The Manor of Ojai

Type of visit: Required - 1 Year

At 9:30am on 06/17/2026, Licensing Program Analyst (LPA) Jeffries arrived unannounced to the facility to conduct that annual facility inspection. LPA met with administrator Halina Garbacz announced who he is and the reason for the visit. Director of Operations, Bryant Barron (DO) participated in the inspection process. This facility has twenty-two resident rooms are set up for double resident occupancy, however all rooms are currently single occupancy do to current census numbers. There is a large TV/Activity room a larger community dining/activities room, commercial kitchen, and 8 assorted office rooms for multi functional use including a full office for medication room (clinic), which also has a full first aide kit. And there are two public restrooms, a hallway shower room and one side of the facility has jack and Jill bathrooms, the other side has on suite bathroom. This facility has a large open center court yard and a large garden and yard are on the south side of the building with several areas of seating and shade from umbrellas and trees for residents and visitors. LPA noted the water temperature tested at at North West corridor of the facility exceeded regulation standards, a citation was issued. LPA noted that DO called plumber and scheduled an appointment same day to address exceeded water temperature. LPA noted several fire extinguishers located throughout the facility all primed and charged in the green indicating functional. LPA observed at least two days of perishable foods and at least 7 days of non perishable foods for at least 15 residents and staff. LPA noted that all walkways and all doors and windows were free and clear of debris. LPA conducted review staff and resident files. LPA noted that there were one violations of water exceeding regulation temperature perimeters noted during the facility full physical walk through. Administrator and LPA conducted a full review and the annual control tools modules. LPA noted not other citations in the care tool review. Exit interview, report read, citation and appeal right issued, and report provided.the state’s words, verbatim · CDSS document, Jun 17, 2026

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

Licensing Program Analyst (LPA) Teresa Camara conducted a required annual inspection at the facility. LPA met with licensee/administrator Halina Garbacz and explained the reason for the visit. LPA, along with the administrator, toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. The facility's last 5-year fire inspection was completed on 1/6/2023 with no concerns noted. LPA, along with the director of operations Bryant Barron, tested randomly chosen combination smoke/carbon monoxide detectors throughout the facility which all functioned properly during the visit. Fire extinguishers appeared fully charged and were last serviced 4/15/2025.. RESIDENT ROOMS/RESTROOMS: There are twenty-two (22) resident rooms licensed for double occupancy, however most of the rooms are used as single-occupancy at this time. LPA inspected ten (10) resident rooms Rooms contained the appropriate furnishings, linens, and bedding. Half of the resident rooms have full bathrooms that are jack-and-jill style - shared between 2 adjacent rooms. The other resident rooms have half bathrooms (toilet and sink) which are private. The residents in these rooms utilize one of the two shower rooms in the hallway nearby their rooms. Restrooms observed were clean and sanitary and in operating condition with grab bars and non-slip surfaces. Water temperature was tested and measured at 110 degrees Fahrenheit which is within the required range of 105*F-120*F. (continued on LIC809-C) COMMON AREAS/BUILDINGS AND GROUNDS: There is a large TV/Activity room with a screened fireplace, sofas, and tables with chairs. There is a patio area equipped with seating and tables with umbrellas. Some of the residents' rooms have semi-private covered patio areas with seating and tables as well. Cleaning chemicals are stored in the locked janitor's closet. Personal Protective Equipment (PPE) and personal care items are stored in a locked storage closet. There is a locked garage on the property which is used for storage. LPA observed required postings. The Emergency Evacuation Plan was complete. Walkways were free of obstructions. KITCHEN/DINING ROOM: The dining room was properly furnished. The facility has a commercial-style kitchen. Appliances appeared clean and functional. There was a sufficient supply of food (perishable and non-perishable) and water. The facility's menu was posted. STAFF: LPA spoke with three (3) staff; there were no concerns noted. LPA reviewed five (5) staff files and all were complete. Documents reviewed included, but were not limited to, training records, TB test results, health screenings, and fingerprint background clearance. Disaster drills are conducted semi-annually and administrator was advised they must be done quarterly for different types of emergencies. Administrator was given a technical advisory for this deficiency. RESIDENTS: LPA interviewed two residents; no concerns were noted. LPA attempted interviews with two other residents, however due to cognitive decline was not able to complete the interviews. LPA reviewed five residents' files and all were complete. Documents reviewed included, but were not limited to, physician's reports, admission agreements, personal rights, and needs and services plans. MEDICATIONS: LPA reviewed medications which are stored in the locked medication room. The facility utilizes Medication Administration Records (MAR) to ensure medications are given correctly. The facility has Centrally Stored Medication and Destruction Records (CSMDR) which were complete. The medications reviewed appeared to be given as prescribed and the medications were properly labeled. The first aid kit is also stored in the locked medication room. No deficiencies cited. Exit interview conducted. A copy of today's report and appeal rights were provided.the state’s words, verbatim · CDSS document, Jun 26, 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.

Allegation investigated: Administrator speaks inappropriately to staff and residents Staff are not meeting residents’ diapering needs Staff force feed residents

Licensing Program Analyst (LPA), Esther Cortez conducted a subsequent complaint visit for the above allegations. Upon arrival, LPA met with Administrator, Helina Garbacz and was explained the reason for the visit. Entrance interview conducted. On 02/13/25, between 10:50 a.m. and 2:50 p.m., the LPA, toured the facility, interviewed the Administrator, three (3) staff, five (5) residents, two (2) witnesses and observed residents at lunch. During today's inspection, between 2:00 p.m. and 5:00 p.m., the LPA, toured the facility, interviewed two (2) family memebers of residents, and conducted a file review. Report will continue on LIC9099-C, 2nd page. Unsubstantiated Regarding the allegations, “Administrator speaks inappropriately to staff and residents and Staff force feed residents ” it is the reporting party’s concern that Staff #1 (S1) yells at the staff in front of the residents and yells at Resident #1 (R1), Resident #2 (R2), Resident #3 (R3) and Resident #4 (R4) when it comes to eating, and if the residents spit out their food, S1 will put it back in their mouth and S1 expect staff to force feed residents. To investigate the complaint the LPA conducted interviews with staff, witnesses, and residents, and on 02/13/25 observed residents and staff during lunch. All staff, witnesses, and resident family members revealed that S1 does not yell at the residents or at staff in front of the residents, S1 has a loud voice and can be firm but is not demeaning and have not observed S1 or any staff force feed the residents. Furthermore, staff stated that if they heard S1 yell at the residents they would report it. All staff, including S1, denied ever yelling at the residents and denied force feeding any of the residents. Additionally, staff revealed that they encourage residents to eat but do not force feed them. All the resident interviewed revealed that they have not been yelled at or spoken inappropriately to. In addition, majority of the resident’s interviews revealed that they have not heard S1 yell or force feed the other residents. Lastly, on 02/13/25, the LPA did not observe S1 or any staff yell or force feed any of the residents during lunch, or at any point during the initial and subsequent visits. The LPA observed staff assisting and encouraging residents to eat and once residents did not want any more, staff did not force feed residents. Based on the information gathered, although the allegations may be valid, at this time there is insufficient evidence to support the allegations or that a violation occurred; therefore, the above allegations are deemed UNSUBSTANTIATED at this time. Regarding the allegation, “Staff are not meeting residents’ diapering needs” it is the reporting party’s concern that they received information that the residents are not being diapered during the night. Interviews with family members of three residents that required incontinence care revealed no concerns regarding resident’s toileting needs. Family members expressed satisfaction with the care provided at the facility, describing staff as wonderful, attentive and accommodating. Staff interviewed revealed that they do not work the overnight shift but that when they come in the morning, they have not witnessed residents with soaked diapers. One witness revealed that residents can be soaked in the morning, however it is not frequently, and another witness revealed that they have observed a resident with wet pants, however it did not seem like it was old, resident’s skin was okay and no rash. During today’s visit the LPA observed staff doing their rounds and taking residents to get incontinence care. Report will continue on LIC9099-C, 3rd page. Lastly, file review revealed that every time a resident gets changed it is documented on a daily output log. The LPA observed documentation of the log being filled out during the night. The administrator revealed that they work the night shift and check on the residents and change them every two to three hours. Based on the information gathered, although the allegations may be valid, at this time there is insufficient evidence to support the allegation or that a violation occurred; therefore, the above allegation is deemed UNSUBSTANTIATED at this time Exit interview and report review was conducted with Administrator. A copy of the report was given,the state’s words, verbatim · CDSS document, Apr 3, 2025 · control 29-AS-20250207113310

Allegation investigated: Staff do not ensure residents’ toothbrushes are kept in a sanitary manner

Licensing Program Analyst (LPA), Esther Cortez conducted an unannounced initial 10-day complaint visit for the above allegations. Upon arrival, LPA met with Administrator, Helina Garbacz and was explained the reason for the visit. Entrance interview conducted. During today's inspection, between 10:50 a.m. and 2:50 p.m., the LPA, toured the facility, interviewed the Administrator, three (3) staff, five (5) residents, two (2) witnesses and observed residents at lunch. Report will continue on LIC9099-C, 2nd page. Substantiated Regarding the allegation, “Staff do not ensure residents’ toothbrushes are kept in a sanitary manner” it is the reporting party’s concern that the resident's toothbrushes are stored in a supplied closet along with cleaning supplies. At 11:21 a.m. the LPA observed seven (7) toothbrushes with no covers stored in an employee room stored with cleaning supplies. Toothbrushes were touching other toothbrushes bristles and did not have any labels on them to describe whom they belonged to. Upon observation, Administrator Halina revealed they belong to the residents, however was not able to state which brush belong to which resident. Based on the information obtained, the Department has sufficient evidence to support the allegation, therefore the allegation Staff do not ensure residents’ toothbrushes are kept in a sanitary manner, is Substantiated at this time. Pursuant to Title 22, California Code of Regulations, the following deficiencies are cited (refer to LIC 9099-D)Exit interview conducted, a copy of this report and appeals rights issued.the state’s words, verbatim · CDSS document, Feb 13, 2025 · control 29-AS-20250207113310

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87303(a) · Plan of correction due date: Feb 14, 2025

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... This requirement is not met as evidenced by: The Licensee did not comply with the section cited above as 7 out of 13 residents un covered toothbrushes were stored together, in a supply room whith cleaning supplies and bristles touching, which poses a potential safety risk to clients in care.the state’s words, verbatim · CDSS document, Feb 13, 2025

Plan of correction: Licensee agreed to replace all 7 toothbrushes with new ones, and store them in a sanitary manner. Will submit proof to LPA no later than 2/13/2025.

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.

Allegation investigated: Due to lack of supervision resident sustained injuiries

At 10:30 a.m. Licensing Program Analyst (LPA) Esther Cortez conducted an unannounced subsequent complaint visit for the above allegation. The LPA met with Administrator Halina Garbacz and the reason for the visit was explained. On 12/28/2023, between 09:40 a.m. and 5:10 p.m., the LPA interviewed the Administrator, one (1) staff, conducted a file review, and obtained copies of resident records and other pertinent documents relevant to the investigation. On 08/09/2024, at 10:25 a.m. the LPA conducted a phone interview with Resident #1 (R1's) family members. During today's visit the LPA, attempted to interview R1 at 10:49 a.m., interviewed the administrator throughout the visit, and obtianed copies of resident erecords and other pertinent documents relevant to the investigation. Report will continue on LIC9099-C. Unsubstantiated On the allegation that due to lack of supervision resident sustained injuries; it is the concern of the reporting party (RP) that Resident #1 (R1) was falling a lot due to possible lack of supervision and during their last fall R1 obtained a hematoma to their face and abrasions to their nose. Record review revealed that R1 was admitted to the facility on 09/21/2022. R1’s physician’s report dated 12/07/2023 indicated that R1 has a diagnosis of dementia, gait instability, and a fall risk. Incident report reviewed revealed that R1 sustained a fall on 12/18/2023, resulting in R1 being transported to the hospital. According to incident report, and staff interviews, R1 was walking to their room with a caregiver watching nearby, and R1 lost their balance as they were entering their room and fell forward onto the floor before the caregiver could prevent their fall. Caregiver immediately went to R1 and called out for the administrator for help. The administrator contacted 911 to have R1 evaluated and taken to the hospital to ensure R1 had no injuries caused by the falls. A second fall occurred on 11/14/2023 resulting in R1 being transported to the hospital. According to the incident report, R1 was in the dining room prior to lunch being served enjoying the background music and decided to get up and try to dance. R1 lost their balance and fell forward, staff immediately rushed to R1’s aid and called EMS to transport for an evaluation. A third fall occured on 05/03/2023, resulting in R1 hitting their head and being transported to the hospital. According to the incident report, R1 was sitting in a chair in the dining room, staff asked R1 if they would like to move to their normal spot for lunch, and as staff made their way to assist R1, R1 stood up from their chair, went to take a step and lost their balance. R1 stumbled forward a few steps and hit their head on the cabinet under the coffee makers. Staff immediately assessed R1, and called 911. Record review and interviews revealed that R1 did not require 1:1 supervision, nor did R1 require an escort when ambulating inside the facility. Incident reports and staff interviews revealed that staff were nearby when all three falls occurred, and that staff followed the proper protocol for obtaining additional medical care and reporting the incidents. Administrator stated that there was nothing that staff could have done to prevent R1's falls. In addition, Interview with R1's family members revealed that they have no concern regarding the care R1 is receiving at the facility, and stated R1 moved too quickly and was not steady. Therefore, based on interview and record review, there is insufficient evidence to support the allegation or that a violation occurred; the allegation that “due to lack of supervision resident sustained injuries” is deemed UNSUBSTANTIATED at this time. No deficiencies cited. Exit interview conducted. A copy of the report was issued to the Administrator.the state’s words, verbatim · CDSS document, Aug 9, 2024 · control 29-AS-20231220161310

Type of visit: Required - 1 Year

At 8:00am on 06/14/2024, Licensing Program Analyst (LPA) Jeffries arrived unannounced to the facility to conduct that annual facility inspection. LPA met with administrator Halina Garbacz announced who he is and the reason for the visit. This facility has twenty-two resident rooms are set up for double resident occupancy, however all rooms are currently single occupancy do to current census numbers. There is a large TV/Activity room a larger community dining/activities room, commercial kitchen, and 8 assorted office rooms for multi functional use including a full office for medication room (clinic), which also has a full first aide kit. And there are two public restrooms, a hallway shower room and one side of the facility has jack and Jill bathrooms, the other side has on suite bathroom all of which were observed and to be in regulation compliance. This facility has a large open center court yard and a large garden and yard are on the south side of the building with several areas of shade for residents and visitors. LPA was able to observe 11 of 22 resident rooms all outfitted within regulation standards. LPA noted the water at two locations on opposite sides of the facility were both within regulation standards. LPA noted several fire extinguishers located throughout the facility all primed and charged in the green indicating functional. LPA observed at least two days of perishable foods and at least 7 days of non perishable foods for at least 11 residents and staff. LPA noted that all walkways and all doors and windows were free and clear of debris. LPA conducted a sample medication audit and review staff and resident files. LPA noted that there were no violations or citations noted during the facility full physical walk through. Administrator and LPA conducted a full review and the annual control tools modules. LPA noted one citation in Operational Plan Requirements pertaining to Dementia information in facilities plan of operation. LPA cited and advised Administrator on corrective measure for this citation. LPA note no other violations, technical, or citations issued on the full annual inspection. Exit interview, report read, citation and appeal right issued, and report provided.the state’s words, verbatim · CDSS document, Jun 14, 2024

Allegation investigated: Licensee yells at residents Licensee speaks inappropriately to residents Staff do not ensure that residents' showering needs are met

Licensing Program Analyst (LPA), Esther Cortez conducted an unannounced initial 10-day complaint visit for the above allegations. Upon arrival, LPA met with Administrator, Helina Garbacz and was explained the reason for the visit. Entrance interview conducted. During today's inspection, between 10:30 a.m. and 3:00 p.m., the LPA, toured the facility, interviewed the Administrator, two (2) staff, five (5) residents, conducted a file review, and obtained copies of pertinent documents relevant to the investigation. Regarding the allegations, “Licensee yells at residents” and “Licensee speaks inappropriately to residents” it is the reporting party’s concern that the Licensee yells at the residents and verbally fights with residents. To investigate the complaint the LPA conducted interviews with staff, Home Health Aide, and residents. Report will continue on LIC9099-C. Unsubstantiated Staff and Home Health Aid interviews revealed that they have not heard the Licensee yell at the residents or heard the Licensee spoken to the residents inappropriately. Furthermore, staff stated that if they did, they would report it to licensing, or 911. The Licensee denied ever yelling or speaking inappropriately to the residents. Majority of the resident interviews revealed that they have not been yelled at or spoken inappropriately to. In addition, majority of the resident’s interviews revealed that they have not heard the Licensee yell or speak inappropriately to the other residents. Based on the information gathered, although the allegations may be valid, at this time there is insufficient evidence to support the allegations or that a violation occurred; therefore, the above allegations are deemed UNSUBSTANTIATED at this time. Regarding the allegation, “Staff do not ensure that residents' showering needs are met” it is the reporting party’s concern that the facility is understaffed, resulting in staff not allowing residents enough time to take their baths. To investigate the complaint the LPA conducted a file review and conducted interviews with staff, Home Health Aide, and residents. File review reveled that three (3) of ten (10) residents receive baths from hospice, and two (2) residents can bathe themselves per their Physicians Report (LIC602), leaving the facility five (5) residents to assist with bathing. Staff interviews revealed that residents are bathe at least two (2) times a week and as needed, however they indicated that there are residents that are on hospice and receive baths from hospice and not from the facility unless needed. Staff interview also revealed that the only reason a resident would go without a shower would be because they refused to shower. Interview with the Home Health Aid revealed that they come two (2) times a week and provide baths for three residents every Tuesday and Friday. Administrator Helena stated that the residents are bathe at least two (2) times a week primarily by the administrator and one other staff (S1) and they keep a record of the weekly baths/showers, however the administrator further stated S1 sometimes forgets to log the showers. The administrator also stated that they have one resident (R1) who refuses to shower. Two (2) of five (5) residents (R1,R2) interviewed revealed that they do not require any assistance with showering and can shower themselves, however per their LIC602 they require minimal or occasional assistance. One (1) of five (5) residents (R3) interviewed revealed that they get assisted with showers every third day. One (1) of five (5) residents (R4) interviewed revealed that they receive a bath two times a week ever since they been admitted to the facility. The LPA observed all residents clean during todays visit. Based on the information gathered, although the allegations may be valid, at this time there is insufficient evidence to support the allegations or that a violation occurred; therefore, the above allegation is deemed UNSUBSTANTIATED at this time. Exit interview and report review was conducted with Administrator. A copy of the report was given,the state’s words, verbatim · CDSS document, Mar 8, 2024 · control 29-AS-20240304100433

Type of visit: Case Management - Annual Continuation

Licensing Program Analyst (LPA) Esther Cortez conducted an unannounced Annual Continuation Visit to the facility to continue the annual inspection visit initiated on 06/02/2023. The LPA met with Administrator Halina Garbacz and informed them of the reason for the visit. Today the LPA conducted a file review, and one staff interview. Record Review: At 09:50 a.m. a review of facility files was initiated. The LPA observed documentation of infection control, staff and resident roster, and Insurance liability. The LPA reviewed five (5) of eleven (11) Resident Files. The following was noted: 1/5 Admission Agreements were not signed by resident and/or responsible party, 3/5 Appraisal/Needs and Service plan LIC625 were missing, 1/5 needed TB result on file, and 4/5 personal rights LIC613 were missing or not signed. The LPA reviewed five (5) out of eight (8) staff files. The following was noted: 3/5 Criminal records statements LIC 508 were missing, 4/5 Health screenings were missing, 2/5 TB results were missing, and 5/5 were missing 40 hours of required training. Interviews: During the visit the LPA conducted one (1) staff interview, no immediate concerns were voiced. Due to time constraints, the LPA will return at a later date to complete the inspection. Pursuant to Title 22 of the CA Code of Regulations, the following deficiencies were cited (refer to LIC 809-D): Exit interview conducted and copy of the report and appeal rights provided to the Administrator.the state’s words, verbatim · CDSS document, Dec 28, 2023

The state marks this report as 10 pages; the online copy we transcribed has 6. You can request the full file from the county licensing office.