New Hope Residential Elder Care III

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) E. Conchas made an unannounced visit to the facility. The purpose of the visit was to conduct the required comprehensive annual inspection LPA met with a staff member and was granted entry to the facility. Caregiver Ralp Abano assisted LPA in the tour during the visit. At the time of the visit there were three (3) staff present. The facility is a six (6) bedroom, two & half (2 & 1/2) bathroom home with a kitchen/dining area, living room/activity room. The facility is licensed for a capacity of six (6) bedridden residents. The facility is approved for six (6) hospice waivers. The current census is six (6) residents. LPA was accompanied by Ralp to conduct a general overall inspection. The facility is operating in the capacity approved by Community Care Licensing Division (CCLD). There are no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature of 75 degrees Fahrenheit. LPA inspected resident bedrooms which are equipped with required furniture. Bathrooms were clean, and appliances were operating appropriately. LPA observed sufficient furniture and lighting throughout the facility. LPA measured and observed the water temperatures in the bathrooms to be between 109-115 degrees F. The facility is equipped with operating smoke detectors and carbon monoxide alarms. One Fire extinguisher was observed at the facility and was current. Posters such as personal rights, the CCLD complaint poster, labor laws, and the disaster plan were posted in a common area. LPA observed non-perishable and perishable food supply that was sufficient for the number of residents in care. LPA observed sharps, and other dangerous items were kept inaccessible to residents in care. There was a designated locked storage space for residents, staff, facility files, first aid kit and medication. Continue to LIC809-C LPA reviewed resident files for admission agreements, updated physician reports, and needs and services plans. Medications/Medication Administration Record (MAR) were audited and observed to be administered appropriately. LPA reviewed staff files for First Aid/CPR certification, criminal record clearance and health screenings with Tuberculosis (TB) test result. LPA reviewed facility file for Emergency Disaster plan, Infection Control plan, quarterly drills and liability coverage. The following was observed and cited: Infection control plan was last reviewed on 04/01/2025. Liability insurance was expired as of 4/24/2026. Room 5 an additional bed with mattress unoccupied. Room 5 does not have a clearance to house 2 clients. Staff 1 stated licensee is working on getting clearance to house an additional resident. Staff room had 3 twin beds. R1, R2, & R3 a pre-appraisal was not in file. 3 staff were present. No designated representative was available. Staff 2 to not have Health screening report completed along with TB results. First aid manual was missing. Resident 1,2, & 3 Emergency contact sheet was incomplete. R1, R2, & R3 had a missing pre-appraisal completed. R1 did not have a complete Physician report. TB results were missing. Inventory property list for R1, R2, & R3 was not observed. Telecommunications form was not completed for all R1, R2 & R3. Quarterly drill was not conducted. The most recent was on May 3, 2026. Emergency disaster plan was last updated on 6/1/2025. Complaint Poster (PUB 475) is posted shall be 20” x 26” in size and be posted in the main entryway of the facility. Based on the observations made during today’s visit, deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted and a copy of this report along with an Appeal Rights were discussed and provided to caregiver Ralp Abano.the state’s words, verbatim · CDSS document, Aug 7, 2026

The state marks this report as 19 pages; the online copy we transcribed has 9. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Becky Mann made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection. LPA Mann met with Ralp Abano, Caregiver. The facility is a five (5) bedroom, two & half (2 & 1/2) bathroom home with a kitchen/dining area, living room/activity room. The facility is Residential Care Facility for the Elderly (RCFE). The facility is licensed for a capacity of six (6) bedridden residents. The facility is approved for six (6) hospice waiver. The current census is six (6) residents. LPA Mann conducted a general overall inspection, which included, but was not limited to, the following: Physical Plant: The facility is operating in the capacity approved by Community Care Licensing Division (CCLD). There are no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature 76 degrees Fahrenheit. LPA inspected resident bedrooms; they are equipped with required furniture such as: beds, mattresses, nightstands, storage space, and sufficient lighting. Bathrooms were clean, and appliances were operating appropriately. LPA observed sufficient furniture and lighting throughout the facility. LPA measured and observed the hot water temperatures in the bathrooms to be between 106 and 108 degrees Fahrenheit. The facility is equipped with operating smoke detectors and carbon monoxide alarms. Fire extinguishers were also observed at the facility. Posters such as personal rights, the CCLD complaint poster, labor laws, and the disaster plan were posted in a common area. Sharps, and other dangerous items were kept inaccessible to residents in care. There was a designated storage space for resident/staff files. Licensee did not conduct quarterly fire/earthquake drill. Last drill was 06/04/2025. Technical Assistance was issued. Food Service: Non-perishable and perishable food supply is sufficient for the number of residents in care. Facility has a variety of food available for residents. Dishes, cups, and utensils were also stored properly. Care & Supervision: Facility does have sufficient care staff for coverage 24 hours a day, 7 days a week. Record Review: LPA reviewed (3) resident files for admission agreements, updated physician reports, and needs and services plans. Resident files are maintained and up to date. LPA reviewed (3) client medications. Medications are labeled and administered as prescribed. Medications are kept locked and inaccessible to residents in care. LPA also reviewed (3) staff files for First Aid/CPR certification, criminal record clearance, training, and health screenings. Facility staff records are up to date. Based on the observations made during today’s visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report LIC809, LIC 809C and LIC 9102 was discussed and provided to Ralp Abano, Caregiver.the state’s words, verbatim · CDSS document, Sep 23, 2025

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.

Type of visit: Required - 1 Year

On 07/22/2024 at 12:05 PM, Licensing Program Analyst (LPA) Melody Brown made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection LPA Brown met with a staff and was granted entry to the facility. Licensee/Administrator Annie Jane Mikenas arrived at the facility during the visit. At the time of the visit there were three (three) staff present, and five (5) residents present. The facility is a five (5) bedroom, two & half (2 & 1/2) bathroom home with a kitchen/dining area, living room/activity room. The facility is Residential Care Facility for the Elderly (RCFE). The facility is licensed for a capacity of six (6) bedridden residents, serving mentally disabled seniors. The facility’s approved for six (6) hospice waiver. The current census is five (5) residents. LPA Brown was accompanied by Staff #2 (S2) to conduct a general overall inspection, which included, but was not limited to, the following: Physical Plant: The facility is operating in the capacity approved by Community Care Licensing Division (CCLD). There are no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature. LPA Brown inspected resident bedrooms; they are equipped with required furniture such as: mattresses, nightstands, storage space, and sufficient lighting; bathrooms were clean, and appliances were operating appropriately. LPA Brown observed sufficient furniture and lighting throughout the facility. LPA Brown measured and observed the water temperatures in the bathroom to be at 110 degrees F. The facility is equipped with operating smoke detectors and carbon monoxide alarms. Fire extinguishers were also observed at the facility. Posters such as personal rights, the CCLD complaint poster, labor laws, and the disaster plan were posted in a common area. Furthermore, LPA Brown observed the den converted to staff room. Deficiency will be issued. ***Continuation in LIC809C *** Sharps, and other dangerous items were kept inaccessible to residents in care. However, LPA Brown observed two (2) gallons of chemicals inside the shed at the backyard, not locked, and accessible to residents in care. Deficiency will be issued. There was a designated storage space for resident/staff files. There is a Medicine Cabinet with the resident’s medications locked. LPA Brown observed incomplete first aid kit. No bandages or roller of bandages in the facilty's first aid kit. Deficiency will be issued. Also, no First Aid Manual approved by the American Red Cross, the American Medical Association or a state federal health agency at the facility. Deficiency will be issued. Food Service: More than seven (7) days’ supply of Non-perishable foods and more than two (2) days’ supply of perishable food supply were observed and sufficient for the number of residents in care. Care & Supervision: The facility has an Administrator present at the facility during the visit. However, LPA Brown observed insufficient staff to cover night shift as required for facilities with dementia residents. Deficiency will be issued. Record Review: LPA Brown reviewed three (3) resident files for admission agreements, updated physician reports, and needs and services plans. LPA Brown observed resident files reviewed were complete. LPA Brown reviewed four (4) staff files for First Aid/CPR certification, criminal record clearance, trainings, and health screenings with Tuberculosis (TB) test result. LPA Brown found that one (1) of the four (4) staff do not have Health Screening Report on file. Deficiency will be issued. Also, three (3) of four (4) staff do not have TB completed and no TB Test Result on File. Deficiency will be issued. Furthermore, LPA Brown observed no required trainings provided to Staff #4. Deficiency will be issued. Medications/Medication Administration Record (MAR) were audited for three (3) residents, and LPA Brown observed no issue. Based on the observations made during today’s visit, deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report (LIC809), LIC809D forms, and Appeal Rights were discussed and provided to Licensee/Administrator Annie Jane Mikenas.the state’s words, verbatim · CDSS document, Jul 22, 2024

The state marks this report as 24 pages; the online copy we transcribed has 10. You can request the full file from the county licensing office.