Tree of Life Living Solutions

Allegation investigated: Staff left resident in soiled diapers for an extended period of time Uncleared adult at the facility Staff did not ensure emergency paperwork was easily accessible in an emergency

At approximately 10:00 a.m. on 09/17/26 Licensing Program Analyst (LPA) Nicholas Reed conducted an unannounced complaint visit. LPA met with the licensee and disclosed the reason for the visit. To investigate the allegations above, LPA conducted a file review prior to today’s visit of criminal background clearances at 1:00 p.m. on 09/15/26. Today, LPA interviewed four (04) out of five (05) residents, administrator, licensee, and witnesses between 11:00 a.m. and 2:15 p.m., toured the facility inside and out at 11:10 a.m., and conducted a record review of pertinent records, including but not limited to an admission agreement, face sheet, care plan and staff roster at 11:45 a.m. Regarding the allegation "Staff left resident in soiled diapers for an extended period of time" it was alleged Resident #1 (R1) was found in soiled diaper that had not been changed for several hours. Interview with R1 at 12:45 p.m. today revealed they use a catheter for urine and can independently use the restroom for bowel movements. R1 did not have an issue with the incontinence care they receive. Unsubstantiated Interview with Resident #2 (R2) at 1:30 p.m. today revealed staff regularly checked them for incontinence and changed them as needed. Interviews with the administrator at 11:30 a.m. and the licensee at 11:45 a.m. revealed R1 has an indwelling catheter for urinary incontinence which home health monitored. R1 is able to care for their own bowel movement incontinence but needed assistance with transferring out of bed. R1 wears a diaper since their catheter occasionally leaks. The administrator observed R1 had catheter complications on 09/05/26. The administrator later called 9-1-1 for R1. The licensee stated R1 was changed “about two hours” prior to their hospitalization. Telephonic interview with R1’s home health agency at 2:00 p.m. today revealed they observed dried fecal matter in R1’s diaper on 09/02/26. The administrator claimed it was not an issue afterwards. Record review of R1’s face sheet and care plan indicated R1 was alert and oriented and needed assistance with transferring and ensuring their catheter site was clean. R1’s care plan revealed they did not need assistance with incontinence care. Based on interviews and record review, R1 was able to care for their own bowel movement incontinence, and although the allegation may have occurred, there is no measurable and verifiable information to confirm validity of the complaint. Hence the allegation is UNSUBSTANTIATED at this time. Regarding the allegation "Uncleared adult at the facility" it was alleged Visitor #1 (V1) was present in the facility without first obtaining a criminal background clearance. Interviews with the administrator and the licensee revealed V1 is not staff and was visiting Resident #3 (R3). Interview with R3 at 2:00 p.m. today confirmed V1 was their visitor, not a staff member. Telephonic interview with V1 at 1:45 p.m. today confirmed they were visiting R3. V1 did not provide care and supervision and is not a staff member. File review of criminal background clearances revealed V1 did not have a criminal background clearance associated to the facility. Based on file review and interviews, although V1 did not have a criminal background clearance, they were not required to obtain one as they were only a visitor. Therefore, the allegation is deemed UNSUBSTANTIATED at this time. Regarding the allegation "Staff did not ensure emergency paperwork was easily accessible in an emergency" it was alleged the facility did not maintain records readily available for R1. Interview with the administrator revealed R1’s records were locked and stored confidentially. The administrator had the only key to the file cabinet while going out to their lunch break. The administrator returned within fifteen (15) minutes and provided all necessary paperwork. Interview with the licensee confirmed that the administrator had the only key to the locked file cabinet, went to lunch, and returned promptly to provide all necessary documents. Interview with R1 did not reveal pertinent information to this allegation. Record review of R1’s file revealed all required paperwork were available for audit today. Based on interviews and record review, it was concluded that although the allegation may have occurred, there is no measurable and verifiable information to confirm validity of the complaint. Hence the allegation is UNSUBSTANTIATED at this time. No immediate health or safety concerns were observed during today’s inspection. Exit interview conducted. Copy of report provided.the state’s words, verbatim · CDSS document, Sep 17, 2026 · control 31-AS-20260910120202

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Michael Cava conducted a Pre-Licensing Inspection with the applicants/administrator, Hovsep Pachanyan and Frida Chizhikian. An Application to operate a Residential Care Facility for the Elderly (RCFE) was received by Community Care Licensing (CCL) on October 28, 2025. A fire clearance was approved on November 26, 2025 for two five (5) non-ambulatory and one (1) bedridden, for a total capacity of six. Per STD 850, Room #4 carries the bedridden fire-clearance. The applicant is also requesting a hospice waiver to retain six (6) residents. The smoke alarms and carbon monoxide detector are dual and inter-connected. The facility has one new fire extinguisher, located in the kitchen. Fire extinguisher was purchased on November 25, 2025. First aid kit and manual kept in the in the living room A tour of the physical plant was initiated at approximately 10:30am and the following was observed: KITCHEN: The kitchen area is equipped with a refrigerator, stove/oven, microwave and sink. At this time, perishable food items not required as there are zero (0) residents. Applicant is advised to purchase perishable food items once facility is licensed and operational. There is an adequate supply of nonperishable food, emergency water and dining ware to accommodate a maximum capacity of six (6). Knives are kept locked in a drawer. Cleaning supplies will be kept locked underneath the kitchen sink. BEDROOMS: There are five (5) bedrooms designated for client use. Room #4 is shared. Rooms #1, #2, #3 and #5 are private. The applicant furnished all three bedrooms with with beds, night stand, chairs, dresser, extra bedding and linen. The bedrooms have sufficient lighting and closet space. Auditory alarms were checked and functional at all bedrooms with an exit. BATHROOMS: The facility has three (3) bathrooms. Two (2) are for resident use and one (1) for staff use. Bedrooms #3 and #4 has a shared bathroom. The other common bathroom is in the hallway. Bathrooms designated for residents use were observed to have the proper fixtures, grab bars, and non-skid mats. The hot water delivered in the bathrooms measured between 110 and 111 degrees. COMMON AREAS: These include the living room and dining room. The living room is furnished with adequate seating/furniture, couch, chairs, table and a television. There is no fireplace, The dining room table is large enough to accommodate six (6). Floors were clean and in good repair. Passageways and hallways were clear of obstruction. Auditory alerts at all exit doors in common areas were tested and functional. LAUNDRY ROOM: Laundry are is located at the side of the home. The washer/dryer is new. Detergents and cleaning supplies will be kept locked in the garage. MEDICATIONS: Medications and medication records will be kept locked in a closet by the living room. RESIDENT/STAFF FILES: Resident/Staff files will be kept locked in a cabinet at the staff workstation. GARAGE: The garage will be used for storage space for cleaning supplies and equipment is attached to the building. Garage will be kept locked at all times. SURROUNDING GROUNDS: The backyard of the facility has a patio area with backyard furniture to accommodate the six (6) residents. The facility backyard has sufficient yard space to hold outdoor activities. There is no swimming pool or any other bodies of water. In addition to the Pre-Licensing inspection, a Component III power point presentation was held. Pursuant to Title 22, Division 6 of the CA Code of Regulations, the facility's physical environment is compliant and ready for licensure. CAB will be advised and a copy of this report provided.the state’s words, verbatim · CDSS document, Mar 17, 2026