Facility Evaluation Report

Licensing Program Analyst (LPA) Jerome Haley conducted an unannounced case management visit regarding an incident that was reported to Orange County Adult and Senior Care Program Regional Office (OCRO) April 27, 2026.

LPA Haley introduced himself and stated the purpose of the visit upon entry.

After a review of the incident report and speaking with Administrator Jonathan Barrios, details in the incident that was sent to the OCRO were confirmed.

On Thursday, April 23, 2026, Resident 1 (R1) was administered the wrong medications. R1 received the morning medications for Resident 2 (R2). The medication error was not realized immediately, and R1 did not display any immediate change in condition. R1 continued with their regularly scheduled activities for the day and left New Horizon to attend a scheduled meeting.

Staff 1 (S1) is the med tech responsible for the medication error and contacted Administrator Barrios once it was realized a medication error occurred.

At some point later in the day, after leaving New Horizon to attend a scheduled meeting, R1 had a change in condition and was sent to West Anaheim Medical Center.

New Horizon staff were notified that R1 was being sent to the hospital. R1 has not returned yet and is currently at a Skilled Nursing Facility (SNF).

As a result of today’s Case Management visit, a deficiency will be cited.

An exit interview was conducted, and a copy of this report and appeal rights were provided.