Ayres Residential Care Home-Century City

Type of visit: Annual/Random

On 09/02/2026, Licensing Program Analyst (LPA) Bernadette Allen conducted an unannounced visit to conduct an annual inspection. LPA met with Administrator Michael Gabai and Amalia Conception Shank- Caregiver who was informed of the purpose of the visit. The Assistant Administrator, Arielle Lewis, arrived approximately at 10:30 AM and Arielle was informed of the purpose of the visit. The facility is licensed to serve (6) elderly adults ages 60 and above, of which (6) can be non-ambulatory. The facility has an approved hospice waiver for (5) residents. Currently there are (6) residents in the facility. The facility is a single-story home located in a residential neighborhood, and it consists of the following: (6) resident bedrooms, (6) resident bathrooms, (1) staff room, (2) staff bathrooms, office, living room, dining room, and kitchen. At 10:35 AM, LPA and Arielle toured the physical plant. There were no bodies of water or obstructions on the premises inside or outside of the home. The Department inspected a total of six (6) bedrooms, and the bedding and supplies appeared to be in good condition, adequate lighting was provided, and storage for the residents’ personal belongings was observed. The department also observed additional bed linens, comforters, and bath towels that were adequately stocked at the time of visit. The bathrooms appeared to be clean and operational. The water temperature ranged from 105 -120 F° and the facility temperature ranged from 72-75 degrees F. The Department observed a 5-day supply of perishables and a 7-day supply of non-perishables food items for the number of residents in care which were stored and maintained properly knives/sharp objects were also inaccessible to residents in care. The Department observed the laundry room/storage area where the cleaning supplies,and toxins were inaccessible to residents in care. Smoke detectors were observed to be fully changed, tested and operating. The fire extinguishers were fully charged, and the last fire drill was conducted on 8/2/2026. The Department reviewed four (4) staff files for First Aid/CPR certification, criminal record clearance, and health screenings,and training's all of which appeared to be current. The Department also reviewed three (3) residents files for admission agreements, updated physician reports, needs and services plans which appear to be up to date. Based on the observations and interviews made during today’s visit there were no health and safety concerns during the visit. An exit interview was conducted, and this report was discussed and provided to Arielle Lewis, Assistant Administrator at the conclusion of the visit.the state’s words, verbatim · CDSS document, Sep 2, 2026

Type of visit: Required - 1 Year

On 09/17/2025, Licensing Program Analyst (LPA) Elvira Gonzalez conducted an unannounced annual required visit using the CARE Inspection Tool. LPA met with Lucy Umana, Caregiver, and explained the purpose of the visit. Administrator, Arielle Lewis, met with LPA shortly after. The facility is licensed to serve (6) elderly adults ages 60 and above, of which (6) can be non-ambulatory. The facility has an approved hospice waiver for (5) residents. Currently there are (6) residents in the facility. The facility is a single-story home located in a residential neighborhood, and it consists of the following: (6) resident bedrooms, (6) resident bathrooms, (1) staff room, (2) staff bathrooms, office, living room, dining room, and kitchen. LPA Gonzalez and Arielle Lewis toured the physical plant. There were no bodies of water or obstructions on the premises. Exits/Walkways around the facility were free of debris and hazards. LPA inspected (3) resident bedrooms, and (3) resident bathrooms. Beds and bedding supplies were in good condition, adequate lighting was provided, and storage for the residents’ personal belongings was observed. Bathrooms were found to be operational and within Title 22 regulations. The water temperature properly measured between 105 F-120 F. LPA observed a comfortable temperature within the facility. LPA observed the facility to be sanitary and appropriately furnished at the time of the visit. Storage areas for personal hygiene were in place. Cleaning supplies, toxins, and sharp objects were stored and inaccessible to residents in care. The kitchen was inspected and there is sufficient perishable and non-perishable food available maintained properly. Fire extinguishers were charged and were operable. Smoke and carbon monoxide combo were tested and are working properly. Continued on LIC 9099-C LPA conducted a review of (6) resident service files, (3) staff personnel files and (3) Medication Administration Record (MAR). LPA observed all records were maintained in order. A stocked First Aid kit with manual was available. The most recent Fire/Emergency Drill was conducted on 06/10/2025. The facility's annual fees are current. During the visit, LPA observed the facility's infection control practices. LPA observed screening protocols for visitors, staff, and residents. There are sanitizing stations in common areas and restrooms. All mandated inspection control posters were posted. During this inspection, LPA did not observe any deficiencies, therefore no citations were issued at this time. An exit interview was conducted, and a copy of the report was given to Arielle Lewis, Administrator.the state’s words, verbatim · CDSS document, Sep 17, 2025

Allegation investigated: Questinable Death Staff did not ensure care plan was followed for resident Staff does not ensure facility has a 3 days of perishable food for residents in care Staff does not ensure reporting requirements are followed

This report serves as an amendement to the 10/17/24 report. The complaint findings reflected from 10/17/24 report remain the same. LPA soley inputted R#1 cause of death. On10/17/2024 Licensing Program Analyst (LPA) Sparkle Day conducted an unannounced subsequent complaint visit .LPA Day met with Administrator, Michael Gabai and explained the purpose of today’s visit. The investigation consisted of the following: During todays visit LPA Day along with the Administrator toured the facility and observed the food supply both perishable and non pershiable . Today LPA Day interviewed 3 of 3 (S1-S3) staff, 2 of 6 residents (R2-R3) and contacted Skirball Hospice Agency (W1). On 3/22/24 LPA Mario Leon toured the facility with the Administrator. LPA DeLeon requested resident roster, staff roster,Resident #1's service records (Admission Agreement, Appraisal, Physician's Report, Doctor's/Hospital records, medication chart, Hospice sign in sheet, nurses notes and death certificate . LPA received Staff Reporting trainings, First Aid certificates and other pertinent records. LPA Leon interviewed three staff (S1-S3). The investigation revealed the following: Unsubstantiated ALLEGATION: QUESTIONABLE DEATH It is alleged that resident #1s (R1) death is questionable due to care at the facility. On 10/17/24 from 11:10am - 11:35 am LPA Day interviewed S1- S3 , 3 of 3 staff deny the allegation. LPA Day reviewed the Death certificate of R#1 and spoke with R#1s Hospice Agency (Skirball Hospice Agency) (W1) who ensured that they had no concerns with the facility care for R#1. On 3/22/24 LPA Mario Leon interviewed S1-S3 , 3 of 3 staff who deny the allegation .LPA Day reviewed R#1 death certificate which indicates the death was due to Cardiopulmonary Arrest with Myelodysplastic Syndrome. Based on information gathered including records review, interviews , physician’s report and death certificate there is no sufficient evidence to corroborate the above allegation. Therefore the LPA finds this allegation to be UNSUBSTANTIATED. ALLEGATION: STAFF DID NOT ENSURE CARE PLAN WAS FOLLOWED FOR RESIDENT It is alleged that the facility staff did not follow the care plan for Resident #1 (R1).On 10/17/24 from 11:10am - 11:35 am LPA Day interviewed S1- S3 , 3 of 3 staff deny the allegation. On 3/22/24 LPA Mario Leon interviewed S1-S3 , 3 of 3 staff deny the allegation . All staff interviewed were consistent with their statements that R#1 was checked on and rotated every 2 hours. On 10/17/2024 LPA Day spoke with Skirball Hospice Agency (W1) who visited the facility every 2 days and ensured that they had no concerns with the facility care for R#1. LPA Day reviewed staff roster and ensured the staffing is within Title 22 guidelines. Based on information gathered including records review, interviews , physician’s report there is no sufficient evidence to corroborate the above allegation. Therefore the LPA finds this allegation to be UNSUBSTANTIATED. ALLEGATION: STAFF DOES NOT ENSURE FACILITY HAS A 3 DAY OF PERISHABLE FOOD FOR RESIDENTS IN CARE It is alleged that the facility does not ensure that there is 3 days of perishable food for the residents in care On 10/17/24 from 11:10am - 11:35 am LPA Day interviewed S1- S3 , 3 of 3 staff deny the allegation. Staff were consistent with their statements that food is purchased every 2 weeks and there is always enough food . LPA Day interviewed R2-R3 who were consistent in their statements that there is always plenty of food During todays visit (10/17/24) LPA Day toured the facility and observed the food supply both perishable and non perishable and found that the food supply was adequate at time of visit. Based on the information gathered, interviews conducted and the observation of the LPA there is no sufficient evidence to corroborate the above allegation. Therefore the LPA finds this allegation to be UNSUBSTANTIATED. ALLEGATION: STAFF DOES NOT ENSURE REPORTING REQUIREMENTS ARE FOLLOWED It is alleged that the facility staff does not ensure reporting requirements are followed. On 10/17/24 from 11:10am - 11:35 am LPA Day interviewed S1- S3 , 3 of 3 staff deny the allegation. Staff were consistent with their statements that all unusual incidents are reported to Licensing, doctors and family members. LPA Day reviewed trainings of all staff of which including reporting requirements. LPA reviewed previous incident reports in file. Based on the information gathered and the observation of the LPA there is no sufficient evidence to corroborate the above allegation. Therefore the LPA finds this allegation to be UNSUBSTANTIATED.the state’s words, verbatim · CDSS document, Oct 17, 2024 · control 11-AS-20240320160727

Type of visit: Required - 1 Year

On 8/15/2024, Licensing Program Analyst (LPA) Alfonso Iniguez conducted an unannounced annual required visit using the CARE Inspection Tool. LPA met with Ariel Lewis /Administrator. LPA explained the purpose of today’s visit. The facility is licensed to serve (6) elderly adults ages 60 and above, of which (6) can be non-ambulatory. The facility has an approved hospice waiver for (5). The home consists of 6 resident bedrooms, 6 resident bathrooms, 1 staff room, 2 staff bathrooms, living room, dining room, one office room, and kitchen. All resident bedrooms also have a private bathroom. Resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. LPA Iniguez and the Administrator toured the physical plant. There were no bodies of water or obstructions on the premises. LPA inspected a total of (6) bedrooms and (2) bathrooms. The beds and bedding supplies were in good condition, adequate lighting was provided, and storage for the residents’ personal belongings was observed. The bathrooms were found to be within Title 22 regulations and were operational. Smoke and carbon monoxide detectors were in operable condition. The water temperature ranged from 113.5°F to 115.2°F, and the room temperature ranged from 76°F to 78°F. The evaluation Report continues on the next page, LIC 809-C, providing further details of the inspection findings. During the visit, LPA Iniguez observed that the facility was clean, sanitary, and appropriately furnished. Storage areas for personal hygiene were in place. Cleaning supplies, toxins, and sharp objects were stored in a way that made them inaccessible to residents in care. The kitchen was inspected, and there was sufficient perishable and non-perishable food available, which was adequately maintained. All fire extinguishers were charged and operable. The last Fire/Disaster Drills were conducted on 6/18/24. A review of (3) residents' service files and (3) staff personnel files was maintained in order. LPA reviewed (3) Medication Administration Records (MARs) and found no discrepancies. LPA observed the facility's infection control practices. All mandated inspection control posters were displayed throughout the facility. A copy of liability insurance was emailed to LPA. Facility Annual Fess current. According to the California Code of Regulations (Title 22, Division 6, Chapter 8), LPA did not observe deficiencies; therefore, no citations were issued at this time. An exit interview was conducted, and a copy of the Facility Evaluation Report was provided to Ariel Lewis / Administrator.the state’s words, verbatim · CDSS document, Aug 15, 2024