Triumphant Elderly Care

Type of visit: Required - 1 Year

On 1/21/2026 Licensing Program Analyst (LPA) Perchui Milena Khurshudyan arrived at this facility to conduct the required Annual Inspection. Upon arrival, LPA was greeted by the Co-Administrator / DCS Solomon Gochin, who granted access to the facility. LPA explained the reason for the visit. LPA Khurshudyan reviewed the required postings posted on the wall of dining and living room areas and requested staff and residents’ rosters for review. The inspection tool was used to complete the visit. At 10:10am LPA, with the help of the DCS/Caregiver, began a physical plant tour of the facility and the following was observed: This is a single-story building with five (5) bedrooms, of which three (3) rooms designated for residents’ use. There are two (2) bathrooms, a kitchen, common areas: living and dining rooms, and an outdoor area. Facility has an approved fire clearance for six (6) Non-ambulatory residents, one (1) bedridden resident for room #1, and a Hospice waiver for three (3) residents. Kitchen: LPA observed a seven-day supply of non-perishable food, and a two-day supply of perishable food properly stored and labeled. No expired food was observed. Facility stores knives and sharps inside the locked cabinet in the laundry room. Sufficient amount of emergency supply of food / water was readily available. Food storage and preparation areas are clean and inaccessible to pests. LPA observed one (1) fire extinguishers located in the living room. The fire extinguisher was last serviced on 5/13/2025. Dish soap and other chemicals were observed to be stored inside the locked cabinet and inaccessible to residents in care. Continue on LIC809-C Bedrooms: LPA observed bedrooms to be properly furnished with beds, linens, night stands, chairs, drawers, closets, and adequate lighting. All bedrooms appeared organized and clean. Residents have enough personal hygiene products. Common Areas: These include living and dining areas. LPA observed dining, living areas clean and clear of clutter. Furniture is generally new and in a good repair. Dining and living room furniture sits at the capacity of the facility. Walls, floors, windows, screens, and blinds were clean and in good repair. At 10:45am, LPA measured the room temperature to be 67 degrees Fahrenheit. There is a linen closet with an adequate supply of fresh linens ready to use. No obstructions and or tripping hazards found inside the facility. Facility has landline, LPA checked it was operational. Bathroom: The bathrooms contained hand soap, paper towels, toilet paper and trash bins with lids. The hot water temperature was measured at approximately 10:50am to be 107.1 degrees Fahrenheit. The bathrooms were checked for cleanliness and proper operations. Towels and washcloths are not shared. LPA observed non-skid mats and grab bars inside the bathrooms. Smoke and Carbon Monoxide Detectors: The smoke and carbon monoxide detectors were tested by staff at 11:30am and were observed to be operational. Garage: There is a garage in the premises and is currently being used for storage and as office space. Laundry Room: Functioning washer and dryer are in a separate laundry room located next to the kitchen area. Laundry detergents and other chemical supplies were observed to be locked and inaccessible to residents in care. Backyard/Front yard: LPA observed sufficient yard space and fenced backyard with appropriately covered shaded area available for clients to rest. There is outdoor furniture under the shaded area. LPA discussed the importance of maintaining care and supervision to meet the needs of clients. During the physical walk through LPA observed all exit areas to be clutter and obstruction free. There is a pool in the property with proper locked gates. Staff/Client File review: Facility records are kept in the office area next to the living room. Between 10:55am -11:45am LPA conducted records review of three (3) staff files and three (3) residents’ records. Files were complete and updated. Continue On LIC809D Medications: At approximately 11:50am, LPA reviewed Centrally Stored Medication Destruction Records for proper documentation. The facility also maintains Medical Administration Records (MAR). LPA observed centrally stored medications locked inside the medication cabinet and inaccessible to residents in care. Complete First-aid kit is also available and placed in the common area. No potentially dangerous items were found in the facility. The facility operates with two (2) shifts and has one -two (1-2) staff members for each shift. LPA conducted an interview with Co- Administrator and one caregiver, no residents were present in the house during the annual inspection. Facility plan/sketch is posted on the wall along with other posting requirements. LPA collected LIC500, LIC9020, and copy of Liability Insurance at the time of the visit. The facility is current with licensing fees. No Deficiencies issued during today’s visit. Exit interview conducted, a copy of this report signed and delivered.the state’s words, verbatim · CDSS document, Jan 21, 2026

Type of visit: Office

On 12/16/2025 Regional Manager (RM) Angela J. Whittaker and Licensing Program Analyst (LPA) Perchui Melina Khurshudyan met with Administrator Rhoda Gochin for an informal office visit. The purpose of the office visit is to discuss the current operation of this facility and to clarify Title 22 requirements. On 12/4/2025, Woodland Hills South received information that an incident occurred on 12/2/2025, involving the Administrator reportedly refusing entry to a Department of Mental Health (DMH) Case Manager who was attempting to relocate a client from the facility. It was reported that the Administrator propped a chair against the facility door and refused to allow the DMH case manager to enter the facility. The Administrator had communicated concerns about wanting a 30-day notice, and that this may have contributed to refusal of entry. After communication with the case manager and assurance of payment throughout the remainder of the month, the Administrator allowed access to the facility and R1 was able to work with the case manager to move out. During today's meeting, Administrator informed RM that although, they informed and requested a proper 30 day notice in order to release the client to another facility, the case manager never submitted the 30 day notice or any formal letter to proceed with the transition. The Administrator also informed that because of his/her health condition it is hard to stand up for a long period of time, therefore a chair was placed next to the door for him/her to seat while waiting for the case manager to contact the DMH supervisor. Continue on LI809-C During the Informal Meeting, Regional Manager (RM) Angela J. Whittaker reminded current Licensee/Administrator Mrs. Gochin that Residents’ Rights must be maintained at all times, including dignity, freedom from intimidation, and the ability to receive visits services from authorized representatives/ Case Managers when applicable. Blocking and/or refusal entry may raise serious compliance concerns, including potential impact to resident care and safety. RM also mentioned that for the safety of clients, it is essential that RCFE staff proceed with these proper actions and steps before releasing residents to another placement by requesting 30 day notice. Adhering to these procedures ensures compliance with licensing regulations, minimizes risks, and promotes a smooth transition that prioritizes the resident’s well-being. Administrator was instructed to ensure future interactions with authorized representatives are handled professionally and in compliance with requirements.the state’s words, verbatim · CDSS document, Dec 16, 2025

Type of visit: POC

Licensing Program Analysts (LPA) Leslie Ngo-Castaneda met with facility licensee Rhoda Gochin for a Plan Of Correction (POC) visit. The purpose of the POC visit is to make sure deficiencies were corrected on reports issued on 12.16.2024. Entrance interview conducted. LPA toured the home and requested the following: -CCR 87465(a)(6): Incidental Medical and Dental Care Services. POC: Based on record review, the licensee did not comply with the section cited above in 6 out of 6 CSMDR which poses/posed a potential health, safety or personal rights risk to persons in care. POC date 12.30.2024: POC Cleared during LPA visit. -CCR 87465(h)(2): Incidental Medical and Dental Care Services. POC: Based on record review, the licensee did not comply with the section cited above in 1 out of 1 S1, R4 and R6 medication was accessible which poses/posed a potential health, safety or personal rights risk to persons in care. POC date 12.30.2024: POC Cleared during LPA visit. Exit interview conducted. Copy of this report given.the state’s words, verbatim · CDSS document, Jan 28, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Leslie Ngo-Castaneda conducted an annual required visit and inspection of the facility. At 12NN was greeted by Abigail Gochin and LPA and advised the reason of the visit. At 12:33PM Rhoda Gochin who is the Licensee arrived and was advised the reason of the visit. At 12:08 PM, with the assistance of staff, LPA took a tour of the physical plant. Required postings were observed in the entry area. The smoke alarms are operational that are located each bedroom, the hallway and kitchen. There are carbon monoxide detectors that functions properly. The fire extinguisher is in the living room. The charge date is 5/9/2024. During the visit the facility is at 74 degrees Fahrenheit. The facility is fire cleared for six (06) non-ambulatory residents, one of which may be bedridden in room #1; hospice waiver is approved for three (3). Kitchen: The kitchen appliances and fixtures were functional. The kitchen has a working gas stove, faucet, freezer, refrigerator, and microwave. LPA found enough at least two (2) days perishable and seven (7) days non-perishable food at the facility that is properly stored. Frozen foods are wrap, dated, and stored properly as well. Knives were stored in a locked drawer in the kitchen. Food storage and preparation areas are clean and inaccessible to pests. Garbage cans have tight fitting covers. Cleaning supplies, pesticides or toxic cleaning supplies were stored and locked away in the laundry area. Bedrooms: There were five (5) bedrooms in the facility, three (3) bedrooms are designated for residents' use. Bedroom #1, bedroom #2, and bedroom #3 are all shared bedrooms. The bedrooms are used by residents were properly furnished with appropriate dresser, beddings, and linens with sufficient lighting. Continue to LIC 809-C Bathrooms: There are two (2) bathrooms in the facility designated for residents' and staff use. The bathrooms were properly supplied and has functional fixtures. Hot water temperature was measured at 117.4 degrees Fahrenheit for bathroom #1 located by the entrance of the facility. Bathroom #2 is located in the hallway that is for residents. Hot water temperature was measured at 118.6 degrees Fahrenheit for bathroom #1 located by the entrance of the facility. There was enough clean linen available in the cabinets in the hallway. Common Areas: LPA toured all common areas of the facility. These included the living room and dining area for residents. The common areas were properly furnished. Residents dining table fits enough for six (6). LPA observed common areas to be very clean and tidy. LPA observed the floors to be in very good condition. No obstructions and or tripping hazards throughout the facility. Office is located beside the dining area. Fireplace is centralized. Furniture in common area was observed to be in good repair. There are no issues with Fire Clearance. Infection control: Facility mitigation plan to make sure licensee was following current infection control recommendations. LPA obtain a copy and reviewed the infection control plan during this visit. Surrounding Grounds: Entry and exits were free of obstruction. There was furniture appropriate for outdoor use. The outdoor area was free of hazards. The facility does not have a swimming pool or body of water. The garage detached and is used for storage and staff refrigerator. Laundry service: There is enough linen available to change weekly or more if need. Cleaning supplies are being stored in a locked cabinet in the laundry area. Staff Files: LPA also conducted a file review of staff records to ensure forms and training are up to date and compliance with licensing forms. Records were checked for expired or missing certificates and clearances: LPA conducted a file review of staff for criminal record clearances and current First Aid. The administrator file was reviewed for current first aid, fingerprint clearance, administrator certificate, and HIV/AIDS and TB training. Continue to LIC 809-C Medications are in a centrally stored and locked place, including over-the-counter medicines; medications are properly labeled and checked for expiration dates. Each centrally stored prescription and PRN medication has been logged in the medications log with proper documentation from the clients’ doctor. Proper medication dispensing instruction are followed and checked for contamination. First-aid has all proper items and is current. Medications and supplements for S1, and residents were seen in an unlock laundry and residents room in an unlock drawer which is accessible to residents. Deficiency will be cited in LIC 809-D. Resident records were reviewed for requirements and legibility: LPA reviewed all of the client’s files for current appraisal for the residents. Liability insurance a copy was handed to LPA. Planned activities are offered. Residents has missing preplacements appraisals and LIC 613 needs to be signed. LPA observed some forms were not signed or filled. Technical Violation (TV) will be given. Licensee needs to ensure pre-placement appraisal and LIC 613 needs to be filled and signed. Facility is within CA code of Regulations Title 22 or Health and Safety Code. No deficiencies were found, exit interview conducted, copy of report has been issued and discussed.the state’s words, verbatim · CDSS document, Dec 16, 2024

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Gary Tan, met with Assistant Administrator Dorcas Baget for a One (1) year required visit for this facility. A tour of the physical plant was conducted at 9:13 AM and the following was noted: There is only one entrance being utilized at the facility, there are required poster posted at the main door. Screening area is located immediately upon entrance. Sign in sheet, hand sanitizer, gloves and masks are available. The facility had submitted and approved Infection Control and Mitigation plan. Signs to wear a mask and other Covid 19 prevention protocol signs were posted outside the doors. Hand washing, coughing etiquette, physical distancing and other necessary signs were posted in the bathroom and all over the facility. The facility has a designated visitors' area at the backyard. The facility has sufficient stock of PPE in the storage room. The facility has five (5) bedrooms and three (3) bathrooms currently occupying six (6) residents. One (1) bedroom is designated for staff use. The facility is fire cleared for six (6) non-ambulatory resident, one of which maybe bedridden on Room #1. Hospice waiver for three (3) residents. Physical environment was checked for cleanliness and condition. Walls, windows, ceilings, floors and floor coverings and doors were checked, the following was noted: Living and dining room furniture were also checked. The living room is neat and clean along with the dining room. The facility maintains a comfortable temperature at 75°F. Smoke detectors were tested and observed to be operational. There is a carbon monoxide detector installed in the facility. There is a fire extinguisher located in the living room and was observed to be full and last inspected on 05/18/23. The backyard of the facility has outdoor furniture, with a covered shaded area for clients. The swimming pool is appropriately fenced and observed to be locked. (continued on LIC 9099-C) (continued from LIC 809) The garage has no access from the inside and was converted into an office and frozen foods storage. Laundry room is located adjacent to the kitchen and was observed to be locked. All the laundry detergents, cleaning solutions, toxins and other chemicals are observed to be locked in a cabinet in the laundry room. Food Service/Kitchen area was sufficiently stocked with two (2) days perishable and seven (7) days of non-perishable food. Frozen foods are properly wrapped and stored appropriately. Food storage and preparation areas are clean and inaccessible to pests. All sharps and knives were also observed to be locked in the laundry cabinet. The Clients' rooms are adequately furnished with appropriate furniture and lighting system. Hall ways/passage ways are lit. Clients have sufficient amounts of personal hygiene product which is provided by the licensee. The bathrooms were checked for cleanliness and proper operation. LPA observed the appropriate grab bars for each toilet, bathtub and shower. Sink in the bathrooms were removed and under construction. The hot water temperature measured at a range of 163.3°F to 164.1°F Towels and washcloths are not shared. There is enough clean linen available in stock at the cabinet. Medications: LPA observed medication was kept in a locked filing cabinet located adjacent to the dining area. Medications are listed on the centrally stored medication and destruction record. There is a complete first aid kit located in the medication cabinet. Client records: Client records are reviewed. Residents records appeared to be complete and updated. Staff records: LPA conducted a complete file review of staff records. Staff records appear to be complete and updated. Disaster drill was last conducted on 02/27/24. Required posting are observed to be complete and current and displayed properly at the facility. Citation issued. Appeal rights discussed and given. Exit interview conducted and copy of this report issued.the state’s words, verbatim · CDSS document, Mar 3, 2024