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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306000502
Report Date: 02/21/2025
Date Signed: 02/21/2025 02:07:39 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/24/2024 and conducted by Evaluator Kevin Saborit-Guasch
COMPLAINT CONTROL NUMBER: 22-AS-20240424143446
FACILITY NAME:NEW HORIZON LODGE, INC.FACILITY NUMBER:
306000502
ADMINISTRATOR:GLEN E GOLDSMITHFACILITY TYPE:
740
ADDRESS:8541 CERRITOS AVENUETELEPHONE:
(714) 821-5781
CITY:STANTONSTATE: CAZIP CODE:
90680
CAPACITY:120CENSUS: 77DATE:
02/21/2025
UNANNOUNCEDTIME BEGAN:
11:01 AM
MET WITH:Glen Goldsmith, administratorTIME COMPLETED:
02:15 PM
ALLEGATION(S):
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Staff is mismanaging medication
Staff do not meet incontinence needs
Residents personal rights are being violated
Facility staff do not provide transportation to medical appointments
INVESTIGATION FINDINGS:
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On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility for the purpose of following up on the investigation of the three allegations listed above. LPA was greeted and granted entry by facility front desk staff after introducing himself and stating the purpose of the visit. Administrator Glenn Goldsmith arrived lated to assist with the visit and was presented with the allegations investigated.

An initial investigation visit was conducted on April 29, 2024. During the visit, LPA requested, obtained and reviewed the facility's current census and employee roster. Records maintained at the facility for three residents were also requested and reviewed. LPA accompanied by facility staf reviewed the Medication Administration Records for all three residents and conducted an interview with the facility Wellness Director/LVN. During the present visit, LPA requested and obtained the facility's current census and reviewed resident records as well as conducted four staff and six resident interviews.
CONTINUED ON FORM LIC9099
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Sheila SantosTELEPHONE: (714) 334-2062
LICENSING EVALUATOR NAME: Kevin Saborit-GuaschTELEPHONE: (714) 497-8754
LICENSING EVALUATOR SIGNATURE:

DATE: 02/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 2
Control Number 22-AS-20240424143446
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME: NEW HORIZON LODGE, INC.
FACILITY NUMBER: 306000502
VISIT DATE: 02/21/2025
NARRATIVE
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CONTINUED FROM FORM LIC9099
Regarding the allegation that Staff is mismanaging medication, the following has been concluded: Based on interviews conducted with residents and staff as well as a review of medication administration records for multiple residents, LPA observed that glucose measurements and insulin dispensation were adequately documented and appeared to be provided as prescribed. No other evidence of medication mismanagement were found during the present visits as well as during an unannounced review conducted during the facility's annual visit on February 11, 2025.

Regarding the allegation that Staff do not meet incontinence needs, the following has been concluded: During both visits, licensing staff toured the premises and found them to be sanitary with no smells. A list of residents with incontinence was provided and four rooms assigned to resident with incontinence were visited. No smells, stains or other signs of inadequate incontinence management were found during either visits. No residents or staff interviewed evidenced issues either.

Regarding the allegation that Residents personal rights are being violated, the following has been concluded: During each visit, LPA observed that all residents ambulating in the common areas, relaxing in activity spaces or relaxing in their own bedroom were dressed in clean clothing. None of the interviews conducted evidenced concerns regarding personal rights violations.

Regarding the allegation that Facility staff do not provide transportation to medical appointments, the following has been concluded: The facility has a courtesy van and will assist with arranging transportation to appointments as needed as confirmed by staff interviews. Additionally, interviews conducted did not evidence any specific instances during which necessary transportation could not be obtained.

Based on the investigation conducted, the four allegations are found to be Unsubstantiated, meaning that although the above allegations may have happened there is not a preponderance of evidence to prove the alleged violations occurred.

An exit interview was conducted and a copy of this report was provided to a facility representative.
SUPERVISOR'S NAME: Sheila SantosTELEPHONE: (714) 334-2062
LICENSING EVALUATOR NAME: Kevin Saborit-GuaschTELEPHONE: (714) 497-8754
LICENSING EVALUATOR SIGNATURE:

DATE: 02/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2