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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306000502
Report Date: 09/03/2025
Date Signed: 09/03/2025 10:13:05 AM

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
02/19/2021 and conducted by Evaluator Alvaro Ramirez Jr.
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20210219083848
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:
09/03/2025
UNANNOUNCEDTIME BEGAN:
08:27 AM
MET WITH:Jonathan Barrios-AdministratorTIME COMPLETED:
09:06 AM
ALLEGATION(S):
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Facility staff does not ensure that resident has clean water.
Facility failed to provide adequate care and supervision.
Facility staff did not notice a change in the resident's condition.
Facility staff failed to assist resident during meal service.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Alvaro Ramirez, Jr. conducted an unannounced visit to deliver findings on the above allegations received on February 19, 2021. LPA was greeted and granted entry into the facility and met with Administrator (AD) Jonathan Barrios. LPA explained the reason for the visit.

This Department has investigated the complaint alleging that facility staff do not ensure that resident has clean water. Regarding the allegation the following was revealed: During the subsequent visits on August 22, 2025, and September 3, 2025, LPA toured the facility and observed that there is a water filter located on the first floor. LPA observed that the water filter provides clean water. During the course of the interviews with residents, Resident 1 (R1) reported that she gets clean water. Per R2, she gets clean drinking water from the facility filter water. R3 reported that she always gets clean water. During the course of the interviews with staff, Staff 1 (S1) reported that the facility provides the residents with clean water. S2 stated that the residents are provided with clean drinking water.
CONTINUED ON LIC9099-C...
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Alvaro Ramirez Jr.
LICENSING EVALUATOR SIGNATURE:

DATE: 09/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2025
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 3
Control Number 22-AS-20210219083848
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: 09/03/2025
NARRATIVE
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Regarding the allegation that facility failed to provide adequate care and supervision, the following was revealed: During the course of the investigation LPA reviewed documents including the New Horizon Lodge, Inc. staff schedule dated August 10, 2025, through August 23, 2025. Per staff schedule on average there are two caregivers and one Medication Technician (MT) for the morning shift from 6:00 a.m. to 2:30 p.m. and for the afternoon shift from 2:00 p.m. to 10:30 p.m. and there is one caregiver and one MT for the night shift from 10:00 p.m. to 6:30 a.m. During the course of the interviews with residents, R1 reported that the facility provides adequate care and supervision. R3 stated that the residents are provided with adequate care and supervision and reported that staff care a lot. Per R4, staff are nice and helpful. R4 stated that staff provide the residents with adequate care and supervision. During the course of the interviews with staff, S1 reported that staff provide the residents with adequate care and supervision and stated that they usually assist the residents within five minutes. Per S2, staff make sure that the residents are provided with adequate care and supervision.

Regarding the allegation that facility staff did not notice a change in the resident’s condition, the following was revealed: During the course of the interviews with residents, R1 reported that staff check when the residents’ have a change in condition. Per R3, staff care a lot and stated that staff keep notes on the residents’ conditions. R4 reported that staff keep track of the residents' change in condition. During the course of the interviews with staff, S1 reported that when she notices a change in condition in a resident, she will report it to the Wellness Director. S2 stated that when staff notice a change in condition in a resident that staff will report it to management.



Regarding the allegation that facility staff failed to assist resident during meal service, the following was revealed: During the course of the interviews with residents, R1 reported that staff will assist those residents who need assistance with their meals and stated that the residents have not complained about not being assisted during meals. Per R2, staff will assist the residents during meals if the residents need help. R3 reported that staff will assist the residents with their meals. Per R4, this place is better than some places. R4 reported that staff will assist the residents during meals. During the course of the interviews with staff, S1 reported that staff will assist the residents with their meals when they need assistance or if they are sick.


CONTINUED ON LIC9099-C...
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Alvaro Ramirez Jr.
LICENSING EVALUATOR SIGNATURE:

DATE: 09/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 22-AS-20210219083848
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: 09/03/2025
NARRATIVE
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Based on the information gathered during the investigation and review of documents obtained, LPA is unable to ascertain if the allegations occurred as reported due to conflicting information. Although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove or refute the alleged violations occurred; therefore, these allegations are deemed UNSUBSTANTIATED.

For today’s visit, there were no citations issued per Title 22, Division 6 of the California Code of Regulations.
LPA conducted an exit interview with AD Barrios, and a copy of this report was provided to the facility.
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Alvaro Ramirez Jr.
LICENSING EVALUATOR SIGNATURE:

DATE: 09/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3