Sweet Apple Assisted Living

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Sandra Urena conducted an unannounced annual required inspection visit. LPA Urena was greeted by staff and staff contacted the Administrator Meri Tarposhyan on the phone, and the LPA explained the reason for the visit. The Administrator stated that they would arrive at the facility within the next 20 minutes. The LPA, and the Administrator toured the physical plant areas inside and outside to ensure there are no health and safety hazards and that the facility will be following Title 22 Regulations. COMMON AREAS: These include a living room area equipped with a television. There is a dedicated area for the posting of required documents at the entrance of the facility. Smoke and carbon monoxide alarms were tested and functional at the time of the visit. Medications are stored and locked in a closet located next to the refrigerator in the kitchen area. The residents’ and staff files are stored and locked in the same closet as the medications. LAUNDRY ROOM: There is a laundry area equipped with washer and dryer. The laundry room is located in the hallway. Detergents and cleaning supplies are stored and locked in the same closet. KITCHEN: Kitchen knives are stored locked and inaccessible in a kitchen drawer. A seven-day supply of non-perishable food was available. The supply of dishes is adequate. Appliances in the kitchen were clean and all appeared functional. Hot water temperature was recorded at 118.5 degrees Fahrenheit. Trash cans have a tight-fitting lid. There were no pesticides or toxins stored near food, or preparation area. The first aid supplies were complete, including a thermometer and a current version of a first aid manual. A fire extinguisher is located near the backdoor, which was purchased on 05/26/2025. BEDROOMS: There are four (4) bedrooms for residents in care. Bedroom #1 was approved for (1) ambulatory resident and bedrooms # 2, 3 and 4 were approved for five (5) bedridden or non-ambulatory residents. There is sufficient lighting as well as closet space available. The closets in bedrooms #1, 2 and 4 will be cleared of supplies to make space for residents’ clothing and personal items. At the time of the visit, the LPA observed seven (7) beds. Two (2) beds in room #1, two (2) beds in room # 2, one (1) bed in room #3 and two (2) beds in room #4. The LPA advised and cautioned the Administrator about having seven (7) residents, since their license is approved for six (6) residents. Currently room #2 is vacant, with no residents. The Administrator stated that they left the two beds in room #2 for the future resident to choose either the hospital bed or a regular bed. Once the new resident is admitted they will remove the second bed. BATHROOMS: There are three (3) full bathrooms, with shower area. One of the three bathrooms is located in the hallway, one is located in bedroom #1 and another one is located in bedroom#4. Bathrooms are equipped with toilets and shower grab bars, and non-skid mats. There are sufficient supplies of towels, paper goods and personal hygiene supplies. Hot water delivered was measured at 118.2 degrees Fahrenheit. SURROUNDING GROUNDS: The exterior passageways were clean. The patio is furnished with outdoor furniture for residents’ use, and shade is available. The building has a central entrance for residents and visitors. The backdoor requires a ramp with handrails to provide access to the residents to get to the backyard/outdoor area. At the time of the visit the LPA observed two ADU units. One unit is identified by the address #6854 and is located on the left-hand side of the facility, it is fully enclosed with fencing at least 6’ feet tall. The second ADU is identified by the address #6854 and is located behind the facility and is separated by fencing at least 6’ feet tall. Neither ADU’s are associated with the facility. RECORDS: Records review began at 12:30 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 1:20 p.m.; medications are centrally stored and locked in a cabinet in the kitchen area next to the refrigerator; medications are labeled and checked for expiration dates. The medications are documented properly on the centrally stored medications and destruction record. Errors were observed during the medication audit. Three medication bottles had less pills than the correct count. The LPA reviewed the following documents: - LIC500 Personnel Report - LIC9020 Client Roster - Certificate of Liability of Insurance _ Emergency Drill Logs Citations were issued. Exit interview conducted. A copy of the report was issuedthe state’s words, verbatim · CDSS document, Jan 6, 2026

Allegation investigated: Staff handled resident in a rough manner resulting in an injury.

Licensing Program Analyst (LPA) Sandra Urena conducted an unannounced subsequent visit to deliver the findings for the allegation listed above. LPA Urena was greeted by the Administrator Armine Avetisyan. The LPA explained the reason for the visit. LPA Urena and the Administrator conducted a brief tour of the facility On 05/13/2025, Licensing Program Analyst (LPA) Sandra Urena conducted an unannounced initial complaint visit regarding the allegation listed above. LPA Urena conducted a brief tour the physical plant areas inside and outside to ensure there are no health and safety hazards and that facility is in compliance with Title 22 Regulations. No physical plant concerns were observed at the time of the tour. The LPA interviewed the Administrator at 12:50 p.m. and asked for documents relevant to the investigation. The LPA interviewed five (5) out of six (6) residents, one staff and the administrator between 12:25 p.m. and 2:24 p.m. Continues on LIC 9099... Substantiated Staff handled resident in a rough manner resulting in an injury. It is alleged that the staff handled a resident in a rough manner resulting in injury, and it is the concern of the reporting party (RP) that staff (S1) was rough with residents while assisting in transferring from one place to another. The residents’ interview revealed that S1 has been rough with them during the time they have been residing at the facility. The residents stated that S1 is rough while transferring from the bed, while waking them up and at other times of the day. The residents showed the LPA with hand gestures how S1 had been rough by poking at their chest while trying to wake them up, pushing the food table against their legs and causing bruises. Residents showed the LPA the bruises caused by the food table pushed against their legs. Furthermore, one resident stated that they were afraid to go to sleep because they feared that staff would attack them at night. LPA Urena reviewed residents’ records and observed that three out of six residents are non-ambulatory and may require assistance with transferring from bed to either a chair or to a walker. The LPA interviewed the staff about the allegation and the staff denied being rough or causing any injuries. The LPA interviewed the Administrator about the allegation and the Administrator stated that they were not aware of unprofessional or abusive behavior from the staff to residents. Based on the information obtained through residents’ interviews, record review and observation of the bruises, there is sufficient evidence to prove the staff handled residents in a rough manner. Therefore, the allegation is deemed Substantiated at this time. Pursuant to Title 22, California Code of Regulations (CCR), the following deficiencies were cited (refer to LIC 9099-D). Exit interview was conducted. Copy of the report and Appeal Rights were issued.the state’s words, verbatim · CDSS document, Jun 3, 2025 · control 29-AS-20250505163541

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87468.1(a)(3) · Plan of correction due date: Jun 10, 2025

87468.1(a)(3)-Personal Rights of Residents in All Facilities-(a)Residents in all residential care facilities for the elderly shall have all of the following personal rights: (3)To be free from punishment, humiliation, intimidation, abuse, or other withholding residents’ money or interfering with daily living functions such as eating, sleeping, or elimination. This requirement was not met as evidence by: Based on interviews, the licensee did not comply with the above cited section when S1 inappropriately handled residents, which posed an immediate health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Jun 3, 2025

Plan of correction: POC: The Licensee stated that they let go of S1 on 05/13/2025, and agreed to train all staff on personal rights and spend more time observing the staff and having frequent conversatiosn with residents in care.

Type of visit: Case Management - Other

LPA Urena received via email pictures of the corrections for the deficiencies cited on the pre-licensing visit conducted on 01/22/2025. Pre-Licensing is complete and deficiencies were resolved. · Chest of drawers was purchased for each bedroom (1,2,3,4). · The back-door's ramp with handrails to provide access to the residents to get to the backyard/outdoor area was adapted to allow for easy exit to residents. · The hallway door was adapted with a magnet to keep door open and be activated during a fire. This report will be sent to the Centralized Application Bureau (CAB). You will be notified by the CAB Analyst when your license has been approved. You are not allowed to begin operating until you have been notified that your license has been approved by the CAB Analyst. Failure to comply could affect approval of your license. Exit interview conducted and a copy of the report was issued.the state’s words, verbatim · CDSS document, Feb 4, 2025

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Sandra Urena conducted a Pre-licensing visit and met with the applicant Armine Avetisyan. This is a new facility application for a Residential Facility for the Elderly (RCFE) for six (6) residents. Fire Clearance was approved on 11/14/2024 for one (1) ambulatory in bedroom#1, and five (5) bedridden residents only in bedrooms #2, #3, and #4. At 9:30 a.m., the LPA, and the applicant toured the physical plant areas inside and outside to ensure there are no health and safety hazards and that the facility will be following Title 22 Regulations. KITCHEN: Kitchen knives are stored locked and inaccessible in a locked closet. A seven-day supply of non-perishable food was available. The supply of dishes is adequate. Appliances in the kitchen were clean and all appeared functional. Kitchen cleaning supplies will be stored and locked in a locked closet in the common area. Hot water temperature was recorded at 118.5 degrees Fahrenheit. Trash cans have a tight-fitting lid. There were no pesticides or toxins stored near food, or preparation area. The first aid supplies were complete, including a thermometer and a current version of a first aid manual. A fire extinguisher is located near the backdoor, which was purchased on 08/09/2024. BEDROOMS: There are four (4) bedrooms for residents in care. Bedroom #1 was approved for (1) ambulatory resident and bedrooms # 2, 3 and 4 were approved for five (5) bedridden residents only. There is sufficient lighting as well as closet space available. Chest of drawers will be purchased for each bedroom (1,2,3,4). BATHROOMS: There are three (3) full bathrooms, with shower area. One of the three bathrooms is located in the hallway, one is located in bedroom #1 and another one is located in bedroom#3. Bathrooms are equipped with toilets and shower grab bars, and non-skid mats. There are sufficient supplies of towels, paper goods and personal hygiene supplies. Hot water delivered was measured at 118.2 degrees Fahrenheit Continues on LIC 809C.. COMMON AREAS: These include a living room area equipped with a television. There is a dedicated area for the posting of required documents at the entrance of the facility. Smoke and carbon monoxide alarms were tested and functional at the time of the visit. Medications will be stored in a locked closet located next to the refrigerator in the kitchen area. The residents’ and staff files will be stored and locked in a closet area located next to the kitchen. The hallway door will require a magnet to keep door open and be activated during a fire. LAUNDRY ROOM: There is a laundry area equipped with washer and dryer. The laundry room is located in the hallway. Detergents and cleaning supplies will be stored in locked closet located next to bedroom #1. SURROUNDING GROUNDS: The exterior passageways were clean. The patio is furnished with outdoor furniture for residents’ use, and shade is available. The building has a central entrance for residents and visitors. The backdoor requires a ramp with handrails to provide access to the residents to get to the backyard/outdoor area. At the time of the visit the LPA observed two ADU units. One unit is identified by the address #6854 and is located on the left-hand side of the facility, it is fully enclosed with fencing at least 6’ feet tall. The second ADU is identified by the address #6854 and is located behind the facility and is separated by fencing at least 6’ feet tall. Neither ADU’s are associated with the facility. Pre-Licensing is incomplete with deficiencies to be resolved by Friday, 01/31/2025. Follow up Pre-licensure LIC809 will be generated upon resolution. · Chest of drawers will be purchased for each bedroom (1,2,3,4). · The backdoor requires a ramp with handrails to provide access to the residents to get to the backyard/outdoor area. · The hallway door will require a magnet to keep door open and be activated during a fire. At 12:15 p.m. the applicant completed Component III orientation. This report will be sent to the Centralized Application Bureau (CAB). You will be notified by the CAB Analyst when your license has been approved. You are not allowed to begin operating until you have been notified that your license has been approved by the CAB Analyst. Failure to comply could affect approval of your license.the state’s words, verbatim · CDSS document, Jan 22, 2025