose of conducting a pre-licensing inspection. LPA met with designated Administrator (AD) Mareties Pontoy. An application to operate a Residential Care Facility for Elderly (RCFE) for (6) capacity, (0) ambulatory, (6) non-ambulatory, and (0) bedridden residents was received by CCL on 7/05/2023. Structure: The facility is a one-story house with five resident bedrooms, four bathrooms, two storage rooms, one staff bedroom, living room, kitchen, dining room, office, and attached two car garage. LPA observed the See Something, Say Something poster (PUB 475) in the facility mounted on the wall in the entranceway. There is a backyard that wraps around the house. There is a shaded seating area and LPA did not observe any obstacles or hazards in the backyard. Resident Bedrooms All resident bedrooms had the required furnishings. LPA observed all beds had linens and blankets. LPA observed all windows were screened. Signal system There is no signal system. Toxins: All and any toxic chemicals, cleaning solutions, laundry toxins and disinfectants are inaccessible to residents and will be stored and locked underneath the kitchen sink. Medications, First-Aid Kit & Book: Medication will be stored in a locked cabinet. First aid kit is stored with medication in the same cabinet. The first aid kit has all the required elements. Resident & Staff Files: Records will be kept locked with medication. Pool/Jacuzzi: No bodies of water were observed. Fire Extinguisher: Fire extinguisher is fully charged. Reading Material, Games, Equipment & Materials: The facility has board games, books, magazines and other recreational materials for the resident use, stored in the living room. Fire clearance: Was approved by a fire inspector of Orange County Fire Authority on 07/18/2023. No special conditions noted. Component III: Conducted at the Pre-Licensing visit, information provided about how to operate the facility within compliance and reporting requirements. Bedrooms Staff: There is one staff bedroom. Bathrooms: All bathrooms have working plumbing and designated hand washing posters. Hot water measured between 105.0-108.3 degrees Fahrenheit. Linens & Hygiene Supplies: A supply of extra linen was stored in the garage. Emergency Phone Numbers, Exit Plan & Menu: Posted and available, means of exiting, emergency phone numbers and food menu. Food Service: A supply of 2-day perishable and 7-day of non-perishable food will be maintained on hand and was observed during today’s visit. Smoke Detectors: Smoke detectors and carbon monoxide detectors tested operational. Appliances: Gas burner stove with oven, refrigerator, dish washer, microwave, washer, and dryer are operational. Licensee to address the following: · Fire clearance was approved for 6 non-ambulatory residents and one out of six residents currently in care is bedridden. The designated 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.the state’s words, verbatim · CDSS document, Oct 20, 2023

The state marks this report as 4 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.