Dependable Overnight Care

Type of visit: Case Management - Other

Licensing Program Analysts (LPAs) Sandra Urena, Zabel Chochian, Kelly Dulek and Martha Arroyo, with Licensing Program Manager (LPM) KaSandra Lopez, Regional Manager (RM) Jill Nakata along with APS representatives Adrian Garcia and Sona Shahumyan, Ombudsman Ginger Perini and LAPD Officers Acosta, Azurin and Cruz conducted an unannounced case management visit at this facility. The purpose of the visit is to issue a Temporary Suspension Order (TSO). The TSO’s effective date is the close of business hour today, 08/26/2025. RM, LPM, and LPAs met with facility staff Nelly Arakelian and Samvel Arakelian. Facility staff contacted the facility Co-Administrator Gaiane Egiarzarian via telephone call. The Co-Administrator arrived at approximately 9:30am. LPM KaSandra Lopez contacted licensee Alisa Galadjian requesting her presence in the facility. Ms. Galadjian informed Jill Nakata (RM) and KaSandra Lopez (LPM) that she is out of town and cannot meet in the facility. At approximately 9:57am, RM and LPM spoke to Licensee Alisa Galadjian telephonically, and Co-Administrator Gaiane Egiarzarian in person, and verbally informed them of the TSO’s requirements; all six (6) residents need to be relocated today, 08/26/2025, and after today the facility would no longer be licensed. During the visit, six (6) residents were relocated from this location to licensed facilities and one private home. In addition, the facility license for Dependable Overnight Care, Inc. was removed from the facility during the visit. A copy of the documents pertaining to the TSO was hand delivered to Co-Administrator Gaiane Egiarzarian. A copy of the TSO packet was also emailed, and mailed via regular mail and certified mail to the licensee’s mailing addresses on file. Exit interview conducted, and copy of this report signed and delivered.the state’s words, verbatim · CDSS document, Aug 26, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Sandra Urena arrived at the facility unannounced to conduct a required annual visit. Upon arrival, LPA Urena was greeted by staff and called the administrator to inform them of the visit. The Administrator Anna Hayrapetyan and Co-Administrator Gaiane Egiarzarian arrived shortly thereafter. The LPA met with Administrator and Co-Administrator and explained the reason for the visit. The LPA and the Administrators toured the physical plant areas inside and outside to ensure there are no health and safety hazards, and that the facility is in compliance with Title 22 Regulations. COMMON AREAS: At the time of the visit, living room and dining room furniture was observed to be in good condition. The facility maintained a comfortable temperature. Smoke detectors and carbon monoxide detectors were tested and operational at the time of the visit. The fire extinguisher was fully charged and was last serviced on 09/02/2024. The LPA observed required postings throughout the common space, however, the CCL poster “If you see something, Say something” is not clearly visible as it is posted up high on the wall partly covered by other postings and the poster appears to be an 8”x12”, instead of the required 20”x24” inches. Continues on LIC 809C... KITCHEN: Knives and cleaning supplies are stored inaccessible. Kitchen appliances were in operable condition. The LPA observed that the facility does not have a sufficient supply of non-perishable food and water supply. The Administrator stated that they have a water tank under the sink which filters the water and has a five (5) gallon capacity. The LPA Advised the Administrators that the water supply is not sufficient for six (6) residents and two staff during an emergency. The LPA advised the Administrators to have sufficient water available in case of an emergency. At the time of the inspection at approximately 12:15 p.m., the LPA observed two refrigerators in the kitchen area. The LPA observed in one refrigerator (Tall) several insulin injection pens (blue/white and gray) in a plastic baggie in the refrigerator’s door compartment. Furthermore, upon inspection of the freezer, there were two pill containers (brown bottles) in the freezer area. One bottle with writing on the label, contained expired suppositories, and the other bottle contained some type of skin ointment/cream, as stated by the administrator and staff. In the second refrigerator (short) the LPA observed two expired (08/2024) Lorazepam small glass bottles (vials) in the door compartment of the refrigerator. None of the medications had the names of the current residents. The insulin injection pens belonged to the Administrator, per their statement. In the freezer area of the tall refrigerator the LPA observed two packets of bacon with a sell date of 12/06/2023 and one with the sell date of 01/07/2024. Furthermore, the LPA observed some type of meat in a plastic baggie that was previously used to hold insulin injection pens. The LPA observed one (1) unlocked, accessible staff bedroom by the backdoor kitchen area. This room is described as “Office” in the facility’s sketch plan. Laundry Area: There is a washer and dryer in a locked room adjacent to the kitchen, as well as a staff bathroom. Laundry detergent was observed in the locked laundry room/ staff bathroom. BEDROOMS: There are 4 (four) total residents’ bedrooms in the facility; two (2) are designated as a shared room, two (2) are designated as private rooms. All resident rooms were observed to be supplied appropriately with clean linens, and sufficient lighting. Bedrooms #3 and #4 do not have closet space; the Administrator will add closet space to the bedrooms. Bedroom #3 was observed to have a desk and a desk top computer that is used by staff. The Administrator was reminded that residents’ bedrooms are not to be used for any other purposes. The Administrator will remove/relocate the desk and tabletop computer. The Administrator will mail pictures to the LPA by the POC correction date. Continues on LIC 809C pg.3 Pg.3 RESTROOMS: The facility has three (3) residents’ restrooms. Two restrooms are inside bedrooms #2 and #4; and the bathrooms were observed to be clean and sanitary and in operable condition, however no grab bars were observed by the toilet area, nor on the wall. The bathrooms had non-skid shower mats. The hallway bathroom was observed to have toilet-adapted grab bars. The hallway bathroom requires that the bottom of the wall plaster next to the toilet be repaired. The bathrooms were sufficiently stocked with supplies and paper towels. The hot water temperature was measured in all three (3) resident restrooms; and water temperature was observed to be within regulations. The Administrator will email pictures of the corrections to the LPA by the POC date. GARAGE/BACKYARD: The garage is maintained locked at all times. The backyard has a covered patio area with patio furniture including a table and chairs for residents’ use. All passageways were observed to be clear. LPA observed one (1) self-latching gate. There were no bodies of water noted at the time of the visit. All exits in the facility have functioning auditory devices and were operational at the time of the visit. RECORDS: Records review began at 1:45 p.m. Residents’ records were reviewed for, but not limited to care plans, medical records, admissions agreement, consent forms. All records were in order. Personnel records were reviewed for, but not limited to health assessments, criminal record clearances, first aid/CPR training, and the appropriate training. All files were in order. MEDICATIONS: Medications review began at 4:26 p.m. The medications are in locked medication cart located in the living room area. Medications are properly documented on the centrally stored medications and destruction record. No errors observed during the medication review. The following deficiencies were observed and cited from the California Code of Regulations, Title 22 and California Health and Safety Code. Failure to correct the deficiencies may result in civil penalties. Exit interview conducted. A copy of the report provided, and Appeal Rights were issued.the state’s words, verbatim · CDSS document, Aug 19, 2025

The state marks this report as 10 pages; the online copy we transcribed has 7. You can request the full file from the county licensing office.

Allegation investigated: Facility denied medical services to client. Staff are not properly managing resident's medication. Resident records are not properly maintained.

Licensing Program Analyst (LPA) Brian Balisi conducted a subsequent complaint visit to further investigate the allegations listed above. During today’s visit, LPA met with caregiver and explained the reason for the visit. Staff #1 (S1) arrived shortly after. On 08/10/2023, the initial complaint visit was conducted by LPA between approximately 09:00 a.m. - 12:45 p.m. During the visit, LPA conducted a tour of the physical plant, interviewed staff, residents, as well as, reviewed and obtained copies of pertinent documentation relevant to the investigation. On 12/04/2024, LPA reviewed medical records from Pegasus Home Health Care and interviewed representative from Pegasus Home Health Care. Additionally, on 11/05/2024, LPA obtained additional records from Resident #1s (R1s) family. On 12/20/2024, Licensing Program Manager (LPM) Desaree Perera conducted interviews with facility administrator and S1 approx. between 11:45 a.m. and 11:50 a.m. During today’s visit, LPA conducted physical plant, interviewed staff and reviewed and obtained additional pertinent documentation relevant to the investigation. Substantiated Continued from 9099 It was reported that "Staff prevented resident from having visitors", “Staff are not properly managing resident’s medication”, and “Resident records are not properly maintained” as it was alleged that facility staff denied a Home Health (HH) nurse access to visit Resident #1 (R1) and facility staff did not provide R1’s family with resident records. It was further reported that when R1’s family requested the medication for R1, staff stated that R1 was taken off that medication. During the initial interviews with facility administrator and staff, all denied that R1 was ever a resident at the facility. Additionally, there was no documentation at the facility pertaining to R1. Moreover, Administrator and two staff members were shown photos of R1, but they stated they did not recognize the person in the photos. However, records obtained and reviewed during the course of the investigation reflected that Kaiser Permanente discharged R1 to Dependable Over Night Board & Care and R1 was admitted to the facility on 04/27/2023. Facility contact person was listed as S1. Moreover, HH records reviewed reflected that HH contacted facility to schedule a visit on 07/15/2023 and spoke with S1 who informed HH nurse that the “…Pt is doing fine – taking meds, diseases under control, pt can eat and walk. If they need help they will let the pt’s sister know and MD…” It was further noted that “…Another agency attempted to go see the pt in the past and facility will not allow anyone…” Moreover, during interview conducted with S1 on 12/20/2024, S1 recalled that R1 was indeed a resident at the facility and stated that S1 was confused when initially interviewed but remembered after. S1 admitted to not contacting the LPA to provide additional information. Additionally, S1 stated they spoke with HH nurse regarding R1 and notified that they were doing well and was able to walk. Staff stated that they were unaware why HH contacted them but that she would contact R1’s family, if warranted. Moreover, S1 stated they didn’t have any records for R1 at the time of the initial interview because they didn’t recall R1 however, later located the records. During today’s visit, LPA reviewed records for residents in care and did not observe any records onsite for R1. Administrator and S1 stated they will have to review what records they have for R1 in their archive and will send to LPA once they obtain it. Moreover, S1 stated that the family of R1 was responsible for obtaining the records from Kaiser and the facility was not responsible. S1 was not able to provide any information regarding R1’s medication or provide any documentation related to the medication. Continued from 9099-C Based on the information gathered, the Department has sufficient evidence to determine that staff prevented R1 from having HH visit, staff did not maintain proper resident records and staff were not managing resident’s medications properly. Therefore, the above allegations are deemed SUBSTANTIATED at this time. Pursuant to Title 22, California Code of Regulations and/or CA Health and Safety Code, the following deficiencies were cited (refer to LIC 9099-D.) S1 was informed that failure to correct the deficiencies may result in civil penalties. Exit interview conducted, appeal rights discussed, and a copy of this report and appeal rights were provided.the state’s words, verbatim · CDSS document, Dec 20, 2024 · control 29-AS-20230804102833

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87468.1(11) · Plan of correction due date: Jan 3, 2025

(11) To have their visitors, including ombudspersons and advocacy representatives, permitted to visit privately during reasonable hours and without prior notice, provided that the rights of other residents are not infringed upon. This requirement was not met as evidence by: Based on interviews and records reviewed the licensee did not comply with the section cited above as a home health nurse was not allowed to conduct a visit with R1, which poses a potential health and safety rise for the residents in care.the state’s words, verbatim · CDSS document, Dec 20, 2024

Plan of correction: Licensee has agreed to review section cited and provide a statement of understanding to LPA via email by COB 01/03/2025.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87465(a)(4) · Plan of correction due date: Jan 3, 2025

87465 (a)(4) Incidental Medical and Dental Care. The licensee shall assist residents with self-administered medications as needed. This requirement was not met as evidenced by: Based on interviews and records reviewed the licensee did not comply with the section cited above there were no centrally stored medication records to review onsite for R1, which poses a potential health and safety risk for residents in care.the state’s words, verbatim · CDSS document, Dec 20, 2024

Plan of correction: Licensee has agreed to review regulation cited and provide a statement of understanding to LPA via email by COB 01/03/2025

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87506(a) · Plan of correction due date: Jan 3, 2025

87506(a) The licensee shall ensure that a separate, complete, and current record is maintained for each resident in the facility or in a central administrative location readily available to facility staff and to licensing agency staff. Based on interviews and records review the licensee did not comply with the section cited above as R1 did not have any records on site to review which poses a potential health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Dec 20, 2024

Plan of correction: Licensee agreed to maintain full resident files in the facility. Licensee also agreed to submit proof of understanding and submit to LPA via email by COB 01/03/2025

Type of visit: Case Management - Deficiencies

Licensing Program Analyst (LPA) Brian Balisi conducted a Case Management - Deficiencies visit in conjunction with a complaint visit (Complaint Control # 29-AS-20230804102833). The purpose of the visit is to issue citations for deficiencies observed during the initial complaint investigation unrelated to the complaint. During today’s visit, LPA met with staff and explained the reason for the visit. During the course of the investigation, facility administrator and staff, all denied that Resident #1 (R1) was ever a resident at the facility. Administrator and two staff members were also shown photos of R1, but they stated they did not recognize the person in the photos. On 11/05/2024, LPA obtained evidence to support that R1’s family paid R1’s monthly services via Zelle to Staff #1 (S1). On 12/20/2024, Licensing Program Manager (LPM) Desaree Perera conducted interviews with facility administrator and staff #1 (S1) approx. between 11:45 a.m. and 11:50 a.m. Interviews with administrator reflected that she did not recall who R1 was even though administrator stated she visited the facility daily. Administrator stated that she needed to review documents and speak to staff prior to responding to LPM. During the interview with S1, S1 initially stated that R1 did not reside at the facility however, when questioned why the family paid for services via Zelle for an individual that did not reside at the facility; S1 then stated she was confused and remembered there was two (2) individuals with the same name that used to reside prior. S1 also admitted to remembering this information after initial interview with LPA but failed to contact the LPA and provide the information. Records review also revealed that when S1 spoke to Home Health Nurse they presented themselves to the nurses as the Administrator of the facility. At approx 2:55pm LPA's records review revealed that there was no active or pending Administrator certificate on file for S1. LPM/LPA informed the facility administrator and staff the importance of providing truthful and accurate information at all times. Pursuant to Title 22, California Code of Regulations and/or CA Health and Safety Code, the following deficiencies were cited (refer to LIC 809-D.) S1 was informed that failure to correct the deficiencies may result in civil penalties. Exit interview conducted, appeal rights discussed, and a copy of this report and appeal rights were provided.the state’s words, verbatim · CDSS document, Dec 20, 2024

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87207 · Plan of correction due date: Dec 23, 2024

87207 False Claims. No licensee, officer or employee of a licensee shall make or disseminate any false or misleading statement regarding the facility or any of the services provided by the facility. This requirement was not met as evidenced by: Based on interviews and records review the licensee did not comply with the reg cited above as S1 presented themselves as Administrator to home health staff, which posed an immediate health, safety and / or personal rights risk to residents in care.the state’s words, verbatim · CDSS document, Dec 20, 2024

Plan of correction: Licensee agreed to review section cited and provide a statement of understanding to LPA via email by COB 12/23/204.

Type of visit: Required - 1 Year

Licensing Program Analysts (LPA) Erica Mosley arrived at the facility unannounced to conduct a required annual visit and entered the facility at 9:30 a.m. Upon arrival, LPA Mosley was greeted by staff and called the administrator to inform them of the visit. The administrator and CO-Owner arrived shortly thereafter. The LPA met with Administrator Anna Hayrapetyan and Co-Owner GAIANE EGIAZARIAN and explained the reason for the visit. The LPA 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. Facility is a single-story residence and consists of a total of four (4) resident bedrooms, one (1) locked, inaccessible to residents’ staff room, three (3) resident bathrooms and one (1) locked, inaccessible staff bathroom. Fire clearance was approved on 7/20/2021 for four (4) non-ambulatory residents, one (1) ambulatory and one (1) bedridden. During physical plant tour LPA observed the required postings throughout the facility. At approximately. 9:35 a.m., LPA observed all six (6) residents mingling together at the dining room table looking through magazines and socializing. RESTROOMS: The three (3) resident restrooms were clean and sanitary and in operable condition with grab bars and non-skid surfaces. The bathrooms were sufficiently stocked with supplies and paper towels. The hot water temperature was measured in all three (3) resident restrooms; the first restroom measured at 107.8 degrees Fahrenheit at 10:15 a.m. the second bathroom measured at 114.4 degrees Fahrenheit at 10:20 a.m., and the third restroom 106.3 at 10:31 a.m. All restrooms within the required range. Report Continued on LIC 809C... Report Continued from LIC 809... BEDROOMS: There are 4 (four) total bedrooms in the facility; two (2) are designated as a shared room, two (2) are designated as private resident rooms. All resident rooms were observed to be furnished appropriately with clean linens, appropriate furnishings, and sufficient lighting. KITCHEN: The LPA inspected the kitchen/food service area at 10:22 a.m. Knives and sharps were observed in a locked cabinet. Kitchen appliances were in operable condition. The facility has a sufficient supply of two (2) day perishable and seven (7) day non-perishable food. Refrigerator and food pantry were checked for proper labels and expiration dates. The kitchen faucet was measured for hot water temperature, and it measured 108.9 degrees Fahrenheit at 10:28 a.m. There is a washer and dryer on premises. Laundry detergent was observed in the locked laundry room/ staff bathroom. COMMON AREAS: At the time of the visit, furniture in the common areas was observed to be in good condition. The facility maintained a comfortable temperature. At 2:30 p.m., smoke detector(s) and carbon monoxide detector were tested and operational at the time of the visit. The fire extinguisher was observed and fully charged on 09/03/2024. The LPA observed required postings throughout the common space. The last emergency disaster drill took place on 06/24/2024. Activities were observed in the common areas. Cameras were observed in common areas during the time of the visit. GARAGE/BACKYARD: The garage is maintained locked at all times. LPA observed an adequate amount of emergency food and water. Cleaning supplies are kept in the garage locked and inaccessible to residents in care. There is a locked shed on the side of the home containing extra cleaning supplies. The backyard has a covered patio area with patio furniture including a table and chairs for resident use. All passageways were observed to be clear. LPA observed one (1) self-latching gate. There were no bodies of water noted at the time of the visit. All exits in the facility have functioning auditory devices and were operational at the time of the visit. Report Continued on LIC 809C... Report Continued from LIC 809... MEDICATIONS: Medications review began at approximately 12:13 p.m. The medications are in locked medication cart in the living room area. Medications for four (4) clients were reviewed. Medications reviewed were found to be self administered as prescribed; however, documentation on the centrally stored medication and destruction record was not accurately documented which poses a potential health and safety risk to persons in care. RECORDS: Resident Records were reviewed at approximately 10:40 a.m. and personnel records at approximately 11:30 a.m. Six (6) resident files were reviewed for, but not limited to, the following: signed admission agreements, current medical assessments with TB results, LIC627(c) Consent for Treatment form, and current needs and services plan. Five (5) personnel files including the Administrator’s file were reviewed for, but not limited to: personnel records, health assessments, criminal record clearances, first aid/CPR training, and the appropriate training. All records were in order. INTERVIEWS: Two (2) staff interviews were conducted. Due to language barriers a translation application was used to conduct interviews. No concerns were noted. Six (6) resident interviews were attempted. Due to language barriers two (2) interviews were conducted. No concerns were noted. LPA obtained the following documents – LIC 500, LIC 9020, and current liability insurance. The following deficiencies were observed (See LIC 809-D.) and cited from the California Code of Regulations, Title 22 and California Health and Safety Code. Failure to correct the deficiencies may result in civil penalties. Exit interview conducted, appeal rights discussed, and a copy of the report provided.the state’s words, verbatim · CDSS document, Sep 20, 2024