Nirvana Gardens Assisted Living

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Sandra Urena conducted an unannounced required annual inspection visit and met with the Licensee Christina Gabuzyan, and the LPA explained the reason for the visit. The facility was approved for six (6) non-ambulatory residents, one (1) bedridden resident in bedroom #3. 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 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. Kitchen cleaning supplies are stored and locked under the kitchen sink. Hot water temperature was recorded at 116.8 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. Two fire extinguishers were observed; one is located by the office and another one is located in the kitchen area. Both were serviced on 10/08/2025. BEDROOMS: There are three (3) bedrooms for residents in care. Rooms 1, 2 and 3 are shared rooms; all bedrooms are cleared for non-ambulatory purposes, and bedroom #3 is cleared for one bedridden resident. All bedrooms were supplied with all required bedding and linens. There is sufficient lighting as well as closet and space available. BATHROOMS: There is one full bathroom, with shower and a bathtub. Bathroom is equipped with toilet and shower grab bars, and non-skid mats. There are sufficient supplies of towels, paper goods and personal hygiene supplies. Hot water delivered was delivered at 115.6 degrees Fahrenheit. Continues on LIC 809C... COMMON AREAS: The living room area is equipped with a television, and the fireplace is non-functional and is permanently covered. 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 in a locked cabinet in the office area. The residents’ and staff files are stored and locked cabinets located in the office area. LAUNDRY: There is a laundry area equipped with washer and dryer. The washer and dryer are located in the hallway between the restroom and bedroom # 1. Detergents and cleaning supplies will be stored in a locked cabinet next to the washer and dryer. SURROUNDING GROUNDS/OUTDOOR AREA: 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. Left passageway is cleared and has a self-latching gate. The self-latching mechanism is located on the outside of the gate facing the street. exit. RECORDS: Records review began at 12:15 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 01:36 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. No errors observed during the medication review. The LPA reviewed the following documents: - LIC500 Personnel Report - LIC9020 Client Roster - Certificate of Liability of Insurance _ Emergency Drill Logs At the time of the visit the LPA observed one (1) ADU unit. The unit is identified by the address #15801 ½. and is located on the left-hand side of the facility. The ADU unit is separated from the main address by a fence and is not accessible to residents in care. Exit interview was conducted and reviewed with the applicant. A copy of the report was issued.the state’s words, verbatim · CDSS document, Dec 23, 2025

Allegation investigated: Staff did not provide proper notice of rate increase.

Licensing Program Analyst (LPA) Sandra Urena conducted an initial unannounced visit to investigate the allegation listed above. The LPA was greeted by staff. The staff contacted the Administrator Christina Gabuzyan, and the LPA explained the reason for the visit. The Administrator was unable to come to the facility at the time of the visit, consequently the LPA explained and read the allegation over the phone. LPA Urena interviewed the Administrator, and requested records pertinent to the investigation. On the allegation that the Staff did not provide proper notice of rate increase, it is the concern of the Reporting Party (RP) that the resident (R1) was being illegally evicted, because the facility Administrator did not provide R1’s responsible party with a legal notice of an increase in rent, with a possibility of eviction if the responsible party could not pay the increase in the rent fee by 10/07/2025. The LPA interviewed the RP on 10/10/2025 at approximately 8:49 a.m. Continues on LIC 9099C... Unsubstantiated Per the RP, a public agency received an eviction letter for R1 from the facility Administrator; however, the letter was not signed. Per the RP neither the R1 nor their responsible party reported that they would be evicted. The LPA interviewed R1’s responsible party, and the responsible party denied receiving an eviction letter from the facility Administrator. Per the responsible party, they had a discussion with the Administrator during the admission agreement meeting that the Administrator agreed to accept R1 for a minimum rent payment, with the agreement that a rent increase would take place after three months of the admission of R1, the responsible party accepted the agreement and signed the agreement dated on 04/07/2025. Furthermore, the party responsible stated that they have not received an eviction letter after the tree months. The responsible party stated that they were very happy with the services being provided to R1 at the facility, happy with the staff and the Administrator, and had no concerns. The interview with the Administrator revealed that they admitted R1 on 04/07/2025, after receiving a referral from LA Care. The Administrator stated that they were told that they could get additional funding from other sources to cover for the difference in fees, given that the responsible party for R1 could only pay a minimum fee, with a $3,000 difference to pay the full $5,000 dollar fee. An admission agreement and a contract document was created at the time of the admission of R1, where R1’s responsible party agreed to the conditions of the admission. Furthermore, the Administrator stated that they have been working with R1’s responsible party to get the additional funds to cover for the full rate of the stay at the facility, and that they do not plan on evicting R1. Record review revealed that in addition to the admission agreement, a Resident Responsible Party Agreement was created and was accepted and signed by R1’s responsible party. Although the allegation may have happened or is valid, based on the interviews, and record review there is not sufficient evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is deemed Unsubstantiated at this time. The Administrator was not present to sign the repot and assigned the facility's representative Melany Gabuzyan to sign the report. Interview exit was conducted. A copy of the report was issued.the state’s words, verbatim · CDSS document, Oct 10, 2025 · control 29-AS-20251003141134

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Sandra Urena arrived unannounced at the facility to conduct a Case Management-Other visit. The LPA was greeted by staff and contacted the licensee on the phone. The LPA spoke with the licensee Christina Gabuzyan on the phone and explained the reason for the visit. Today’s visit is to confirm the relocation of R1 to this facility, and to conduct a well check for R1. The Administrator stated that R1 is doing well. The LPA and the staff 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. LPA Urena observed R1 residing in bedroom # 2 -Harmony Suite, which is a private room. The LPA spoke with R1 and R1 reported doing well. The Licensee was unable to come to the facility and asked the staff Melany Gabuzyan to sign the report. Exit interview was conducted. A copy of the report was issued.the state’s words, verbatim · CDSS document, Sep 9, 2025

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 01/16/2025. The following deficiencies have been cleared. -The applicant will install a ramp with handrails for residents to access the patio area. -Applicant will add additional chest of drawers to bedrooms 1 and 2. Applicant will add two (2) lamps to bedroom #3. -Applicant will add handrails to ramp connected to bedroom #3. -An auditory device will be installed to monitor the gate exit. -The applicant will have the following items removed or relocated to another area: Bricks, and fencing. -A gate will be installed on the right-hand side of the building to prevent residents from wondering to this area. -A small threshold ramp will be installed in the bathroom.the state’s words, verbatim · CDSS document, Jan 27, 2025

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Sandra Urena conducted a Pre-licensing visit and met with the applicant Christina Gabuzyan. This is a new facility application for a Residential Facility for the Elderly (RCFE) for six (6) non-ambulatory residents, one (1) bedridden resident can be admitted and reside in bedroom #3. Fire Clearance was approved on 11/01/2024 for all rooms for non-ambulatory use, and room # 3 for one bedridden resident. At 10:05 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 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. Kitchen cleaning supplies will be stored and locked under the kitchen sink. Hot water temperature was recorded at 116.8 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. Two fire extinguishers were observed; one is located by the office and another one is located in the kitchen area. Both were serviced on 08/13/2024. The applicant will install a ramp with handrails for residents to access the patio area. BEDROOMS: There are three (3) bedrooms for residents in care. Rooms 1, 2 and 3 will be shared rooms; all bedrooms are cleared for non-ambulatory, and bedroom #3 is cleared for one bedridden resident. All bedrooms were supplied with all required bedding and linens. There is sufficient lighting as well as closet and some space available. Applicant will add additional chest of drawers to bedrooms 1 and 2. Applicant will add two (2) lamps to bedroom #3. Applicant will add handrails to ramp connected to bedroom #3. LIC 809C... BATHROOMS: There is one full bathroom, with shower and a bathtub. Bathroom is equipped with toilet and shower grab bars, and non-skid mats. There are sufficient supplies of towels, paper goods and personal hygiene supplies. Hot water delivered was at 116.7 degrees Fahrenheit. A small threshold ramp will be installed. COMMON AREAS: The living room area is equipped with a television, and the fireplace is non-functional and is permanently covered. 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 cabinet in the office area. The residents’ and staff files will be stored and locked cabinets located in the office area. LAUNDRY: There is a laundry area equipped with washer and dryer. The washer and dryer are located in the hallway between the restroom and bedroom # 1. Detergents and cleaning supplies will be stored in a locked cabinet next to the washer and dryer. SURROUNDING GROUNDS/OUTDOOR AREA: 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. Left passageway is cleared and has a self-latching gate. The self-latching mechanism is located on the outside of the gate facing the street. An auditory device will be installed to monitor the gate exit. The applicant will have the following items removed or relocated to another area: Bricks, and fencing. A gate will be installed on the right-hand side of the building to prevent residents from wondering to this area. At the time of the visit the LPA observed one (1) ADU unit. The unit is identified by the address #15801 ½. and is located on the left-hand side of the facility. The ADU unit is separated from the main address by a fence, and is not accessible to residents in care. Continues on LIC 809C... Pre-Licensing is incomplete with deficiencies to be resolved by 01/24/2025. Follow up Pre-licensure LIC809 will be generated upon resolution. · The applicant will install a ramp with handrails for residents to access the patio area. · Applicant will add additional chest of drawers to bedrooms 1 and 2. Applicant will add two (2) lamps to bedroom #3. · Applicant will add handrails to ramp connected to bedroom #3. · An auditory device will be installed to monitor the gate exit. · The applicant will have the following items removed or relocated to another area: Bricks, and fencing. · A gate will be installed on the right-hand side of the building to prevent residents from wondering to this area. A small threshold ramp will be installed in the bathroom. At 1:00 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. Exit interview was conducted and reviewed with the applicant. A copy of the report was issued.the state’s words, verbatim · CDSS document, Jan 16, 2025

Type of visit: Office

Component II completion: Successful Facility Type: Residential Care Facility for the Elderly (RCFE) Application Type:Initial Capacity: 6 Census (if any clients in care): none COMP II Participants: Christina Gabuzyan, Applicant/Administrator Interview Method: Telephone interview On December 11, 2024 at 9:00 AM, Applicant/Administrator participated in COMP II. Identification of the Applicant/Administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, Applicant/Administrator confirmed that they have read and understand community care facility licensing laws included in the Health and Safety Codes and the California Code of Regulations Title 22. During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of following areas: 1. Facility Operation: License type, client/resident populations, and program 2. Admission Policies 3. Staffing Requirements & Training 4. Restrictive/Prohibited Health Conditions 5. General Provisions 6. Emergency Preparedness 7. Complaints & Reporting 8. Pre-licensing Readiness Exit interview conducted with Applicant/Administrator. Report sent via email and informed to return sign copy to CAB by end of business day today.the state’s words, verbatim · CDSS document, Dec 11, 2024