Saint Nick Assisted Living

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Michael Cava conducted an Annual Required visit and inspection of the facility. LPA met with administrator, Nazar "Nick" Yegeyan and explained the reason for the visit. At approximately 8:45am, with the assistance of the administrator, LPA took a tour of the physical plant. The facility is a one story building. No swimming pool or bodies of water on property. The smoke alarms are hardwired. There are carbon monoxide works dual with the smoke alarms. The fire extinguisher new. It is located in the kitchen. Purchase date is 03/25/25. Kitchen: The kitchen appliances and fixtures were functional. LPA found a sufficient amount of perishable and non-perishable food at the facility; properly stored. Additional food, perishable and non-perishable food items are also stored in the garage. Knives were stored in a locked box inside a kitchen drawer. Bedrooms: There are three (3) bedrooms designated for residents' use. The three bedrooms are shared. Bedrooms were properly furnished with appropriate beddings and linens and closet space. There is sufficient lighting in all rooms that were inspected. Bathrooms: There are two and one half (2 1/2) bathrooms. Bathrooms were properly supplied and had functional fixtures. Hot water temperature was measured between 111 and 114 degrees Fahrenheit. No cleaning supplies were observed. Common Areas: These included the living room, family room and dining area. Furniture in common areas were maintained and in good repair. The dining room has a table large enough to seat the six residents. Floors were mopped and clean. The auditory alarms on all exit doors were on and functional at the time of the visit. All exits were clear of obstruction. Surrounding Grounds: Entry/exits were free of obstruction. There was furniture in the backyard appropriate for outdoor use. The front and backyard has sufficient space to hold outdoor activities. Laundry area: The laundry area is located in the hallway by the staff bathroom. No detergents or cleaning supplies observed out during the visit. Detergents and cleaning supplies stored locked in the garage. Staff office/work station: The staff office/work station is located at the back end of the home. There is a desk and additional seating. Resident and staff files are maintained locked there. Staff office/work station leads to the backyard. Garage: Garage is attached to the home. Garage is locked and inaccessible to residents. Garage is used to keep cleaning supplies and for extra storage space. Resident Files: LPA conducted a file review of resident records to insure compliance of licensing forms. Staff Files: LPA also conducted a file review of staff records to insure forms and training are up to date and compliance with licensing forms. Medications: Medication and Medication Records are stored in a locked cabinet at the staff office/work station. Medications and medication records were reviewed for proper storage and documentation. Pursuant to Title 22 Division 6 of the CA Code of Regulations, there were no deficiencies observed during the visit. Exit Interview Conducted and a Copy of the Report Issued.the state’s words, verbatim · CDSS document, Sep 18, 2025

Allegation investigated: Resident sustained an unstageable pressure injury while in care Facility failed to comply with reporting requirements.

Licensing Program Analyst (LPA) Michael Cava conducted a subsequent complaint visit to the facility to conclude the investigation regarding the above allegations. LPA met with the administrator, Nazar (Nick) Yegeyan, and advised him of the allegations. The initial visit was made by LPA Evelin Rios 08/22/24. Today's investigation consisted of interviews with the administrator, staff and residents. A record review and physical plant inspection was also conducted. Resident sustained an unstageable pressure injury while in care: In regards to the allegation, it was reported that Resident 1 (R1) a 90 year old resident, sustained an unstageable pressure injury while in the facilities care. On 8/4/24 R1 was brought to the hospital after it was discovered that R1 had an unstageable wound to the sacrum. R1's responsible persons did not know that resident had a wound and trusted the facility with R1's care. Unsubstantiated Interview with the administrator and staff deny the allegation of R1 sustaining an unstageable injury. The following information was obtained through interviews and record review: R1 admitted 03/14/24 Hospice was initiated on or around 03/15/24. Review of the hospice care plan indicates risk for skin integrity due to immobility & Stage II pressure ulcer. Instructions to turn/reposition every two hours No indication of pressure injuries greater than a Stage II ulcer. Interviews made with hospice nurse and record review on 03/14/25 reveal nurse visits two times per week, with a doctor follow up every other week to assess the wound Interview with hospice nurse and review of care plan from 03/15/24 through 08/02/24 only indicate wound to coccyx to be Stage II pressure injury (no indication of pressure injury greater than Stage II) Interview with hospice nurse stated next scheduled visit to facility to treat and assess R1's pressure injury would have been 08/05/24, or the following Monday. According to both administrator and hospice nurse, R1's wound was never more than Stage II while under the care and supervision at the facility. Both were in communication daily regarding the status of the wound. Facility staff continued to reposition R1 every two hours through 08/04/24. Per staff, no indication the wound had progressed. On 08/04/24, during visitation, there was some indication that R1's wound may have progressed. According to both administrator, and hospice nurse, R1 was sent to the hospital for assessment. Although there is evidence that R1 had a Stage II pressure injury, Documentation and interviews with hospice nurse reveal that wound care was provided up until the Stage II pressure injury had possibly progressed. Once it was assumed that it progressed, R1 was sent to the hospital for assessment. Therefore, based on the information obtained, it could not be proven that R1 sustained a pressure injury while in care. The allegation is deemed Unsubstantiated at this time. Facility failed to comply with reporting requirements: In regards to the allegation, it was reported that R1's responsible person did not know that R1 had a wound and trusted the licensee (Board & Care) with R1's care since admission to the facility. Interview with both the administrator and hospice nurse deny the allegation, stating R1's responsible person was aware of the wound care because the responsible person signed off on the hospice care plan, and was made aware of the plan. Moreover, the responsible person is given a copy of the agreement with the hospice agency and care plan. LPA reviewed a copy of R1's hospice agreement, and observed dates and signatures by R1's responsible person, acknowledging hospice care. In addition, according to administrator, R1's responsible person is often at the facility at least once a week, and is given updates regarding R1's care. During those visits, administrator stated R1's responsible person never made any concerns or complaints regarding care and supervision provided to R1. Based on the information obtained, there wasn't enough information to corroborate the allegation of licensee failing to comply with reporting requirements. Therefore, the allegation is deemed Unsubstantiated at this time.the state’s words, verbatim · CDSS document, Mar 14, 2025 · control 31-AS-20240821115956

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Michael Cava conducted an Annual Required visit and inspection of the facility. LPA met with administrators, Mary Yegeyan and Nazar "Nick" Yegeyan and explained the reason for the visit. At approximately 8:45am, with the assistance of the administrator, LPA took a tour of the physical plant. The facility is a one story building. No swimming pool or bodies of water on property. The smoke alarms are hardwired. There are carbon monoxide works dual with the smoke alarms. The fire extinguisher new. It is located in the kitchen. Purchase date is 04/11/24 Kitchen: The kitchen appliances and fixtures were functional. LPA found a sufficient amount of perishable and non-perishable food at the facility; properly stored. Additional food, perishable and non-perishable food items are also stored in the garage. Knives were stored in a locked box inside a kitchen drawer. Bedrooms: There are three (3) bedrooms designated for residents' use. The three bedrooms are shared. Bedrooms were properly furnished with appropriate beddings and linens and closet space. There is sufficient lighting in all rooms that were inspected. Bathrooms: There are two and one half (2 1/2) bathrooms. Bathrooms were properly supplied and had functional fixtures. Hot water temperature was measured at 113 degrees Fahrenheit. No cleaning supplies were observed. Common Areas: These included the living room and dining area. The living room had two couches, recliner and table. There is extra seating around with additional side tables. The dining room has a table large enough to seat up to six (6) residents. Furniture were in good repair. Floors were mopped and clean. Internal temperature was set at 70 degrees. The auditory alarms on all exit doors were on and functional at the time of the visit. All exits were clear of obstruction. Surrounding Grounds: Entry/exits were free of obstruction. There was furniture in the backyard appropriate for outdoor use. The front and backyard has sufficient space to hold outdoor activities. Laundry area: The laundry area is located in the hallway by the staff bathroom. No detergents or cleaning supplies observed. Staff office/work station: The staff office/work station is located at the back end of the home. There is a desk and additional seating. Resident and staff files are maintained locked there. Staff office/work statin leads to the backyard. Garage: Garage is attached to the home. Garage is locked and inaccessible to residents. Garage is used for extra storage space. Resident Files: LPA conducted a file review of resident records to insure compliance of licensing forms. Staff Files: LPA also conducted a file review of staff records to insure forms and training are up to date and compliance with licensing forms. Medications: Medication and Medication Records are stored in a locked cabinet at the staff office/work station. Medications and medication records were reviewed for proper storage and documentation. Pursuant to Title 22 Division 6 of the CA Code of Regulations, there were no deficiencies observed during the visit. Exit Interview Conducted and a Copy of the Report Issued.the state’s words, verbatim · CDSS document, Nov 16, 2024