Golden Age Living Newman

Allegation investigated: Client was not treated with dignity and respect by staff Facility did not provide client food meeting nutritional guideline minimums

On 8-4-2026 at 1:30pm, Licensing Program Analyst (LPA) Michael Bilger arrived unannounced to open and investigate the complaint allegations noted above. LPA met with house manager Carl Alvarez and explained the purpose of the visit. Administrator Janine Timoteo was made aware of LPAs visit and purpose via phone. During this investigation, LPA conducted interviews with three residents in care and three staff members. LPA also conducted a facility observation and reviewed facility file documentation including but not limited to: Physician's report, facility menu, and progress notes pertaining to resident1 (R1). Allegation: Client was not treated with dignity and respect by staff. LPA conducted interviews and record reviews as noted above. It was alleged that staff spoke in a derogatory manner regarding a resident's food preferences. Based on interviews and record reviews, it was revealed that no corroborated statements or other evidence existed to prove the above allegation. Interviews revealed staff do not make negative remarks regarding residents' food choices. {Cont. on 9099C} Unsubstantiated Additionally, interviews conducted did not reveal any other evidence of staff not treating residents with dignity and respect in any other form. As a result, the preponderance of evidence standard is not met, and this allegation is UNSUBSTANTIATED. Allegation: Facility did not provide client food meeting nutritional guidelines. LPA conducted interviews, observation, and record reviews as noted above. Record reviews revealed staff have consistently offered various food choices and to accommodate resident1 (R1) food preferences and diet including but not limited to: Soups, vegetables, fruits, bread, and beverages. Interviews and record reviews further revealed R1 has chosen to purchase own food from an outside source. An observation conducted revealed facility has appropriate amounts of food items on hand to meet general nutritional guidelines for residents' diets, and matching current menu items. Observation conducted further revealed that staff offers diabetic options to appropriate residents in care. Interviews conducted did not reveal any corroborated statements of staff not offering residents food appropriate to meet regulatory nutritional guidelines. As a result, there is not a preponderance of evidence to conclude that facility is not providing a resident with food meeting nutritional guidelines, therefore, this allegation is UNSUBSTANTIATED. A finding of unsubstantiated means the allegation may have happened or is valid, but there is not a preponderance of evidence to prove that the alleged violation occurred. An exit interview was conducted with house manager and a copy of this report was provided.the state’s words, verbatim · CDSS document, Aug 4, 2026 · control 27-AS-20260728181630

Type of visit: POC

Licensing Program Analyst, LPA, Noel Wolf Petersen arrived unannounced to the facility to follow up with compliance on the citations from the annual. LPA met with Caregiver Carl Pasco and explained the purpose of the visit. later Christnine(administrator by phone) Physical kitchen locks on half doors: Locks removed. Showers are functional: one is still disconnected. the remaining shower is accessible only through a bedroom of another resident. Weeds in the back: dealt with excepting a patch near a side gate. there are still many garbage bags of dead weeds, that present an obstruction to the use of the side gate. and the gates themselves are only somewhat able to swing freely and latch closed, there is some rust on the latches and there is some minor dragging into the ground. staff food labeled/dated:yes Fire drill log: exists, last drill 5/2/26 Fire extinguishers: dated april 30th 2026. 610d: exists Continued on c page. Medical med records:Review of medications: one resident: 2 medications did not make it to a residents mar, one perscribed as a daily prn, one perscribed as routine. The medication orders were availible digitally, a log of the dispersal of those drugs was not. one residents, 1 medication 600mg Ibuprophin is not present, staff provided the statement that it was being ordered, no document support for the refill call. one resident has a medication that is totally out, a colesterol med, family refuses so far to get it filled, LPA was shown text exchange where the family was warned about the need to fill it with 2 weeks and 1 week of dosages left. The LPA gave guidance, the facility has a responsibility to assist with medication as needed, and it may be time to talk to the family member about surrendering this level of control of the medication. One resident does not have medication since the 6th of june, about two weeks now, excepting her self injectables. The staff made a statement that the client, refuses to go to the pharmacy to get them refilled. LPA gave guideance that the client has the right to refuse and not participate in their medical treatment up until they have a court order saying they do not. Medication destruction log: Log not availible, staff belives it is located in the facility somewhere and will email it to the LPA(address below) Death reports timely: yes. last client who had died was reported and no clients have passed since. Staff Fingerprinting for all staff: Lic 500 has all eligble entries on gaurdian database Clients rail orders: no full rails, all beds have half or no rails Needs and services plans dated appropriately to the last year: not for one client on hospice with dementia, the other clients seem to have them dated between 2023 and 2026, LPA gave guidance the dementia clients should have needs and services plans filled out annually, and other clients as needed following a change in condition. 602's dated appropritely to the last year: yes Client inventory of safeguarded property logs: not well filled out in one case(jewelry, photoalbums) and not present at all in another case Liability/workers compensation insurance: a copy will be emailed to the LPA(noel.wolfpetersen@dss.ca.gov). Citations issued on following d-Page. A copy of the report was read and given to the designated staff for signing, a copy will be emailed to the address on file. exit interview was conducted, appeal rights provided.the state’s words, verbatim · CDSS document, Jul 22, 2026

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87465(a)(1,2) · Plan of correction due date: Jul 23, 2026

87465 Incidental Medical and Dental Care(a) A plan for incidental medical and dental care shall be developed by each facility. The plan shall encourage routine medical and dental care and provide for assistance in obtaining such care, by compliance with the following:(1) The licensee shall arrange, or assist in arranging, for medical and dental care appropriate to the conditions and needs of residents. (2) The licensee shall provide assistance in meeting necessary medical and dental needs. This requirement was not met as evidenced by: record review of the MAR: one client is out of a routine drug and staff report in interview a family thats refusing to cooperate with aquiring the drug. Not following this requirement poses a risk for the clients health, saftey, and personal rights.the state’s words, verbatim · CDSS document, Jul 22, 2026

Plan of correction: LPA suggested that its time to have a conversation with the family and the perscribing doc, because a families refusal does not negate the facilitys legal obligation to ensure a residents health needs are met, if an agreement cant be reached that either the family will be more responsible with delivering drugs on time or the facility should manage the clients medications, the LPA belives matter needs to be escalated to the ombudsman or APS as a medical neglect by the family. the facility will develop a plan of action regarding this matter and inform the LPA by end of day 7/23/26.designated representitve agrees.

From the deficiency page — Deficiency type: Type A · Section cited: CCR87303(a) · Plan of correction due date: Jul 23, 2026

87303 Maintenance and Operation (a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors. This requirement was not met as evidenced by: a lot(8+) of garbage bags of flamable biological matter in the pathway of the evacuation route gate. Not following this requirement poses a risk for the clients health, saftey, and personal rights.the state’s words, verbatim · CDSS document, Jul 22, 2026

Plan of correction: LPA is suggesting that matieral be immediately removed by the poc date (7/23/26) and the facility enact regular(semi annual) sweep of the emergency route gates for hazzards and obstructions. picures to the lpa(noel.wolfpetersen@dss.ca.gov) designated representitve agrees.

Type of visit: Required - 1 Year

Licensing Program Analyst, Noel Wolf Petersen, arrived unannounced to the facility on 4/29/2026 at 12:45pm. Met with Owner Yogi Ann Armond to explain the purpose of the visit. LPA asked about the outcome with a recent situation with the landlord, a statement was made that both parties intended to go forward with the sale of the property to the three owners, and therefore no residents would be impacted by a loss of control of the property. Physical inspection was completed, including the bedrooms, bathrooms, kitchen, common areas, storage areas, exterior and evacuation route. Kitchen has locks on halfdoors leading in to/out of it that are utilized to prevent access to the facility whole or in part. LPA asked locks to be removed, and increased supervision substitute the function of the lock. One of the resident bathrooms has a shower that's nonfuctional. facility provided that a work order would be completed. A second shower is functional and available for client use, but requires transversal through another residents bedroom to access. facility provided that the gardner has not been around in a while.The exterior has weeds grown up to the LPA's waist, the side gate to the facility is competely obstructed by weeds. Staff food is unlabled, some partially consumed food/beverages are missing dates. Fire extinguishers are dated January seven 2025. Fire department is able to come out tomorrow. quarterly fire drill last completed in september 2023. Smoke alarm is functional. A review of clients medications has three medications which arrived in early April of 2026(one on 4/3/2026 and two on 4/9/2026), which were not added to the clients PRN medication list. One of the medications is a benzo prn and there is no record of its doses being distributed. There are about half of the initial 28 doses remaining. LPA gave guidance that medication in the care of the facility should be added to the centerally stored medication administration record, PRN dispersal should always be documented. A recently expired resident's medications are still in the facility. LPA asked those medications to be properly destroyed. Continued on C Page. Recently expired client does not yet have a death notification sent in to licensing. LPA gave guidance that residents who die on hospice should have the department notified of their death within five days. LPA observes two cameras in common areas overlooking the kitchen and living room. LPA was told they are disconnected and part of the previous owners deal. LPA asked for them to be removed if they are no longer in use, or else send in the request and supporting documentation to the department to use them. A review of staff records, including but not limited to: health screenings, recent and initial trainings, CPR, and First Aid trainings, and backround checks. Documents are present and up to date for all but 1 employee. 1 employee does not have his fingerprinting finished, he may attempt to transfer his fingerprints from his previous job as a CNA, if that transfer doesn't work for our criteria he should get refingerprinted. he cannot work/vollunteer/reside until the results have been returned to the facility. This employee should also complete any of the required initial training before working. review of client records, one client is on hospice, dementia diagnosis, has a order for half rails for repositioning(9/10/2025), a crush med order, and weekly hha visits.Second client relatively health. one client has no filled out inventory of property, last 602 is dated 2023 and march of 2025 for each client respectively. last needs and services plan is dated 2023 and 2024. LPA gave guidance that clients with a dementia diagnosis should get 602 medical assessments and needs and services plan updates once a year. Administrator docs, including the infection control plan and evacuation plan were reviewed. Owner will send along liability insurance and workers comp insurance. 13 citations issued on following d page, appeal rights were provided, a copy of the report was read and given to the owner. exit interview.the state’s words, verbatim · CDSS document, Apr 29, 2026

Type of visit: Office

A meeting was held 4/20/26 at 10am, regarding the issue of the impending loss of control of the property, in attendance was the Licensees, Kristine Domingo, Yogi Armond, and Elmer Bais, and representatives from the department of social services: Licensing Program Analyst, Noel Wolf Petersen, Licensing Program Manager, Liza King, and Regional Office Manager Stephenie Doub. Slight delay to gather the participants, the meeting begins at 10:05am. Via the Landlord, the department has become aware of an intent to quit the lease of the property to the licensees, the Landlord claims to have a breach of the lease by nonpayment. further there was at one time an opportunity for the licensees to make an offer for the purchase of the property, but that opportunity has not yet been exercised in the form of entering an escarow period or accepted an offer from the licensees to the current property owner. if the quit is enforced, there are two residents who would be without a place to live. The department asks, what is the plan in navigating the situation from the licensees. Licensees respond: there will be a conversation with the realtor/landlord about the viability of moving forward with the purchase of the property, and failing that a decision will be made to either forfit the license and assist the current residents with finding new housing, or seek a rental property, have it fire cleared, and get an approved change of location before they loose control of the current property. The department asks for an update by the end of the day, 4/20/2026, on the outcome of that decision being reached, and emphasizes that their intent to stay in the role of licensees should also be considered. The meeting concludes at 10:38am. A copy of the meeting report was read and given to the licensees to be sent back with electronic signature. exit interview was conducted.the state’s words, verbatim · CDSS document, Apr 20, 2026

Type of visit: Post Licensing

On 09/18/2025, Licensing Program Analyst (LPA) Renee Campbell arrived to the community to conduct a post-licensing visit. A provisional license was provided to the facility as of 07/15/2025. The community is currently licensed to serve residents over 60. It is approved for 6 non-ambulatory and a hospice waiver was granted for 4 residents. Upon entry, LPA Campbell observed that the wall color and furnishings had been updated. LPA Campbell conducted a tour of the facility and confirmed that all bedrooms had a bed with covers, drawers, a table with lamp and a closet. There are currently 3 people residing in the community. One resident was at San Luis Care Center receiving physical therapy after recovering from a urinary tract infection (UTI). The administrator certificate was displayed on the wall for Administrator Janine Timoteo (6068828740, Exp 05/16/2026). A See Something Say Something poster was on the wall as well. The Facility had a Medication closet (locked) where medication is stored. A first aid kit was observed for clients and contained scissors, tweezers, thermometer and a first aid manual. Monthly meals, night shift tasks and a cleaning schedule were displayed on the refrigerator. There were three days of perishable meals in the refrigerator and freezer. The temperature for the refrigerator was 38 degrees Fahrenheit (F) and the freezer was 0 degrees F. The thermostat was set at 75 degrees F. LPA Campbell observed that the fire extinguisher was last inspected on 01/08/2025. Smoke alarms were tested and found to be functioning. There was a linen closet near the staff room that contained linens and towels. Currently, two residents share a room and two residents have their own rooms. Bedroom furnishings for use by each resident were present. Residents had access to their own closets as well. LPA Campbell spoke with Licensee Kristine Domingo and House Manager, Linda Garrett regarding improvements to the community and personnel records. A tour of the exterior grounds was conducted. A review of the facility perimeter fence, side gates, and walkways were observed to be maintained in compliance at this time. No deficiencies were observed and cited during this visit. Exit interview held and a copy of report left.the state’s words, verbatim · CDSS document, Sep 18, 2025

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Albert Johnson arrived announced to conduct a Pre-Licensing Inspection. LPA was allowed entry into the home that will be licensed for a capacity of 4 ambulatory residents. LPA met with Elmer and Kristine who assisted with today's visit. LPA toured and inspected the physical plant inside and outside to ensure there are no health and safety concerns. LPA observed there are 4 residents at this time. LPA observed the kitchen area, dining area, bedrooms, bathroom, storage areas, and laundry rooms. LPA observed knives/sharps area to be locked. LPA observed required furniture, and lighting throughout the facility. The hot water temperature was measured during this visit. Facility shall maintain the hot water temperature within the required range of 105-120*F. The temperature inside the facility measured at 77*F which is within the required range of 68-85*F. LPA observed supplies of nonperishable foods for a minimum of one week and perishable foods for a minimum of two days maintained on the premises. The first aid kit included supplies such as sterile first aid dressings, bandages or roller bandages, adhesive tape, scissors, tweezers, thermometers, antiseptic solution and guide. LPA observed centrally stored medications area to be locked. LPA observed the fire extinguisher(s), smoke and carbon monoxide detector(s) in the home. Facility has central heating and air. LPA observed the area where the staff and resident files are locked and readily available for review. Component III conducted. There are no objections to licensure at this time. -Licensure pending.the state’s words, verbatim · CDSS document, Jun 23, 2025