Barr Senior Courtyard II

Type of visit: POC

Licensing Program Analyst (LPA) Michael Tea made an unannounced visit for the purpose of conducting a Plan of Corrections Inspection for a deficiency issued on 12/02/2025 during the required annual inspection conducted by LPA Tea. LPA was greeted and granted entry by facility staff. LPA discussed the purpose of the inspection with the facility. LPA Tea checked the water temperature. The water temperature measured around 118.5 Fahrenheit degrees. Based on LPA Tea's observation on today's visit, the Plan of Corrections has been fulfilled by the assigned POC due date of 12/23/2025, thus clearing the Type B deficiency CCR 87303(e)(2). An exit interview was conducted with the facility and a copy of this report was provided.the state’s words, verbatim · CDSS document, Jan 16, 2026

Type of visit: Required - 1 Year

Licensing Program Analysts (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. Facility is licensed for six non-ambulatory residents, with a hospice waiver for six. Currently there are six residents, of which one is on hospice during today's visit. LPA reviewed six resident files and two staff files. Resident files and staff files contained all required documentation. Administrator Honglan Tran’s administrator certificate expires on July 30, 2026. The last disaster drill was conducted on December 1, 2025. LPA Tea and caregivers 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 4 resident bedrooms, 1 storage room, 2 bathrooms, living room, dining room, kitchen, and detached 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 89 F degrees, which was too low. The water boiler was not working properly. The staff explained that in the morning it was working fine. 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 stored in a container and locked in the medication cabinet. LPA also observed toxin substances locked and inaccessible to clients (Annual inspection continued on LIC809-C) in care secured underneath the kitchen sink, storage shed, and garage. The fire extinguishers throughout the facility were fully charged. Kitchen appliances are operational during today's visit. There was a little trouble with the kitchen stove burners, but the staff were able to turn all the burners on. LPA suggested that kitchen stove will probably need to be replaced. LPA toured the outside grounds and there is ample seating with shade in the backyard. LPA observed emergency supplies, food and water in the storage room and garage. Facility provides activities based on resident interests and physical condition. The residents watch television, listen to music, do puzzles, and play Monopoly. They like to go on walks in the morning. The residents love to sing. At the time of annual visit, residents were watching television and enjoying their early dinner. 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 deficiency is being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted with the facility, and a copy of these reports were given to the facility along with a copy of the LIC 858; 859;809-D, and Appeal Rights.the state’s words, verbatim · CDSS document, Dec 2, 2025

Type of visit: Required - 1 Year

Licensing Program Analysts (LPAs) Michael Tea and Fred Arias 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 caregivers Francis Ramirez Jimenez and Astrid Ojeda 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, with a hospice waiver for six. Currently there are four residents, of which one is on hospice during today's visit. LPAs reviewed four resident files and two staff files. Resident files and staff files contained all required documentation. Administrator Honglan Tran’s administrator certificate expires on July 30, 2026 but is not physically displayed in the facility. LPAs advised LE Nguyen that administrator certificate needs to be displayed in the facility. LPAs Tea and Arias along with the caregivers toured the facility at 2:39 PM. LPAs toured the physical plant, checked food service, and the first aid kit. The facility is a single-story home that consists of 4 resident bedrooms, 1 storage room, 2 bathrooms, living room, dining room, kitchen, and detached garage. LPAs 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 152.2 F degrees but warnings signs were posted in the restroom for the hot water. 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. LPAs observed sharps stored in a container and locked in the medication cabinet. LPAs also observed toxin substances to be locked and inaccessible to clients in care secured underneath the kitchen sink. Annual inspection continued on LIC809-C The fire extinguishers throughout the facility were fully charged. Kitchen appliances are operational during today's visit. LPAs toured the outside grounds and there is ample seating with shade in the backyard. LPAs observed emergency supplies, food and water in the storage room and garage. Facility provides activities based on resident interests. The residents watch television, listen to music, do puzzles, and play Monopoly. They like to go on walks in the morning. A physical therapist comes to the facility do exercise with them. They love to sing and dance. At the time of annual visit, residents were seen watching television and relaxing. LPAs reviewed medication storage and administration. Medications are stored in a locked cabinet in a staff area. Medications are being administered per physician order, but not properly documented. LPAs interviewed residents regarding their quality of care and spoke to staff present regarding care provided. The following deficiency 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 11, 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 four resident bedrooms, two bathrooms, living room, kitchen, dining area and detached 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 in the same cabinet as medication. 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, and other recreational materials for residents’ use stored in the living room. Fire clearance: Was approved by a fire inspector of Orange County Fire Authority on 08/08/2023. 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 no staff bedroom. Bathrooms: All bathrooms have working plumbing and designated hand washing posters. Hot water measured at 116.9 degrees Fahrenheit. Linens & Hygiene Supplies: A supply of extra linen was stored in the detached 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. Smoke Detectors: Smoke detectors and carbon monoxide detectors tested operational. Appliances: Gas four burner stove with oven, refrigerator, microwave, washer, and dryer are operational. 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, Dec 5, 2023

Type of visit: Office

Facility Type: CHOW Application Type: RCFE Capacity: 6 Census (if any clients in care): 4 COMP II Participants: Mareties Pontoy (Administrator) and Ban Nguyen (Corporate Board Member) Interview Method: Virtual interview via Microsoft Teams On October 27, 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 that they have read and understand community care facility licensing laws included in the Health and Safety Codes and the California Code of Regulations Title 22. 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. Restrictive/Prohibited Health Conditions 5. General provisions 6. Emergency Preparedness 7. Complaints & Reporting 8. Pre-licensing readinessthe state’s words, verbatim · CDSS document, Oct 27, 2023