Luna Assisted Living

Type of visit: Required - 1 Year

On September 29, 2026 Licensing Program Analyst (LPA) Toni Nwala conducted an unannounced visit to conduct an annual inspection. LPA met with Care giver Michle Tjanbra for a Residential Care Facility for the Elderly (RCFE) with a capacity of six (6) residents. The facility is a six (6) bedroom, four (4) bath home. There are kitchen/dining area, one (1) living room area, a laundry room, and a fenced swimming pool in backyard with locked gate. The facility does not contain firearms or ammunition. LPA toured the interior and exterior areas of the facility. The following were inspected: All bedrooms have the required bedding and furniture, night-stands, dressers, chairs, lighting, and emergency lighting. The bathroom appliances were operating in safe and sanitary condition. The bathrooms have non-slip floors and grab bars. Utensils and dishware are in good repair and ready for client use. Kitchen appliances and counter-top were free of debris and in good repair. The knives and sharp objects were in kitchen cabinet. LPA observed a knife and a pair of scissors sitting out next to clean dishes. The water temperature was measured to be 107.8 degrees F. There is adequate seating in the common areas. Resident and staff files stored in a locked cabinet located in the living room. LPA observed medication cabinet to be unlocked and accessible to residents . The facility keep the detergents and cleaning chemicals in cabinets located in the laundry room, LPA observe laundry room to be unlocked and accessible to residents. An adequate supply of clean linens and hygiene supplies for the residents were readily available at the facility. There are one (1) charged fire extinguishers in the facility. Continued on LIC809-C.... LPA observed operating smoke detectors and carbon monoxide alarms in the facility. LPA observed required postings including the visitation policies, emergency/disaster plans, complaint procedures, and personal rights. During LPA visit, LPA observed that the physical plant is clean and in good repair, , LPA issued two (2) Type A deficiency under Title 22 regulations for 87309a and 87465(h)2 An exit interview was conducted, and this report was discussed and provided to Care giverthe state’s words, verbatim · CDSS document, Sep 29, 2026

Allegation investigated: Staff did not issue Resident 1's refund to the responsible person in a timely manner

On 05/18/2026, Licensing Program Analyst (LPA) Janette Romero made an unannounced visit to the facility to investigate the allegation listed above. LPA was greeted and granted entry by Caregiver Gloria Hanapu who was informed of the purpose of the visit. LPA contacted Administrator Narine Mamyan and notified them of the purpose of the visit. Administrator reported she was unavailable to meet with LPA and directed LPA to contact Licensee Sahak Hovsepian. LPA made contact with Licensee Hovsepian who was also informed of the purpose of LPA's visit and reported being available via telephone. LPA toured the facility, conducted interviews, and obtained copies of pertinent records. Regarding the allegation, "Staff did not issue Resident 1's refund to the responsible person in a timely manner" it was alleged that on 02/25/2026, Resident 1's (R1's) responsible person issued a check payable to the facility in the amount of $7,800 for R1's prepaid board and care services covering the period of 03/08/2026 through 04/07/2026. R1 passed away in the facility on 03/08/2026 and was therefore entitled to a full refund of $7,800. R1's personal belongings were removed from the facility the day after R1 passed. However, Licensee Hovsepian only refunded $3,900 to R1's responsible person and despite multiple attempts to obtain the remaining refund, licensee still owes R1's responsible person the remaining refund balance of $3,900. Substantiated LPA reviewed R1's admission agreement and Identification and Emergency Information dated 10/08/2025 signed by their responsible person. The Refund Conditions/Resident Death and Belongings Removal subsection in the admission agreement notes that fees paid in advance will be refunded within 15 days of the removal of a deceased resident's belongings. This subsection reflects the signature of R1's responsible person. LPA also reviewed a death report listing R1's date of death as 03/07/2026. LPA conducted a phone interview with Licensee Hovsepian who reported the following information. R1's responsible person issued a check payable to the facility in the amount of $7,800 for prepaid board and care services covering the period of 03/08/2026 through 04/07/2026. R1 passed away in the facility on 03/07/2026. R1's responsible person removed R1's belongings from the facility on 03/08/2026 with the exception of some durable medical equipment donated for future residents, which licensee accepted. Due to R1's passing and removal of personal belongings, R1 was entitled to a full refund of $7,800. Licensee immediately refunded $3,900 to R1's responsible person and requested additional time to refund the remaining $3,900, explaining that the facility had recently experienced low admissions resulting in operating on limited funds. Approximately two weeks after R1's passing, R1's responsible person requested the remaining refund balance of $3,900. However, it took an additional month for licensee to secure a new resident placement due to low admissions. On 05/17/2026, Licensee issued a check payable to R1's responsible person in the amount of $3,900 mailed to them via United States Postal Service. The delayed refund did not impact the facility's ability to purchase food for the residents, timely pay staff's earned wages, or cover any of the facility's operating expenses. During today's visit, LPA did not observe any immediate health or safety concerns. The facility had more than a two-day supply of perishable foods and seven-day supply of non-perishable food items along with operating utilities including electricity, gas, and water. Based on LPA’s interviews conducted and records reviewed, the preponderance of evidence standard has been met, therefore the allegation of "Staff did not issue Resident 1's refund to the responsible person in a timely manner" is found to be substantiated. Title 22, Division 6, Health and Safety Code 1569.652 is being cited on the attached LIC 9099-D. An exit interview was conducted over the phone with Licensee Hovsepian and a copy of this report, LIC 9099-D, Confidential Names list (LIC 811) and Appeal Rights were reviewed with Licensee Hovsepian and Caregiver Hanapu and provided to Caregiver Hanapu.the state’s words, verbatim · CDSS document, May 18, 2026 · control 18-AS-20260514085849

From the deficiency page — Deficiency type: Type B · Section cited: HSC 1569.652(c) · Plan of correction due date: May 22, 2026

1569.652 (c) A refund of any fees paid in advance covering the time after the resident’s personal property has been removed from the facility shall be issued to the individual, individuals, or entity contractually responsible for the fees or, if the deceased resident paid the fees, to the resident’s estate, within 15 days after the personal property is removed. This requirement was not met as evidenced by: Based on interviews and record review, R1 passed on 3/7/26 or 3/8/26 and their belongings were removed from the facility the day after their death. Therefore, R1's Responsible Person (RP) was entitled to a refund of $7800 within 15 days. Licensee reported they did not fully refund RP until 5/17/26. This poses a potential personal rights risk to residents in care.the state’s words, verbatim · CDSS document, May 18, 2026

Plan of correction: Licensee reported he will email LPA a bank record displaying a photo copy of the check dated 05/17/2026 issued to R1's responsible person in the amount of $3,900 to serve as proof of the refund balance payment. Proof of correction to be submitted to LPA by close of business on 05/22/2026.

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Seo Jeon conducted an announced visit to conduct a Pre-licensing inspection. LPA met with Sahak Hovsepian, Applicant, for a Residential Care Facility for the Elderly (RCFE) with a capacity of six (6) residents. The facility is a six (6) bedroom, four (4) bath home. There are kitchen/dining area, one (1) living room area, a laundry room, and a fenced swimming pool in backyard with locked gate. The facility does not contain firearms or ammunition. LPA toured the interior and exterior areas of the facility. There is a detached garage with locked gate. The following were inspected: All bedrooms have the required bedding and furniture, night-stands, dressers, chairs, lighting, and emergency lighting. The bathroom appliances were operating in safe and sanitary condition. The bathrooms have non-slip floors and grab bars. Utensils and dishware are in good repair and ready for client use. Kitchen appliances and counter-top were free of debris and in good repair. The knives and sharp objects were locked in a kitchen cabinet. The water temperature was measured by LPA, and the thermometer read at 105 degrees F. There is adequate seating in the common areas. Resident and staff files will be stored in a locked cabinet located in the living room. The facility will have medication and first aid kitlocked in a kitchen cabinet. The facility will keep the detergents and cleaning chemicals in locked cabinets located in the laundry room. An adequate supply of clean linens and hygiene supplies for the residents were readily available at the facility. There are two (2) charged fire extinguishers in the facility. LPA observed operating smoke detectors and carbon monoxide alarms in the facility. LPA observed required postings including the visitation policies, emergency/disaster plans, complaint procedures, and personal rights. Continued on LIC809-C.... LPA observed that the physical plant is clean, in good repair, and to be hazard-free during today’s visit. LPA has determined that the facility met the operational requirements for licensure. The Pre-licensing inspection is complete. The facility has satisfied all requirements in accordance with Title 22 California Code of Regulations. An exit interview was conducted, and this report was discussed and provided to Applicant, Sahak Hovsepian.the state’s words, verbatim · CDSS document, Aug 26, 2025

Type of visit: Office

Component II completion: Successful Facility Type: Residential Care Facility for the Elderly (RCFE) Application Type: Initial Capacity: 6 Census (if any clients in care): none COMP II Participants: Sahak Hovespian, Applicant Narine Mamyan, Administrator Interview Method: Virtual interview (Microsoft) On August 13, 2025, Applicant and Administrator participated in COMP II. Identification of the Applicant and Administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, Applicant and Administrator confirmed that they have read and understand community care facility licensing laws included in the Health and Safety Codes and the California Code of Regulations Title 22. Signed LIC 809 with copy of photo ID have been obtained. During COMP II, CAB analyst confirmed Applicant and Administrator’s understanding of following areas: 1. Facility Operation: License Type, Client/Resident Populations, and Program. 2. Admission Policies 3. Staffing Requirements & Training 4. Restrictive/Prohibited Health Conditions 5. General Provisions 6. Emergency Preparedness 7. Complaints & Reporting 8. Pre-licensing Readinessthe state’s words, verbatim · CDSS document, Aug 13, 2025