New Rivershore Care Home

Type of visit: Required - 1 Year

On 07/03/2026 at 10:20am, Licensing Program Analyst (LPA) L. Hall conducted an unannounced 1-Year required inspection. LPA met with Administrator, Aurora Balancio and explained the purpose of the visit. The Administrator certificate #7000305740 and expires on 03/26/2027. The facility’s fire clearance was approved for six (6) non-ambulatory residents. LPA toured the facility with Administrator including but not limited to bedrooms, bathrooms, kitchen, common area, garage and backyard. The facility consists of three (3) bedrooms and one and one-half (1-1/2) bathrooms. Upstairs is not licensed by CCLD. No bodies of water was observed. A comfortable temperature is maintained at 74 degrees F. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in the residents’ shared bathroom was measured at 110.3 degrees F. Residents’ bathrooms are equipped with grab bars and non skid mats. There is a minimum of 7-day supply of non-perishable and 2-day of perishable foods. Smoke detectors and carbon monoxide were in operating condition during visit. Fire extinguisher was last serviced on 02/23/2026. Emergency Disaster Plan was last reviewed on 05/26/2026. First aid kit was observed to be complete. Fire drill was last conducted on 03/06/2026. Continued on LIC809. Continued from LIC809. LPA reviewed four (4) resident files and both staff files. The following forms to be updated and submitted to CCLD by 07/10/2026: LIC610E Emergency Disaster Plan (last page) Liability Insurance LIC308 Designation of facility responsibility LIC500 Personnel report A copy of the Administrator certificate. LPA observed the following deficiencies: At 10:25am, LPA observed upon arrival a stroller, exercise bicycle, treadmill, fishing poles, and bbq grill on outside of exit gate from back yard. Garbage cans blocking exit. At 10:45, LPA observed during record review R4 has not obtained a medical assessment since 2023. At 11:00am, LPA observed food in the refrigerator and cabinets. Unsure what belonged to residents and Administrator. Nothing was date, there was unwrapped and open packages of food. At 11:25am, during tour LPA observed R1 had a hoyer lift and half rails. Administrator did not have an order for either. Deficiencies are cited from Title 22 California Code of Regulations (see 809D). Failure to submit proof of corrections by plan of correction due date, and any repeat violations within 12-month period may result in civil penalties. Exit interview conducted. A copy of appeal rights and this report provided.the state’s words, verbatim · CDSS document, Jul 3, 2026

Type of visit: Required - 1 Year

On 05/27/2025 at 3:25 PM, Licensing Program Analysts (LPAs) Y. Brown and L. Hall conducted an unannounced 1-Year Required inspection. LPAs met with Administrator, Aurora Balancio and explained the purpose of the visit. The Administrator certificate #7000305740 and expires on 03/26/2027. The facility’s fire clearance was approved for six (6) non-ambulatory residents. LPAs toured the facility with Administrator including but not limited to bedrooms, bathrooms, kitchen, common area, garage and backyard. The facility consists of three (3) bedrooms and one and one-half (1-1/2) bathrooms. No bodies of water was observed. A comfortable temperature is maintained at 81 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in the residents’ shared bathroom was measured at 121.5 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non skid mats. There is a minimum of 7-day supply of non-perishable and 2-day of perishable foods. Smoke detectors and carbon monoxide were in operating condition during visit. Fire extinguisher was last serviced on 05/19/2025. Emergency Disaster Plan was last posted on 05/01/2025. First aid kit was observed to be complete. Fire drill was last conducted on 03/4/2024. Continued on LIC809. Continued from LIC809. LPAs reviewed four (4) resident files and 3 out of 4 resident files were incomplete. LPAs reviewed (3) staff files and 2 out of 3 staff did not have any training records. LPA observed the following deficiencies: At 3:42 PM, LPAs observed during record review that R1, R2, and R3 files were incomplete. At 3:47 PM, LPAs observed during record review that R1 and R2 had missing Hospice care plans. At 4:06 PM, LPAs observed during record review that S1, S2, and S3 had missing required training. At 4:21 PM, LPAs observed refrigerator, freezer, and cabinet that contained can and dry goods was unsanitary. At 4:26PM, LPAs observed four (4) trimmers, a bicycle, a treadmill, a shovel, a stationary bicycle, a weight bench, wire plant trellis', and motor scooter in back yard. At 4:27 PM, LPAs observed the master bedroom was missing screens on the patio door and bathroom window. At 4:33 PM, LPAs observed 2 (two) bottles of 409 Multi-surface disinfectant cleaner, 1 (one) Pine cleaner, 2 (two) bottles of bleach Clorox disinfectant, 1 (one) Lysol disinfectant and air freshener in the unlocked bathroom cabinet. LPA requested the following documents to be submitted to CCLD by 06/03/2025. LIC 308 Designation of Administrative Responsibility LIC 500 Personnel Report LIC 610E Emergency Disaster Plan (Last page) Liability Insurance Continue to LIC809C Continued from LIC 809C Deficiencies are cited from Title 22 California Code of Regulations (see 809D). Failure to submit proof of corrections by plan of correction due date, and any repeat violations within 12-month period may result in civil penalties. Exit interview conducted. A copy of appeal rights and this report provided.the state’s words, verbatim · CDSS document, May 27, 2025

Allegation investigated: Illegal eviction.

On 9/20/2024 at 2:00pm, Licensing Program Analyst (LPA), L. Hall arrived unannounced to conduct the 10-day initial visit and deliver complaint findings for the allegation above. LPA met with Aurora Balancio, Administrator, and explained the reason for the visit. During the investigation LPA interviewed reporting party (RP), Staff 1 (S1), reviewed R1's file including physician's report, admission agreement, appraisal needs and services plan, and resident appraisal which LPA requested be emailed to CCLD by 8/23/2024. Continued on LIC9099C. Substantiated Continued from LIC9099. RP stated during interview that R1 was to be discharged from Sutter Delta Hospital in Antioch on 9/16/2024, but S1 refused to let R1 return to the facility. R1 was to be discharged with the assistance of home health. S1 stated the facility is no longer able to provide the care necessary for R1 and that's why she refused. S1 stated it is hard to take care of S1 due to R1 being heavy and not listening. S1 showed LPA an invalid eviction letter that was given to R1 on 8/14/2024. R1's condition have not changed Deficiency is cited per Title 22 California Code of Regulations and listed on LIC9099D. Failure to submit proof of corrections (POC) by plan of correction due dates and/or any repeat deficiencies within a 12-month period may result in civil penalties. Exit interview conducted. A copy of this report and appeal rights provided.the state’s words, verbatim · CDSS document, Sep 20, 2024 · control 15-AS-20240917204038

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87224(a) · Plan of correction due date: Sep 28, 2024

87224 Eviction Procedures (a) The licensee may evict a resident for one or more of the reasons listed in Section 87224(a)(1) through (5). Thirty (30) days written notice to the resident is required except as otherwise specified in paragraph (5) Based on interview and record review the Licensee did not comply with the section cited above in serving R1 with an appropriate eviction notice, which poses a potential health and safety risk to persons in care.the state’s words, verbatim · CDSS document, Sep 20, 2024

Plan of correction: The Licensee will read regulation 87224 and submit self-certification that it has been read and she will abide going forward to CCLD by POC date. A mandatory informal meeting will be held at a later time.

Type of visit: Required - 1 Year

On 6/15/2024 at 11:25am, Licensing Program Analyst (LPA) L. Hall conducted an unannounced 1-Year Required inspection. LPA met with Rochelle Balancio, Caregiver, and explained the purpose of the visit. Administrator, Aurora Balancio, arrived at 11:55am. The Administrator certificate #7000305740 3/26/2025. The facility’s fire clearance was approved for six (6) non-ambulatory residents. LPA toured the facility with Administrator including but not limited to bedrooms, bathrooms, kitchen, common area, garage and backyard. The facility consists of three (3) bedrooms and one and one-half (1-1/2) bathrooms. No bodies of water was observed. A comfortable temperature is maintained at 76 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in the residents’ shared bathroom was measured at 114.6 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non skid mats. There is a minimum of 7-day supply of non-perishable and 2-day of perishable foods. Smoke detectors and carbon monoxide were in operating condition during visit. Fire extinguisher was last serviced on 10/23/2023. Emergency Disaster Plan was last posted on 06/22/2022. First aid kit was observed to be complete. Fire drill was last conducted on 03/4/2024. Continued on LIC809. Continued from LIC809. LPA reviewed three (3) staff files. Two (2) of three (3) staff did not have first aid or CPR. All five (5) residents' file were reviewed, current, and complete. LPA observed the following deficiencies: At 12:00pm, LPA observed during record review S1 and S3 did not have first aid or CPR certification. LPA requested the following documents to be submitted to CCLD by 5/24/2024. LIC 308 Designation of Administrative Responsibility LIC 309 Administrative Organization LIC 500 Personnel Report LIC 610E Emergency Disaster Plan (Last page) Liability Insurance Deficiency is cited from Title 22 California Code of Regulations (see 809D). Failure to submit proof of corrections by plan of correction due date, and any repeat violations within 12-month period may result in civil penalties. Exit interview conducted. A copy of appeal rights and this report provided.the state’s words, verbatim · CDSS document, Jun 15, 2024