Brilliant Senior Care Facility

Allegation investigated: Staff provided inadequate information to resident's medical providers. Staff provided inadequate information to resident's responsible party.

At approximately 9:30 AM, Licensing Program Analyst (LPA) Leslie Ngo-Castaneda conducted an unannounced subsequent complaint visit in response to the above-mentioned allegations. LPA met with Staff#1 (S1), who granted access to the facility. Entrance interview conducted. LPA conducted a physical plant tour at 9:40 AM. To investigate the allegations, on 11.24.2025, LPA interviewed the licensee, two (2) staff, and four (4) out of five (5) residents between 10:14 AM to 11:47 AM. Between 11:48 AM and 12:00 PM, LPA requested and reviewed copies of pertinent information, which included, but were not limited to, LIC 500 (Staff Roster), LIC 9020 (Client Roster), R1’s Physician’s report, Admission Agreement, Identification and Emergency Information, Appraisal Needs and Service Plan, and other documents relevant to the investigation. Continue to LIC 9099-C Unsubstantiated Allegation #1: Staff provided inadequate information to resident's medical providers. It was alleged that facility staff provided inadequate information about Resident #1 (R1) to the medical provider when they were admitted to the hospital. R1 was brought to the hospital via ambulance due to a UTI. Interview with licensee (S1) revealed that the emergency medical technician (EMT) requested copies of R1 records, and documents were given to the EMT. Interview with staff #2 (S2) revealed that they witness S1 rushing to make copies of R1’s records for EMT. Interviews with four (4) out of five (5) residents revealed that they have no issue with facility staff relaying and providing information to their medical providers. During licensing visits, LPA Ngo-Castaneda observed copies of the documents prepared for each resident to provide the medical providers and emergency personnel. Based on the information, observation, and record review gathered during this, the allegation is deemed unsubstantiated. Allegation #2: Staff provided inadequate information to resident's responsible party. It was alleged that facility staff did not provide adequate information about R1 to their responsible party. During interviews with the licensee (S1), it was revealed that R1 is responsible for themselves, and no family members/ individual are responsible for R1. An interview with four (4) out of five (5) residents revealed that they have no issues with facility staff notifying their family and their responsible party regarding their care at the facility. A review of R1’s admission agreement, Emergency identification and other documents verified that R1 is self responsible and no other individual is noted as a responsible party. Based on the information, observation, and record review gathered during this, the allegation is deemed unsubstantiated. Exit interview conducted. Copy of this report issuedthe state’s words, verbatim · CDSS document, Dec 23, 2025 · control 31-AS-20251118091713

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Leslie Ngo-Castaneda conducted an annual required visit and inspection of the facility. LPA met with licensee Anna Davtyan and was explained the reason for the visit. At 11:19 AM, with the assistance of licensee, LPA took a tour of the physical plant. Required postings were observed in the entry area. At 11:05 AM the smoke alarms were tested and 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 kitchen. The charge date is 11/07/2025. During the visit the facility is at 74 degrees Fahrenheit. The facility is fire cleared for six (06) non-ambulatory residents; one (1) bedridden. Facility has five (5) hospice waiver. Facility has no issue with fire clearance. 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 cabinet 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 kitchen . Bedrooms: There were five (5) bedrooms designated for residents' use. Bedroom #1, bedroom #2 (empty), bedroom #3, and bedroom #5 are all private, Bedroom #4 is shared. All of 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) bathroom designated for residents' use. The bathrooms were properly supplied and had functional fixtures. Hot water temperature was measured at 107.6 degrees Fahrenheit for bathroom #1 located in the hallway across bedroom #3. Bathroom #2 is inside bedroom #5. Hot water temperature was measured at 107.1 degrees Fahrenheit. 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. Furniture in common area was observed to be in good repair. 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. There is no garage in the facility, only car ports. 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 kitchen area and is located in between the dining room and kitchen. 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. Office space is beside the dining area. 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. Resident records were reviewed for requirements and legibility: LPA reviewed client’s files for current appraisals. Liability insurance copy was handed to LPA. Planned activities are offered. 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 23, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Leslie Ngo-Castaneda conducted an annual required visit and inspection of the facility. LPA met with staff Alice Keshishian and was explained the reason for the visit. At 1:11 PM Anna Davtyan who is the administrator met with LPA, explained the reason for the visit. At 1:10 PM, with the assistance of staff and administrator, 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 kitchen. The charge date is 10/31/2024. During the visit the facility is at 75 degrees Fahrenheit. The facility is fire cleared for six (06) non-ambulatory residents; one (1) bedridden. Facility has five (5) hospice waiver. Facility has no issue with fire clearance. 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 cabinet 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 kitchen . Bedrooms: There were five (5) bedrooms designated for residents' use. Bedroom #1, bedroom #2, bedroom #3, and bedroom #5 are all private, Bedroom #4 is shared. All of 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) bathroom designated for residents' use. The bathrooms were properly supplied and had functional fixtures. Hot water temperature was measured at 105.8 degrees Fahrenheit for bathroom #1 located in the hallway across bedroom #3. Bathroom #2 is inside bedroom #5. Hot water temperature was measured at 106.8 degrees Fahrenheit. 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. Furniture in common area was observed to be in good repair. 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. There is no garage in the facility, only car ports. 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 kitchen area and is located in between the dining room and kitchen. 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. Office space is beside the dining area. 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. Staff #3 (S3) is missing training, deficiency will be cited on LIC 809-D. 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. Resident records were reviewed for requirements and legibility: LPA reviewed client’s files for current appraisals. Liability insurance copy was handed to LPA. Planned activities are offered. R2, R4 and R5 is missing TB test, deficiency will be cited on LIC 809-D. 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, Nov 12, 2024

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Leslie Ngo-Castaneda conducted an annual required visit and inspection of the facility. At 10:11 am Anna Davtyan who is the administrator met with LPA, explained the reason for the visit. At 10:12 am, with the assistance of administrator, 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 kitchen. The charge date is 9/28/2023. During the visit the facility is at 69 degrees Fahrenheit. The facility is fire cleared for six (06) non-ambulatory residents. Facility has five (5) hospice waiver. Facility has no issue with fire clearance. 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 cabinet 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 kitchen. Bedrooms: There were five (5) bedrooms designated for residents' use. Bedroom #1, bedroom #2, bedroom #3, and bedroom #5 are all private, Bedroom #4 is shared. All of 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) bathroom designated for residents' use. The bathrooms were properly supplied and had functional fixtures. Hot water temperature was measured at 111.1 degrees Fahrenheit for bathroom #1 located in the hallway across bedroom #3. Bathroom #2 is inside bedroom #5. Hot water temperature was measured at 118.1 degrees Fahrenheit. 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. Furniture in common area was observed to be in good repair. 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. There is no garage in the facility, only car ports. 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 kitchen area and is located in between the dining room and kitchen. 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. Office space is beside the dining area. 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. Resident records were reviewed for requirements and legibility: LPA reviewed client’s files for current appraisals. Liability insurance copy was handed to LPA. Planned activities are offered. 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, Feb 6, 2024