Amazing Senior Care on Lassen

Allegation investigated: Staff neglect resulted in resident sustaining multiple pressure injuries

On 03/16/26, at 9:27am, Licensing Program Analyst (LPA) Gina Saucedo arrived at the facility to conduct an unannounced, subsequent complaint visit and was greeted by Administrator, Yelena Aladadyan. LPA explained the purpose of this visit was to gather additional information and deliver findings for this complaint. On 02/09/26, the above complaint was referred to the Investigations Branch (IB) but was returned to the Regional Office (RO) on 02/09/26 for investigation. On 02/10/26, LPA Saucedo conducted an initial complaint and asked for the census, staff, and resident rosters. On 02/10/26, LPA Saucedo interviewed staff, received documents and conducted a physical plant tour. On 02/10/26, LPA attempted to interview two (2) residents to no avail. LIC 9099C-continued Unsubstantiated Regarding the allegation: Staff neglect resulted in resident sustaining multiple pressure injuries. It is being alleged that resident #1 (R1) was neglected by staff at the facility and developed several wounds. LPA interviewed two (2) staff that confirmed R1 was receiving wound care from Star World Home Health. Staff #1 (S1) confirmed that R1 was receiving home health services two (2) -three (3) times a week and home health never informed S1 that the wounds were not getting better. LPA also interviewed two (2) staff at Star World Home Health that confirmed R1 was previously receiving wound care from Grand Valley Health Care Rehabilitation Center. LPA requested notes from Star World Home Health that noted R1 had a left and right pressure injury and R1 also had a stage 3 wound on their sacrum. When LPA interviewed both Home Health staff, they both stated, “that R1 appeared to have a stage 2 on their sacrum but the notes confirmed Home Health marked the wound as a stage 3. LPA requested medical records from Kaiser Permanente where it confirms that on 09/02/25, R1 had gone for emergency services and was referred to a Skilled Nursing Facility (SNF) for wound care on the sacrum and right and left heels, physical therapy and occupational therapy. R1 did not get admitted to the above facility until 12/02/25. R1 was then taken to the hospital on 02/02/26 where the medical records from Kaiser Permanente noted the same wounds as of 09/02/25, wound to the sacrum area and right and left heel. LPA also interviewed R1’s daughter and R1’s daughter stated, R1 did not get admitted to the above facility until 12/02/25. R1 was then taken to the hospital on 02/02/26 where the medical records from Kaiser Permanente noted the same wounds as of 09/02/25, wound to the sacrum area and right and left heel. LPA also interviewed R1’s daughter and R1’s daughter stated, “I have no concerns with the facility and/or the staff. My concern is with the Home Health that provided care for R1 because they were not really communicating with us. They should have told us that the wounds were not getting any better or were remaining the same so R1 could have been sent back to the Skilled Nursing Facility.” Based on the LPA's medical record review, home health notes, file review and interviews conducted, the allegation(s) for physical abuse is UNSUBSTANTIATED at this time. An exit interview was conducted, no citation(s) issued, and a copy of this report was given to the Administrator.the state’s words, verbatim · CDSS document, Mar 16, 2026 · control 31-AS-20260208113715

Type of visit: Required - 1 Year

On 05/07/25, at 09:25am, Licensing Program Analyst (LPA) Gina Saucedo arrived at the facility to conduct an unannounced, annual visit. LPA was met by caregiver, Zhana Ghambaryan. The administrator Yelena Aladadyan arrived about 15 (fifteen) minutes later. There was also another staff present at the time of visit. The physical plant was toured inside and out at 10:15 am. Living/Dining Room Area: LPA observed the living room furniture to be clean and in good repair. The facility maintains a comfortable temperature at 71 degrees Fahrenheit. The fireplace is secured in the living room area covered by a black gate. Bedrooms: All three (3) bedrooms are shared. The three (3) resident rooms are numbered. Two (2) of the bedrooms have private bathrooms. LPA observed rooms to have bedding sheets, pillowcase, blankets, nightstands, televisions, and sufficient lighting for each of the residents sharing the room. Bathrooms: All three (3) bathrooms were toured and checked to make sure bathrooms were clean and in good repair. The hot water temperature measured within regulations of 116 degrees Fahrenheit and 117. The showers have non-slip bath mats and grab bars. There is another bathroom on your right hand side of the entrance of the facility. Medications were kept in a locked cabinet in the bedroom hallway. All medications were properly labeled and inaccessible to residents. There is a complete first aid kit located in the kitchen. LIC 809C-Continued Kitchen Area: LPA inspected the kitchen area. The refrigerator was clean and in good operation. Fire extinguisher was observed to be full and expires October 2025. Knives and sharp objects were kept centrally stored and locked in a cabinet located in the kitchen on your left-hand side. LPA observed sufficient supply of seven (7) day non-perishable and perishable foods in the cabinet. Garage: In addition, there is another refrigerator in the garage stored with extra food. The washer and dryer are also located in the garage. Cleaning supplies/toxins were kept locked in the garage being inaccessible to residents on the top shelf of the washer and dryer. Outside: LPA toured the outside area. LPA observed a covered shaded area for residents and appropriate outdoor furniture. The facility has no body of water on the premises. There is one (1) gate that is locked leading to the outside area towards the street. There are also ramps provided for wheelchair residents. There is a shed that contains extra wheelchairs and resident property. There is a side door on your left hand side of the entrance of the facility that leads to a living area which is empty. There are no residents and/or staff in that area. LPA was able to tour that area. Administration: The mitigation and the Infection control were reviewed and are kept in a binder and there was Covid 19 signs on the wall, hygiene sanitation signs, Personal Rights, Visitation Rights, Theft and Loss Policies, Emergency and Disaster Plan, Report of suspected abuse, Rights of Resident Council, Ombudsman and YES sign, surety bond was viewed, and it is up to date-08/10/24-08/10/25. The staff and the resident files were in a secure/private location in the dining hall area on your left hand side. The carbon monoxide is interconnected with the smoke detector was tested and it was operable. The facility has a signal system currently there is only one (1) dementia resident. An exit interview was conducted, no citation(s) were issued, and a copy of this report was given to the administrator.the state’s words, verbatim · CDSS document, May 7, 2025

Type of visit: Required - 1 Year

On 05/08/24, at 10:55 a.m., Licensing Program Analyst (LPA) Gina Saucedo arrived at the facility to conduct an unannounced, annual visit. LPA was met by caregiver, Zhana Ghambaryan. The administrator Yelena Aladadyan arrived about 10 (ten) minutes later. The physical plant was toured inside and out at 11:40 am. Living/Dining Room Area: LPA observed the living room furniture to be clean and in good repair. The facility maintains a comfortable temperature at 69 degrees Fahrenheit. The fireplace is secured in the living room area covered by a black gate. Bedrooms: All three (3) bedrooms are shared. The three (3) resident rooms are numbered. Two (2) of the bedrooms have a private bathroom. LPA observed rooms to have bedding sheets, pillowcase, blankets, nightstands, televisions, and sufficient lighting for each of the residents sharing the room. Bathrooms: All three (3) bathrooms were toured and checked to make sure bathrooms were clean and in good repair. The hot water temperature measured within regulations of 112 degrees Fahrenheit and 114. The showers have non-slip bathmats and grab bars. There is another bathroom on your right hand side of the entrance of the facility. Medications were kept in a locked cabinet in the bedroom hallway. All medications were properly labeled and inaccessible to residents. There is a complete first aid kit located in the kitchen. LIC 809C-Continued Kitchen Area: LPA inspected the kitchen area. The refrigerator was clean and in good operation. Fire extinguisher was observed to be full and dated November 2024. Knives and sharp objects were kept centrally stored and locked in a cabinet located in the kitchen on your left-hand side. LPA observed sufficient supply of seven (7) day non-perishable and perishable foods in the cabinet. The PPE is stocked in the kitchen area. Garage: In addition, there is another refrigerator in the garage stored with extra food. The washer and dryer are also located in the garage. Cleaning supplies/toxins were kept locked in the garage being inaccessible to residents. Outside: LPA toured the outside area. LPA observed a covered shaded area for residents and appropriate outdoor furniture. The facility has no body of water on the premises. There is one gate that is locked leading to the outside area towards the street. There are also ramps provided for wheelchair residents. There is a shed that contains extra wheelchairs and resident property. There is a side door on your left hand side of the entrance of the facility that leads to a bedroom for staff use only, separate from the property access. There are no residents in that area. LPA was able to tour that area. Administration: The mitigation and the Infection control were reviewed and there was Covid 19 signs on the wall, hygiene sanitation signs, Personal Rights, Visitation Rights, Theft and Loss Policies, Emergency and Disaster Plan, Report of suspected abuse, Rights of Resident Council, Ombudsman and YES sign, surety bond was viewed, and it is up to date. The staff and the resident files were in a secure/private location in the dining hall area on your left hand side. The carbon monoxide is interconnected with the smoke detector was tested and it was operable. An exit interview was conducted, no citations were issued, and a copy of this report was given to the administrator.the state’s words, verbatim · CDSS document, May 8, 2024

Allegation investigated: Staff did not meet a resident's diabetic needs while in care Staff are not meeting a resident's incontinence needs while in care

Licensing Program Analyst (LPA) Gary Tan conducted an unannounced subsequent complaint visit at this facility to further investigate the above allegations. LPA met with administrator Yelena Aladadyan and explained the reason for the visit. LPA conducted physical plant tour at 10:20 AM, requested copies of facility documents relevant to the investigation at 10:45 AM and interviewed staff and resident between 11:00 AM to 1:00 PM. LPA also conducted record review between 1:00 PM to 2:00 PM. Regarding the allegation that Staff did not meet a resident's diabetic needs while in care, it was alleged that Resident #1 (R1) was given sugar filled diet (i.e., donuts) and R1 was diabetic. LPA's record review today revealed that R1 was on diabetic diet since admission. LPA's interview with another diabetic resident (R2) today at 11:02 AM revealed that the staff are very careful on R2's diet and was not given anything that might affect R2. R2 and three (3) other aware residents interviewed denied being served doughnuts nor witnessed R1 being served doughnuts when R1 was still at the facility. (continued on LIC 9099-C) Unsubstantiated (continued from LIC 9099) Regarding the allegation that Staff are not meeting a resident's incontinence needs while in care, it was alleged that R1 had incontinence associated Dermatitis and not cleaned while living at the facility. LPA's record review today at 1:00 PM revealed that R1 was admitted at the facility on 07/01/22. On 07/02/22, R1 was admitted for a Hospice services and on the same day of admission, Hospice nurse trained the staff on how to care for R1's wounds including but not limited to turning, hydration and incontinent needs to avoid infection and skin tear. LPA's interview with three (3) incontinent residents today between 11:00 AM to 1:00 PM revealed that all three (3) of the residents interviewed were being checked every two (2) hours or less, regularly changed diapers between four (4) to five (5) times a day by the staff. All the three (3) incontinent residents added that staff are very attentive and takes good care of them and their care needs. Based on the information gathered during this and prior visit, the allegations are deemed unsubstantiated at this time. Exit interview conducted. Copy of this report issued.the state’s words, verbatim · CDSS document, Nov 30, 2023 · control 31-AS-20220921151917