New Era Guest Home

Type of visit: Required - 1 Year

This unannounced inspection is being conducted by Licensing Program Analyst (LPA) Sean Haddad for the purpose of conducting a Required – 1 Year Inspection. LPA met with Administrator (AD) Josefina Gutierrez and discussed the purpose of the inspection. LPA reviewed Infection Control requirements. At about 3:00PM, LPA and AD conducted a tour of the inside and outside of the facility, common areas, resident rooms, kitchen, and garage and observed the following: Structure: facility is a 6-bedroom, 4-bathroom, one-story house with storage sheds in the backyard used for storage. There is a back yard with a patio cover for the residents. LPA observed 2 care staff and 3 residents present at the facility in addition to AD. Resident Bedrooms: the 4 resident bedrooms are spacious and will easily accommodate the residents’ furnishings. Furniture for each resident bedroom inspected. Staff Bedrooms: LPA inspected the 2 staff bedrooms. Bathrooms: the bathrooms were clean, faucets and toilets were operational. Water temperature: tested at 119 degrees F in the resident bathroom. Linens & Hygiene Supplies: new linens and fully stocked linen closets were observed. Emergency Phone Numbers, Exit Plan & Menu: reviewed. Food Service: LPA observed the facility has a 2-day supply of perishables and a 7-day supply of non-perishable food is available as required by regulations. Carbon Monoxide, Smoke Detectors, Fire Extinguisher: observed and tested. Appliances: stove burners, microwave, washer, and dryer inspected. Knives: observed locked in the kitchen. Toxins: observed locked in the laundry room. Medication cabinet: observed to be locked. First-Aid Kit and Activity Supplies: observed and available. Facility’s licensing fees are paid. At about 1:45PM, LPA reviewed 3 resident files and 3 staff files, interviewed 2 residents and 2 staff, and inspected medications for 3 residents. Facility does not handle resident money. During the inspection, LPA and AD observed the following: based on observation, the facility's fire extinguisher has not been inspected since May 22, 2024; based on observation, the licensee did not ensure medications were secured in the unlocked staff bedroom and tools, including a chainsaw, were secured in the unlocked back shed with the keys not readily available; based on documents, Resident #3’s (R3) appraisal has not been updated since December 15, 2024; and based on documents, the licensee's emergency disaster drill records show only two emergency disaster drills in the last year, which is not quarterly as required. Based on the observations made during today’s inspection, deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. See LIC809D. An exit interview was conducted and a copy of this report and appeal rights was discussed with and provided to facility representative.the state’s words, verbatim · CDSS document, Feb 9, 2026

The state marks this report as 7 pages; the online copy we transcribed has 6. You can request the full file from the county licensing office.

Allegation investigated: Facility does not have liability insurance

This unannounced inspection is being conducted by Licensing Program Analyst (LPA) Sean Haddad for the purpose of investigating the above-mentioned complaint allegation. LPA met with Administrator (AD) Josefina Gutierrez, discussed the purpose of the inspection, and explained the allegation. The investigation into the allegation that facility does not have liability insurance revealed the following: During the course of the investigation, LPA inspected the facility, conducted health and safety checks on residents, interviewed AD and witnesses, and obtained and reviewed copies of the resident roster, staff roster, the facility’s Cancellation Endorsement for Policy No. 0100231885-2, and the facility’s Certificate of Liability Insurance for Policy No. PCI96398721-01. CONTINUED Substantiated It was alleged that the facility’s liability insurance lapsed due to non-payment and the facility does not have liability insurance. LPA interviewed AD who stated they stopped paying for their old insurance because the premium had gotten too high and had switched to a new insurance. LPA reviewed the facility’s Cancellation Endorsement for Policy No. 0100231885-2 which indicates the facility’s liability insurance policy was cancelled effective August 20, 2025. However, per AD, the facility obtained new insurance and now has insurance. LPA reviewed the facility’s Certificate of Liability Insurance for Policy No. PCI96398721-01 which indicates the facility has liability insurance effective September 3, 2025. LPA interviewed a witness at AD’s new insurance company who confirmed that this policy is effective September 3, 2025, and is not retroactive. Although the facility currently has liability insurance, the information obtained corroborated that the facility did not have liability insurance between August 20, 2025, and September 3, 2025. During the course of the investigation, the Department obtained sufficient evidence to substantiate the allegation mentioned above. The preponderance of evidence standard has been met; therefore, the above allegation is Substantiated. See LIC9099D for cited deficiencies per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted and a copy of this report and appeal rights was discussed with and provided to facility representative.the state’s words, verbatim · CDSS document, Sep 11, 2025 · control 22-AS-20250910084428

From the deficiency page — Deficiency type: Type A · Section cited: HSC 1569.605 · Plan of correction due date: Sep 12, 2025

… all residential care facilities for the elderly … shall maintain liability insurance ... in the amount of at least one million dollars ($1,000,000) per occurrence and three million dollars ($3,000,000) in the total annual aggregate, caused by the negligent acts... This requirement was not met as evidenced by: Based on documents and interviews, the licensee did not maintain liability insurance between August 20, 2025 and September 3, 2025, which poses an immediate personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Sep 11, 2025

Plan of correction: Licensee stated they have already obtained liability insurance and LPA confirmed. POC CLEARED.

Allegation investigated: Staff inappropriately restrained resident in care.

This unannounced inspection is being conducted by Licensing Program Analyst (LPA) Sean Haddad for the purpose of investigating the above-mentioned complaint allegation. LPA met with Administrator (AD) Josefina Gutierrez, discussed the purpose of the inspection, and explained the allegation. The investigation into the allegation that staff inappropriately restrained resident in care revealed the following: During the course of the investigation, LPA inspected the facility, interviewed AD, clients, witnesses, and staff, and obtained and reviewed copies of the resident roster and staff roster. It was alleged that facility staff feed residents too quickly and held a resident’s arms down after getting frustrated that the resident wanted them to slow down. LPA inspected the facility, conducted health and safety checks on residents, observed no health and safety issues, and observed no evidence of injuries on any of the residents. Unsubstantiated LPA interviewed one resident who reported that staff are too rough and fast when changing them and feeding them and that staff grabbed their arms. LPA did not observe any marks or injuries on this resident’s arms. LPA also interviewed a witness who reported that this resident is sometimes confused. LPA interviewed AD and both staff who denied being too rough, too fast, or restraining residents while providing care. LPA interviewed the other three residents and did not obtain information corroborating the allegation. The information obtained is conflicting. Based on the information gathered during the investigation and review of all documents obtained, the Department is unable to ascertain if the above allegation occurred as reported. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove or refute the alleged violation occurred; therefore, this allegation is deemed Unsubstantiated. An exit interview was conducted and a copy of this report was discussed with and provided to facility representative.the state’s words, verbatim · CDSS document, May 14, 2025 · control 22-AS-20250509141500

Type of visit: Required - 1 Year

This unannounced inspection is being conducted by Licensing Program Analyst (LPA) Sean Haddad for the purpose of conducting a Required – 1 Year Inspection. LPA met with Administrator (AD) Josefina Gutierrez and discussed the purpose of the inspection. LPA reviewed Infection Control requirements. At about 10:45AM, LPA and AD conducted a tour of the inside and outside of the facility, common areas, resident rooms, kitchen, and garage and observed the following: Structure: facility is a 6-bedroom, 4-bathroom, one-story house with storage sheds in the backyard used for storage. There is a back yard with a patio cover for the residents. LPA observed 3 care staff and 5 residents present at the facility. Resident Bedrooms: the 4 resident bedrooms are spacious and will easily accommodate the residents’ furnishings. Furniture for each resident bedroom inspected. Staff Bedrooms: LPA inspected the 2 staff bedrooms. Bathrooms: the bathrooms were clean, faucets and toilets were operational. Water temperature: tested between 111 and 120 degrees F in the two resident bathrooms. Linens & Hygiene Supplies: new linens and fully stocked linen closets were observed. Emergency Phone Numbers, Exit Plan & Menu: reviewed. Food Service: LPA observed the facility has a 2-day supply of perishables and a 7-day supply of non-perishable food is available as required by regulations. Carbon Monoxide, Smoke Detectors, Fire Extinguisher: observed and tested, except for carbon monoxide detectors. Appliances: stove burners, microwave, washer, and dryer inspected. Knives: observed locked in the kitchen. Toxins: observed locked in the laundry room. Medication cabinet: observed to be locked. First-Aid Kit and Activity Supplies: observed and available. Facility’s licensing fees are paid. At about 11:45AM, LPA reviewed 5 resident files and 2 staff files, interviewed 2 residents and 2 staff, and inspected medications for 5 residents. Facility does not handle resident money. CONTINUED During the inspection, LPA and AD observed the following: based on observation, LPA and AD could not find a standalone carbon monoxide detector and none of the smoke detectors had markings indicating they also detected carbon monoxide; based on documents, the licensee has not completed reappraisals for 4 out of 5 residents for over a year; and based on documents, the licensee was unable to provide records for emergency disaster drills conducted in the last two quarters. Based on the observations made during today’s inspection, deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. See LIC809D. Civil penalties for repeat violations are being assessed. See LIC421FC. An exit interview was conducted and a copy of this report and appeal rights was discussed with and provided to facility representative.the state’s words, verbatim · CDSS document, Feb 6, 2025

Type of visit: Required - 1 Year

This unannounced inspection is being conducted by Licensing Program Analysts (LPAs) Sean Haddad and Michael Tea for the purpose of conducting a Required – 1 Year Inspection. LPAs met with Administrator (AD) Josefina Gutierrez and discussed the purpose of the inspection. LPAs reviewed Infection Control requirements. At about 8:45AM, LPAs and AD conducted a tour of the inside and outside of the facility, common areas, resident rooms, kitchen, and storage areas and observed the following: Structure: facility is a 6-bedroom, 4-bathroom, one-story house with no garage. There is a back yard with a patio cover for the residents. LPAs and AD observed 2 staff and 4 residents present at the facility. Resident Bedrooms: the 5 resident bedrooms are spacious and will easily accommodate the residents’ furnishings. Furniture for each resident bedroom inspected. Staff Bedrooms: LPAs inspected the 1 staff bedroom. Bathrooms: the bathrooms were clean, faucets and toilets were operational. Water temperature: tested between 113 and 118 degrees F in the 3 resident bathrooms. Linens & Hygiene Supplies: new linens and fully stocked linen closets were observed. Emergency Phone Numbers, Exit Plan & Menu: reviewed. Food Service: LPAs observed the facility has a 2-day supply of perishables and a 7-day supply of non-perishable food is available as required by regulations. Carbon Monoxide, Smoke Detectors, Fire Extinguisher: observed and tested. Appliances: stove burners, microwave, washer, and dryer inspected. Knives: observed locked in the kitchen. Toxins: observed locked in the hallway closet, after corrections. Medication cabinet: observed to be locked. First-Aid Kit and Activity Supplies: observed and available. Facility’s licensing fees are paid. At about 9:45AM, LPAs reviewed 4 resident files and 2 staff files, interviewed 1 resident and 1 staff as all other residents were sleeping and staff were unavailable, and inspected medications for 4 residents. Facility does not handle resident money. CONTINUED During the inspection, LPAs and AD observed the following: based on documents, the facility does not have an Infection Control Plan; based on observation and documents, the fire extinguisher has not been inspected or replaced since 2022; based on documents, R1 is bedridden per their physician's report dated 10/25/23 but the facility does not have a bedridden fire clearance; based on observation, the licensee does not have nightlights anywhere in the facility; based on observation, the licensee did not ensure toxins were secured in the laundry room when staff could not locate the key to the lockable storage closet during the inspection, but the residents are all non-ambulatory and the facility has 2 staff caring for 4 residents to ensure safety; based on observation, the licensee did not ensure medications were secured in the non-lockable staff bedroom, but the residents are all non-ambulatory and the facility has 2 staff caring for 4 residents to ensure safety; based on documents, the licensee did not ensure S1 and S2 received their 20 hour annual training; based on observation, the licensee's PUB475 is letter sized; based on documents and admission, the facility does not have a current LIC610E and cannot locate their full emergency disaster plan; and based on documents and admission, the facility has not conducted an emergency disaster drill since January 1, 2020. Based on the observations made during today’s inspection, deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. See LIC809D. Immediate civil penalties are being assessed. See LIC421IM. An exit interview was conducted and a copy of this report and appeal rights was discussed with and provided to facility representative.the state’s words, verbatim · CDSS document, May 22, 2024