American Dream Assisted Living

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Abeye Duguma met with administrator, Anna Gasparyan, for a Required One (1) Year visit. LPA explained the reason for the visit. A tour of the physical plant was conducted at around 10:30 AM and the following was noted: The facility has outdoor furniture with a covered shaded area for residents and visitors. The facility has a swimming pool/body of water with required fence and locking mechanism. The facility has a total of five (5) bedrooms and three (3) bathrooms. The facility is fire cleared for six (6) non-ambulatory, of which one (1) may be bedridden, and a hospice waiver for five (5). The facility is currently occupying six (6) residents. The living and dining room are neat and clean. The residents' rooms are adequately furnished with appropriate lighting system. Hallways are well lit. Residents have enough personal hygiene product provided by the licensee. The bathroom was checked for cleanliness and proper operations. Towels and washcloths are not shared. There was enough clean linen available in the cabinets. Kitchen is sufficiently stocked with at least two (2) days perishable and seven (7) days non-perishable food. Frozen foods are wrapped and stored appropriately. Food storage and preparation areas are clean and inaccessible to pests. Knives and sharps are observed to be locked and inaccessible to residents. Laundry detergents, cleaning agents and other toxins are locked away. (continued on LIC 809-C) The facility maintains a comfortable temperature at 76°F. The smoke and carbon monoxide detectors are hardwired, interconnected and observed to be operational. Fire extinguisher is located near the kitchen and observed to be fully charged and last inspected 09/02/2025. The hot water temperature was measured at 109.7°F. LPA observed medication to be locked and inaccessible to residents. Facility maintains a complete first aid kit. No health and safety hazards noted during the visit. Exit interview conducted. Copy of this report issued.the state’s words, verbatim · CDSS document, Aug 7, 2026

Allegation investigated: Staff do not respond at night to resident's calls for assistance. Staff did not treat resident with dignity or respect.

Licensing Program Analyst (LPA) Abeye Duguma conducted an unannounced initial complaint visit to this facility to investigate the above allegations. LPA met with Anna Gasparyan and explained the reason for the visit. --- Staff do not respond at night to resident's calls for assistance. It was alleged that staff are not responding to residents who call out for help with toileting, transferring, or food service, particularly around 12:30 a.m. To investigate the allegation, LPA requested documents at 10:00a.m., interviewed two (2) staff from 11:00a.m. to 12:00p.m. and five (5) out of six (6) residents from around 12:00p.m - 1:30p.m. LPA was unable to interview remaining resident as they were out in the community. A review of staff schedule shows there is at least one (1) caregiver and one (1) back-up such as an administrator and/or licensee present at all times. (CONT. on LIC9099-C) Unsubstantiated During the night shift there is one (1) caregiver available. During interviews, Staff #1 (S1) and Staff #2 (S2) stated residents are checked on every hour or more if needed during the day and every two (2) hours at night. During interviews, Resident #1 (R1) stated S2 does not respond to calls for assistance for other residents. R1 added they are independent and do not require assistance. Four (4) out of five (5) residents stated staff respond to calls and they are checked on often, including overnight. --- Staff did not treat resident with dignity or respect It was alleged that Staff #2 (S2) pushes sofa while Resident #1 (R1) is sitting on it to clean. To investigate the allegation, LPA interviewed two (2) staff from 11:00a.m. to 12:00p.m. and five (5) out of six (6) residents from around 12:00p.m - 1:30p.m. LPA was unable to interview remaining resident as they were out in the community. Staff #1 (S1) and Staff #2 (S2) stated all residents are treated with respect and dignity. S2 added they do not recall pushing any furniture with residents sitting on it. During interviews, R1 stated S2 pushed the sofa while they were seated to clean and felt it was disrespectful. Four (4) out of five (5) residents stated they are treated with respect and dignity. Based on interviews and record review, there is not enough information to verify the allegations, therefore, the allegations are UNSUBSTANTIATED at this time. No health and safety hazards noted during the visit. Exit interview conducted. Copy of this report issued.the state’s words, verbatim · CDSS document, May 8, 2026 · control 31-AS-20260430103732

Type of visit: Prelicensing

On 7/3/2025 at 9:30AM Licensing Program Analyst (LPA), Perchui Milena Khurshudyan conducted an announced Pre-Licensing visit to the above facility and met with facility Administrator Anna Gasparyan. LPA introduced herself by showing her department badge and conducted entrance interview. Fire Clearance was approved on 02/12/2025 for a maximum capacity of six (6) non-ambulatory residents, of which one (1) can be Bedridden resident in bedroom #5. Facility has a Dementia Care Program. The purpose of today’s visit is to inspect the facility to ensure that the facility is in compliance with rules and regulations under the California Code of Regulations, Title 22. The facility is a single-story building. Today's site visit consisted of LPA touring the physical plant inside and outside and observed the following: KITCHEN: The facility has a Kitchen area that is equipped with a new refrigerator, microwave oven and sink. At 9:45AM, LPA observed adequate supplies of nonperishable food properly stored inside the kitchen cabinets. Perishable food items are not required at this time as there are no residents in the facility. Licensee will supply sufficient amount of perishable food upon arrival of the residents. LPA observed dining ware to accommodate a maximum capacity of six (6) residents. All knives and sharps are observed to be locked in a kitchen cabinet and inaccessible to residents in care. The facility has one (1) new fire extinguisher, which was purchased on 02/04/2025. BEDROOMS: There are five (5) bedrooms designated for residents’ use. All bedrooms are furnished with beds, dressers, chairs, nightstands and required bedding and linen. The bedrooms have sufficient closet space and have sufficient lighting. Auditory alarms were tested and observed to be operational at 10:20AM. There is no bedroom designated for staff use. Facility will have awake staff at night. Continue On LIC809-C LAUNDRY ROOM: The laundry area is next to the kitchen. The washer and dryer machines appear to be new and in good condition. Laundry supplies along with other chemical items observed locked and under supervision when not in use. BATHROOMS: Facility has three (3) bathrooms. At 10:35am LPA observed all bathrooms are clean, in good repair and properly supplied with toilet paper, soap and paper towels. LPA observed appropriate grab bars and non-skid mats in all bathrooms. Trash cans had closed tight fitting lids. Water temperature was within regulation, and it was measured by an LPA at 10:50am to be at 106.3°F degrees. COMMON AREAS: The facility maintains a comfortable temperature at 72°F. The living room and dining area appeared clean and were properly furnished. Activity supplies were nicely organized inside the office area. Activities include puzzles, coloring books, crayons, and board games. No obstructions or tripping hazards throughout the facility. An emergency exit plan/sketch is posted along the hallway with other posting requirements. The facility has a fireplace which is properly fenced. LPA informed the fireplace is not operational. No firearms observed or will be maintained on the premises. MEDICATION: The medication will be kept inside the commercial cabinet which is placed between the dining and kitchen area. The facility staff/resident files will be kept centrally stored and locked in the office area between the living room and the kitchen. First-aid kit was checked to be complete and has the new manual available. The facility will operate with two (2) shifts (AM and PM). SMOKE DETECTORS/CARBON MONOXIDE. Dual smoke detectors and carbon monoxide were located in the bedrooms and throughout the facility. At 10:55am they were tested and observed to be operational. SURROUNDING GROUNDS: The facility has sufficient yard space. LPA observed appropriate outdoor furniture, with a covered shaded area for residents. The backyard is fenced. LPA discussed the importance of maintaining care and supervision to meet the needs of the residents. There is a pool in the backyard, properly fenced and locked. The facility has land line, LPA checked to be operational. LPA observed the facility is clean, safe and sanitary. All window screens were in good repair. Auditory signals were installed on all exit doors. All passageways were free of obstruction. Continue on LIC809-C GARAGE: The garage is currently being used as storage for facility equipment, supplies and water. The garage is attached to the facility; however, it has no access from the house. Component III: On 7/3/2025 during Pre-Licensing visit at the facility, the Administrator Anna Gasparyan completed Component III. At which time it was explained how to operate the facility within substantial compliance, The Administrator also had an opportunity to ask questions. Based on inspection and observation, the physical plant is in compliance with Title 22 Regulations at this time. This report will be forwarded to the Centralized Application Bureau (CAB) and the applicant will be notified by the CAB Analyst when the license has been approved. Exit interview conducted and copy of this report signed and delivered to the Administrator.the state’s words, verbatim · CDSS document, Jul 3, 2025

Type of visit: Office

COMP II by CAB successfully completed Method: Phone Call at CAB Census (if any clients in care): Applicant/administrator participated in COMP II at CAB telephone call with analyst at CAB. Identification of the applicant and administrator was verified by presenting photo ID via phone. During COMP II, applicant and administrator confirmed the understanding of Title 22. Component II was successfully completed. Applicant and administrator were advised to email/fax signed LIC 809 with copy of photo ID to CAB. During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of following areas: 1. Facility operation: License type, client/resident populations, and program 2. Staff qualifications and responsibilities 3. Applicant and Administrator qualifications 4. Program policy: Abuse, admission agreement, medication management, reporting incidents to CCL, restricted & prohibited conditions 5. Grievances, Complaints, Community resources 6. Physical plant, food service 7. Application document review and technical assistance: Criminal record clearance, Health screening, Fire clearance, First Aid/CPR certificate, Administrator certificate, Financial verification, Pre-licensing inspection, Compliance history, Control of propertythe state’s words, verbatim · CDSS document, May 30, 2025