Balboa Senior 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 staff, Rebekah Ramirez, and explained the reason for the visit. The administrator could not be present for the annual, but the licensee/owner, Vladislav Blitshteyn. At approximately 9:25am, LPA took a tour of the physical plant. Required postings were observed in the entry area. The smoke alarms and carbon monoxide are dual and interconnected. There are two fire extinguishers. One is located in the kitchen, and the other is located at the hallway by resident room #6. Kitchen: The kitchen appliances and fixtures were functional. LPA found a sufficient amount of perishable and non-perishable food properly stored. Knives were stored in a locked drawer in the kitchen. LPA did no observe any cleaning supplies out and accessible in the kitchen. Bedrooms: There are seven (7) bedrooms. Six (6) of the bedrooms designated for residents' use are private. One (1) room is designated for staff. The bedrooms designated for the residents use were observed to be properly furnished with appropriate beddings and linens with sufficient lighting. Bathrooms: There are three (3) bathrooms designated for the residents' use. Bathrooms were properly supplied and had functional fixtures. Hot water temperature was measured between 111 and 112 degrees Fahrenheit. No cleaning supplies were observed in either bathrooms during the day of the inspection. Common Areas: These included the living room and dining area. The living room has sufficient seating of a large couch and a television. The dining room, located adjacent to the living room has a table large enough to seat up to six (6) residents. Living room and dining room furniture are observed to be in good repair. Floors were mopped and clean. Exits and passageways were clear of any obstruction. Surrounding Grounds: The front and back yards were free of obstruction. There was furniture in the backyard appropriate for outdoor use. There is sufficient yard space in the backyard to hold outdoor activities. There is no swimming pool or any other bodies of water. Exterior gates are only locked from the outside of the property. It is unlocked from the inside making it accessible for exit. Laundry area: The laundry area is by the kitchen. Detergents and cleaning agents were locked. Staff Workstation/Office: There is a staff workstation by the kitchen where resident and staff records are kept in a filing cabinet. 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: Medications are stored locked in a kitchen cabinet. Medication and Medication Records were reviewed for proper storage and documentation. Garage: The garage is attached to the building. Entry is from either outside from the backyard, or internally, by room #6. Garage is used to store supplies. It was locked during the annual. 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, Jan 30, 2026

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 staff, Rusanna Sargsyan, and explained the reason for the visit. The administrator, Mario Ochoa, joined shortly after. At approximately 9:00am, with the assistance of staff, LPA took a tour of the physical plant. Required postings were observed in the entry area. The smoke alarms and carbon monoxide are dual and interconnected. There are two fire extinguishers. One is located in the kitchen, and the other is located at the hallway by resident room #6. Kitchen: The kitchen appliances and fixtures were functional. LPA found a sufficient amount of perishable and non-perishable food at the facility; properly stored. Knives were stored in a locked drawer in the kitchen. LPA did no observe any cleaning supplies out and accessible in the kitchen. Bedrooms: There are seven (7) bedrooms. Six (6) of the bedrooms designated for residents' use are private. One (1) room is designated for staff. The bedrooms designated for the residents use were observed to be properly furnished with appropriate beddings and linens with sufficient lighting. Bathrooms: There are three (3) bathrooms designated for the residents' use. Bathrooms were properly supplied and had functional fixtures. Hot water temperature was measured between 109 and 114 degrees Fahrenheit. No cleaning supplies were observed in either bathrooms during the day of the inspection. Common Areas: These included the living room and dining area. The living room was furnished with two couches, a recliner and a television. The dining room, located adjacent to the living room has a table large enough to seat up to six (6) residents. Living room and dining room furniture ere in good repair. Floors were mopped and clean. Exits and passageways were clear of any obstruction. Surrounding Grounds: The front and back yards were free of obstruction. There was furniture in the backyard appropriate for outdoor use. There is sufficient yard space in the backyard to hold outdoor activities. There is no swimming pool or any other bodies of water. There is a storage that is observed to be locked. Exterior gates are only locked from the outside of the property. It is unlocked from the inside making it accessible for exit. Laundry area: The laundry area is by the kitchen. Detergents and cleaning agents were locked. Staff Workstation/Office: There is a staff workstation by the kitchen where resident and staff records are kept in a filing cabinet. 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: Medications are stored locked in a kitchen cabinet. Medication and Medication Records were reviewed for proper storage and documentation. Garage: The garage is attached to the building. Entry is from either outside from the backyard, or internally, by room #6. Garage is used to store supplies. It was locked during the annual. 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 14, 2024

Allegation investigated: Staff are not able to meet resident's needs due to inadequate staffing.

Licensing Program Analyst (LPA) Michael Cava conducted a complaint visit to the facility to investigate the above allegation. It was reported that Resident 1 (R1), who stayed at the facility on or about 01/23/24 until on or about 01/25/24, and or their family was unable to communicate with staff, therefore unable to meet R1's needs due to a language barrier. LPA met with staff, Rosanna Sargsyan and advised her of the complaint. The administrator, Armine Eritisian was notified shortly after. Today's investigation consisted of interviews with the administrator and staff, and a physical plant inspection. Interviews with the administrator confirm that R1 stayed at the facility for approximately three days. R1's family found another facility suitable for their needs. It was also revealed that Staff 1's (S1) English was limitied, making it challenging for staff to communicate with a resident and their responsible party. S1 no longer works at the facility. Based on the information obtained, the allegation of staff unable needs to to inadequate staffing is Substantiated. Citation issued on the 9099D. Substantiatedthe state’s words, verbatim · CDSS document, Feb 14, 2024 · control 31-AS-20240207114039

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87411(a) · Plan of correction due date: Feb 21, 2024

Personnel Requirements - General: Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs. This requirement was not met as evidenced by confirmation during investigation on 02/14/24. It was revealed that Staff 1's (S1) English was limited, making it challenging for staff to communicate with a resident and their family.the state’s words, verbatim · CDSS document, Feb 14, 2024

Plan of correction: S1 no longer works at the facility. Moving forward, the licensee will insure that all staff hired will be sufficient in numbers and competetent enough to communicate with the resident and their families. As POC, the administrator will read this section of the regulation, and self certify, that they have read and undeerstood this section of the regulations. Self certification is due to the licensing agency by 02/21/24.