The Ivy at Golden Gate

Type of visit: Case Management - Incident

On 08/06/2026, Licensing Program Analyst (LPA) Yi Sam Jian conducted an unannounced case management visit to follow up on an incident report that was submitted to CCLD on 07/22/2026. LPA met with Interim Executive Director, Ron Ryan. LPA explained the purpose of the visit. During the visit, LPA interviewed facility staff and reviewed resident and facility records, including R1's current appraisal/reappraisal, progress notes, and other records pertinent to the resident's care. Based on record review and interviews, LPA determined that R1 experienced a change in condition that warranted a reappraisal. Facility did not complete and document a timely reappraisal for R1 following the change in condition. Deficiencies of the California Code of Regulations, Title, 22 cited on the LIC809D. Failure to correct the deficiencies may result in civil penalties. Report is reviewed with the Interim Executive Director, and a copy is provided with appeal rights.the state’s words, verbatim · CDSS document, Aug 6, 2026

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87463(a) · Plan of correction due date: Aug 14, 2026

Reappraisals(a)The pre-admission appraisal, as specified in Section 87457, Pre-Admission Appraisal, shall be updated in writing as frequently as necessary or once every 12 months, whichever occurs first, to note significant changes in condition, Based on record review, the facility did not comply with the section cited above as R1 did not have an updated appraisal which poses/posed a potential health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Aug 6, 2026

Plan of correction: The facility will complete a reappraisal for R1 by POC due date.

Type of visit: Required - 1 Year

On 8/22/2025, Licensing Program Analyst (LPA) Yi Sam Jian conducted an unannounced Annual inspection visit. LPA met with Interim Executive Director, Ron Ryan and explained the purpose of the visit. LPA conducted a tour of the facility with Interim Executive Director, all outdoor and indoor passageway were free and clear of obstruction. No accessible bodies of water or fire safety hazards observed. Kitchen was inspected, sufficient supply of food observed. Infection control practices reviewed. Medications, toxins and sharps stored appropriately and inaccessible to clients, a comfortable temperature was maintained, hot water temperature inspected to be compliant, furnishing and lighting was sufficient for comfort and safety. Carbon monoxide detector and smoke detector system inspected and met the requirements. fire extinguisher checked and fully charged. Facility has a written emergency disaster plan. Licensee has multiple completed first aid kit located in the office. Criminal record clearances or exemptions for facility staff or other individuals who have client contact have been reviewed. No deficiencies were cited. The report was reviewed and discussed with Interim Executive Director. A copy of the report was left at the facility.the state’s words, verbatim · CDSS document, Aug 6, 2026

Type of visit: Case Management - Incident

On 04/09/2026, Licensing Program Analyst (LPA) Yi Sam Jian conducted an unannounced case management visit to follow up on an incident report that was submitted to CCLD on 04/02/2026. LPA met with Administrator, Adiam Welday. LPA explained the purpose of the visit. The facility submitted a written incident report stating that on 04/01/2026, at approximately 4:06 PM, R1’s WanderGuard device activated at an emergency exit. Staff were immediately alerted, initiated a search, and located R1 near the front entrance at approximately 4:10 PM. LPA conducted interviews, collected and reviewed documentation. Administrator reported that R1 is placed with 24 hours private companion until further notice. This report is reviewed and discussed with the administrator. A copy is provided.the state’s words, verbatim · CDSS document, Apr 9, 2026

Type of visit: Case Management - Other

On April 1, 2026, Licensing Program Analyst (LPA) Murial Han conducted an unannounced visit. LPA met with administrator, Adiam Welday and LPA explained the purpose of today's visit. During today's visit, the administrator confirmed that staff #1 (S1) is no longer working at the facility and has been disassociated from the facility. This report is reviewed and discussed with the administrator. A copy is provided.the state’s words, verbatim · CDSS document, Apr 1, 2026

Type of visit: Case Management - Incident

On 2/19/2026, Licensing Program Analyst(LPA) John Calandra arrived at the facility to conduct a Case Management visit in regards to an incident self reported by the facility involving a resident who became agitated during meal time, and threatened staff. LPA Calandra was greeted by Adiam Welday, Executive Director/Administrator and explained the purpose of the visit. According to the Administrator, R1 entered the kitchen of the memory care unit and threatened staff. Staff attempted to redirect the resident but R1 became more aggressive and the police department had to be contacted. R1 has been to the doctor recently and re-evaluated. No other incidents have been reported at this time. During the visit, LPA received copies of R1's recent assessment and discharge notes. During record review, LPA observed that the incident had not been reported to the Department for 10 days. Licensees are required per Title 22 to submit a written report within 7 days of the occurrence. A Technical Assistance Advisory note was provided explaining the best practice to maintain compliance. No deficiencies were cited during today's visit. An exit interview was conducted. A copy of the report and Technical Assistance were provided.the state’s words, verbatim · CDSS document, Feb 19, 2026

Type of visit: Case Management - Incident

On 12/23/2025, Licensing Program Analyst (LPA) Yi Sam Jian conducted an unannounced case management visit regarding an incident report. LPA met with Executive Director, Adiam Welday, LPA explained the purpose of the visit. On 12/17/25, the facility reported that a resident’s family member alleged missing personal property from the resident’s room at the facility. No photographs or documented values of the items were available at the time of the report. At the time of the visit, the resident was hospitalized and undergoing treatment. The LPA interviewed staff and collected relevant documentation. The LPA reviewed the report with the Executive Director, and a copy of the report was provided to the Executive Director.the state’s words, verbatim · CDSS document, Dec 23, 2025

Type of visit: Case Management - Incident

On 12/3/2025, Licensing Program Analyst(LPA) John Calandra arrived at the facility to conduct a Case Management visit in regards to an incident that occurred on 11/25/2025 in which a resident, R1 was able to leave the facility unassisted. LPA Calandra was greeted by Sayma Arnautovich, Director of Housekeeping an and explained the purpose of the visit. Daisy Dizon, Director of Memory Care arrived later during the visit. According to Sayma Arnautovich, Director of Housekeeping, R1 lives in a memory care apartment and frequently takes walks outside of the community in a gated outdoor space. On 11/22/2025, R1 walked out of their apartment and walked towards a gated outside space. From there R1 was able to leave the facility unassisted and was found four hours later by staff with no apparent injuries when they returned to the facility front steps. Based on observations, and interview, all door alarms and delayed egress systems were working properly. LPA requested a copy of R1's LIC 602 Physician's report. According to the medical assessment which was dated last year, R1 is not at risk if allowed to leave the community unsupervised due to dementia or cognitive decline and is not a wander risk. LPA received a copy of the physician's report and last doctor's visit record during the visit. No deficiencies cited during today's visit. An exit interview was conducted. A copy of this report along was provided.the state’s words, verbatim · CDSS document, Dec 3, 2025

Type of visit: Case Management - Incident

On 10/08/2025, Licensing Program Analyst (LPA) Yi Sam Jian conducted an unannounced case management visit to follow up on an incident report that was submitted to CCLD on 10/03/2025. LPA met with Memory Care Director, Daisy Dizon, and Regional Operations Specialist, Caroline Frangieh, arrived later during the visit. LPA explained the purpose of the visit. The facility submitted a written incident report indicating on 09/27/2025, at approximately 9:30 AM, Resident R1 participated in a morning walk accompanied by activity staff S1 and other residents. S1 was unaware that Resident R1 was not to leave the facility without assistance. Staff S1 returned to the facility without Resident R1. At approximately 5:00 PM the same day, Resident R1 returned to the facility accompanied by an individual from outside the facility. Resident R1’s physician’s report identifies Alzheimer’s dementia as the primary diagnosis. The resident’s mental status indicates that R1 is not able to leave the facility unassisted. Due to lack of care and supervision by facility staff, R1 was able to elope from the facility. Deficiencies of the California Code of Regulations, Title, 22 cited on the LIC809D. Failure to correct the deficiencies may result in civil penalties. Report is reviewed with the Regional Operations Specialist, and a copy is provided with appeal rights.the state’s words, verbatim · CDSS document, Oct 8, 2025

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87464(f) · Plan of correction due date: Oct 9, 2025

87464 Basic Services: (f) Basic services shall at a minimum include: (1) Care and supervision as defined in Section 87101(c)(3) and Health and Safety Code section 1569.2(c). This requirement is not met as evidenced by: Based on file review and incident report, Licensee did not provide care and supervision to resident R1 who is diagnosed with Dementia. R1 eloped from facility without supervision, with documented mental condition stated not able to leave facility unassisted.the state’s words, verbatim · CDSS document, Oct 8, 2025

Plan of correction: Licensee agrees to submit a written plan detailing additional staff training that will take place to ensure that care and supervision will be provided to every resident in care. Licensee will continue to conduct appraisals and needs and services plans. Plan to be submitted to CCL by POC due date.

Type of visit: Required - 1 Year

On 8/22/2025, Licensing Program Analyst (LPA) Grace Donato conducted an unannounced Annual inspection visit. LPA met with Regional Operations Specialist, Chris Schuster and explained the purpose of the visit. LPA conducted a tour of the facility with Director of Housekeeping, Sayma Arnautovich, facility found to be clean and at a comfortable temperature with all exits free from obstruction. Residents are either engaged in activities or are in the tea rooms or dining area. Resident’s bedrooms, common areas, kitchen & food storage areas were inspected. Fire Extinguishers located on each resident floor and kitchen. Carbon monoxide detectors were located at each hallway. Smoke detectors and fire safety systems are interconnected. Water at faucets accessible to residents measured at 110 degF. There was a sufficient supply of both perishable and nonperishable foods. Facility provides a wide variety of meal preferences and preparation while also ensuring proper dietary restrictions are followed. Cleaning supplies and other toxins are safely stored in locked closets throughout each floor, and housekeeping/maintenance rooms all of which were secured upon inspection. All resident’s bedrooms have lighting & appropriate furnishings and bedding items. Seven resident records and seven staff records were reviewed. All records are complete and updated. Staff has annual training logs. Medication room was reviewed and everything is complete and locked in the med room. No deficiencies cited today. Report is reviewed and copy is provided.the state’s words, verbatim · CDSS document, Aug 22, 2025

Allegation investigated: Client's care needs not met by staff

On 6/5/2025, Licensing Program Analyst (LPA) Tobola arrived unannounced for the purpose of delivering complaint investigation findings and was greeted by Regional Operations Specialist, Alan Fox. LPA toured the facility, interviewed residents, staff and outside parties, reviewed records and made observations during the course of the investigation. Complaint alleges client (R1) care needs are not being met by staff regarding R1 being observed in poor condition. Upon interview with R1's responsible party (I1), witness (I2) and facility Executive Director (S1), it was explained that R1 had been transferred to the UCSF emergency room after an incident occurred during a scheduled medical appointment. R1 was transferred from the UCSF primary medical center, not from the residential care facility. Observed wounds were pre-existing and were being treated appropriately by the facility along with additional documented outside medical agency care. Continued onto LIC9099-C Unsubstantiated Based upon review of R1’s physician’s report, R1 is cognitively able to determine their own medical and assistance needs. Interviews with residents (R1, R2), responsible party (I1) and witness (I2) indicated the facility is providing appropriate care and meeting resident needs with no concerns indicated. A finding that the complaint allegation client's care needs not met by staff is unsubstantiated meaning that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED. No deficiency cited.the state’s words, verbatim · CDSS document, Jun 5, 2025 · control 14-AS-20250314144621

Allegation investigated: Staff did not distribute resident's medication as prescribed Staff did not maintain current resident records Staff are not communicating with responsible party regarding resident's care service

On 5/2/2025, Licensing Program Analyst (LPA) Tobola arrived unannounced for the purpose of delivering complaint investigation findings and was greeted by Executive Director, Katherine Rauhkman. LPA interviewed staff, reviewed resident records and made observations during the course of the investigation. Complaint alleges staff did not distribute resident's (R1) medication as prescribed. LPA conducted a spot review of R1’s medication administration records and did not identify any medication not properly administered. Upon additional interview with Reporting Party, LPA received contradicting information to the initial complaint intake statement. LPA was not provided specific information on medication errors by Reporting Party. Continued onto LIC9099-C Unsubstantiated Staff did not maintain current resident records. LPA conducted a review of R1’s records and found that the facility had maintained R1’s medication records. Upon additional interview with Reporting Party, LPA received contradicting information to the initial complaint intake statement. LPA was not provided specific information on medication record issues by Reporting Party. Upon review of R1's medication records, LPA found that R1's medication administering records were on file. Staff are not communicating with responsible party regarding resident's care service. Upon interview with Executive Director, and corresponding documented communication with R1’s, responsible party, it was determined that there was documented communication from the facility regarding R1's care service. From documentation gathered, LPA found contradicting information in relation to the allegation. A finding that the complaint allegations, staff did not distribute resident's medication as prescribed, staff did not maintain current resident records and staff are not communicating with responsible party regarding resident's care service are unsubstantiated meaning that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED.the state’s words, verbatim · CDSS document, May 2, 2025 · control 14-AS-20250212155932

Allegation investigated: Staff did not ensure that resident was dispensed their medication as prescribed Staff did not refill resident’s medication prescription in a timely manner

On 5/2/2025, Licensing Program Analyst (LPA) Tobola arrived unannounced for the purpose of delivering complaint investigation findings and was greeted by Executive Director, Katherine Rauhkman. LPA interviewed staff, reviewed resident records and made observations during the course of the investigation. Complaint alleges, staff did not ensure that resident was dispensed their medication as prescribed for resident (R1). Upon interviews with staff and information provided by Reporting Party, LPA found consistent information regarding staff observing resident R1 to be asleep and unable to administer a (as needed/PRN) narcotic to R1 because of R1's observed status. In addition, staff did administer medication upon observation as needed when R1 had awoken later within the hour. Upon review of R1’s medication administration records, LPA was unable to find corroborating evidence supporting the allegation. Continued onto LIC9099-C Unsubstantiated Complaint also alleges a second medication for daily administration was not provided. Upon interviews with staff and a review of R1's medication records, LPA gathered information regarding medication delivery and orders. Facility staff (S2,S3,S4) statements were consistent, indicating that the medication was delivered but a physician order was not included. Staff stated they contacted R1's hospice agency multiple times by phone, requesting for the signed order. Lastly, the signed physician's order was eventually provided several days after the delivery for reconciliation, indicating potential delay in documentation being provided to the facility. R1 was provided the medication the following day of receiving the signed order. LPA determined that there is conflicting information and a lack of corroborating evidence towards the allegation. Complaint alleges, staff did not refill resident’s medication prescription in a timely manner. Upon review of resident records it was found that R1 was prescribed a daily medication that assist with bowel movement. In addition, R1 is also prescribed a second medication that targets bowel movement, but only used as needed (PRN) when the primary daily medication is not effective after several days. Interview with Executive Director (S1) and review of R1's medication and hospice records indicated that the amount of PRN medication administered was within the total quantity of the PRN medication doses on supply. There is no other indication of R1's observed symptoms in either charting notes, hospice records or medication records that indicate R1's need for additional PRN nor indication of the facility not having sufficient supply on hand. LPA attempted to contact the hospice agency but was not able to gather statement. A finding that the complaint allegations, staff did not ensure that resident was dispensed their medication as prescribed and staff did not refill resident’s medication prescription in a timely manner are unsubstantiated meaning that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED.the state’s words, verbatim · CDSS document, May 2, 2025 · control 14-AS-20250221141055

Allegation investigated: Facility did not issue a refund

On 12/10/2024, Licensing Program Analyst (LPA) Tobola conducted an unannounced visit for the purpose of delivering complaint investigation findings and was greeted by Executive Director, Katherine Raukhman. LPA interviewed staff, outside parties, reviewed resident records and made observations during the course of the investigation. Complaint alleges facility did not issue a refund to residents (R1 & R2). Reporting party claims that a refund of all expenses paid to the facility, including community move-in fees and first month rent should be owed to R1 & R2. Based upon interviews with staff (S1) and outside party (I1), it was confirmed that residents R1 & R2 had signed an admissions agreement with an effective date of 7/31/2024. Upon review of records, LPA found that In the admission agreement, it is stated that 100% of the community fee will be refunded if residents decide to withdraw prior to assessment and signing agreement. LPA however found that the facility had conducted a pre-appraisal assessment for both R1 (7/27/2024) and R2 (7/31/2024), prior to or on same date of the signed effective admissions agreement. Continued onto LIC9099-C Unfounded Reporting Party claims that all expenses are owed to residents (R1 & R2) because neither resident had not physically moved into the facility. Based upon interviews with staff (S1) and outside parties (I1,I2), LPA found that R1 & R2 had a signed effective agreement and were able to move into the facility as of 7/31/2024. However, it was found that R1 & R2 voluntarily refused to move their belongings into the facility from their personal home with said effective agreement and paid community and rent fees. Lastly, document review also indicated that R1 & R2 had submitted a withdrawal letter dated 8/30/2024 to the facility however was unsigned. A second letter was submitted to the facility dated 9/2/2024 declared an outside party (I1) as residents' (R1 & R2) authorized representative. A final letter from I1 dated 9/6/2024, requested a full refund of fees. Although LPA found that the facility received inconsistent documentation for withdrawal, a request was initially submitted by residents' (R1 & R2) within the first month of rent. Again it is indicated on the signed admissions agreement, that R1 & R2 had agreed to facility admission, effective 7/31/2024 and are not owed the alleged amount. In consideration to time frame of withdrawals, the facility was found to have provided the appropriate pro-rated community fees refund amount to residents (R1 & R2). The agency has investigated the allegation and we have found that the complaint was UNFOUNDED, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. No deficiencies cited during today's visit.the state’s words, verbatim · CDSS document, Dec 10, 2024 · control 14-AS-20240917181205

Allegation investigated: Facility did not issue refund

On 12/4/2024, Licensing Program Analyst (LPA), Tobola arrived unannounced for the purpose of delivering complaint investigation findings and was greeted by Executive Director, Katherine Raukhman. LPA Interviewed staff, outside parties and reviewed resident records during the course of the investigation. Complaint alleges facility did not issue refund regarding resident (R1). Upon interview with staff (S1) and outside parties (I1) it was found that resident R1 had been moved out of the facility on 7/13/2024 with all remaining personal property removed by 7/27/2024. Based upon documents gathered, LPA found that R1's responsible party had submitted a written notice on 7/1/2024, to terminate agreement (30) days prior. Based upon R1's admission agreement it is indicated that upon self-termination, "you will continue to be responsible for all fees and charges accruing under this Agreement until the later of the expiration of the thirty (30) day period or you have vacated your Residence..". Continued onto LIC9099-C Substantiated The admissions agreement regarding refunds continues indicating, "within twenty-one (21) days after the Residence has been vacated, your property has been removed from the Residence, and the Residence has been restored to its original clean condition, we will pay you a refund equal to any unused portion of your final Monthly Fee and Level of Care Fee..". Based upon interviews with staff (S2) it was found that the facility had refunded the level of care fees to R1 but had not yet refunded the monthly fees. It was found that R1's belongings had been moved out of the facility by 7/27/2024 but had not been fully refunded including the monthly fees until 10/9/2024 which goes against R1's admissions agreement. Allegation, facility did not issue refund is found to be SUBSTANTIATED. A finding that the complaint is SUBSTANTIATED means that the allegation is valid because the preponderance of the evidence standard has been met. The following deficiencies were cited on 9099-D, per Title 22 Regulations, Division 6. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Exit interview conducted and appeal of rights provided.the state’s words, verbatim · CDSS document, Dec 4, 2024 · control 14-AS-20240905102251

From the deficiency page — Deficiency type: Type B · Section cited: HSC 1569.625(c) · Plan of correction due date: Dec 4, 2024

H&S 1569.625 - 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 was not met as evidence by: Based upon review of R1's admissions agreement, it is indicated that R1 is to be refunded within (21) days for any level of care and monthly fees upon move out and removal of all personal property. It was found that R1's belongings were moved by 7/27/2024 but not provided a full refund of fees until 10/9/2024. This serves as a potential personal rights risk to resident in care.the state’s words, verbatim · CDSS document, Dec 4, 2024

Plan of correction: Executive Director and Business Office Director had determined correct refund amount accounting for R1's final move out date and both care and monthly fee's owed. LPA was provided copy of corrected refund amount to R1/responsible party. Deficiency cleared at time of visit.

Allegation investigated: Facility staff failed to provide safe, healthful and comfortable accommodations. Facility failed to provided tray service when resident is ill. Facility staff failed to provide medication according to the physician's directions. Facility staff failed to accord dignity in their personal relationships with other persons. Facility Staff did not clean and disinfect COVID positive resident room.

On September 6, 2024, Licensing Program Analyst(LPA) John Calandra arrived at the facility to deliver conclusionary findings for a complaint opened on February 7, 2024. LPA Calandra was greeted by Katherine Raukhman, Executive Director and explained the purpose of the visit. During the initial visit, LPA gathered information including relevant records and conducted staff interviews. Based on information gathered, the facility provided a work order for carpet cleaning service due to the need for maintenance services because a section of the resident’s room was found to be unsanitary and unclean due to the resident’s temporary illness. The facility was notified by responsible party during a visit that the room needed to be cleaned again on January 18, 2024 and the facility took action on that date. Regarding allegation of meals not being provided to residents who have to isolate in their rooms, there was an occasion where a resident was ill and required to be isolated to his room for approximately five days. If a resident is isolating in their room, the facility will provide and deliver the meals to resident’s room. This resident has a private caretaker that would pick up the meals and bring them to the room. Based on information gathered, there appears to have been a misunderstanding regarding who would retrieve the meals because of this situation. Regarding the medication issue, the resident had medication that was prescribed and the doctors order on file specified medication be given at particular times of day. Furthermore, based on the medication package instructions, which the facility was directed to follow by the physician the medication was provided at those particular times of day. Unsubstantiated Regarding the allegation that facility staff failed to accord dignity in their personal relationships with other persons, the reporting party alleges that a family member was visiting resident and she was spoken to in a manner that she feels was disrespectful. Information was obtained from both sides and there is not enough specific information to determine if this happened. LPA interviewed several staff and they stated they are unaware of any incidents regarding any person being spoken to in a disrespectful manner. Allegation regarding facility not cleaning and disinfecting room due to resident having COVID, the responsible party alleges that “staff felt it was dangerous and possibly be exposed” to COVID. Facility stated that staff can clean the room as long as they are wearing the required PPE and continue as their normal schedule. Facility policy of cleaning rooms when a resident has COVID is that "the Care Provider will disinfect the apartment during the shift by replacing tissue, disposable bags when full, wiping off the surfaces in the apartment and bathroom with disinfectant wipes or by cleaning with paper towels and the spray bottle of germicidal agent." Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegations are unsubstantiated. An exit interview was conducted. This report was reviewed with Katherine Raukhman, Executive Director and a copy of the report left at the facility.the state’s words, verbatim · CDSS document, Sep 6, 2024 · control 14-AS-20240129162503

Type of visit: Required - 1 Year

On 8/21/2024, Licensing Program Analyst (LPA) Tobola conducted an unannounced Annual Required – 1 yr. inspection for this facility and was greeted by Executive Director, Katherine Raukhman. The facility currently provides care for 127 residents, 6 of which are receiving hospice services, along with a designated memory care unit. LPA continued with a tour of the facility with staff, facility found to be clean and at a comfortable temperature with all exits free from obstruction. Resident’s bedrooms, common areas, kitchen & food storage areas were inspected. Fire Extinguishers located on each resident floor and kitchen were found to be last charged on 11/8/2023. Carbon monoxide detectors were located at each hallway tested and functioning. Smoke detectors and fire safety systems are interconnected. Fire Safety Inspection was completed on 8/16/2024 indicating all fire safety devices and systems to be in order. Water at faucets accessible to residents measured between 105.3 and 114.4 degrees F which is within regulation. There was a sufficient supply of both perishable and nonperishable foods as required by Title 22 Regulations, with food stored in the kitchen, sufficient for residents in care. Food supply is replenished twice per week and stored properly. Facility provides a wide variety of meal preferences and preparation while also ensuring proper dietary restrictions are followed. Cleaning supplies and other toxins are safely stored in locked closets throughout each floor, and housekeeping/maintenance rooms all of which were secured upon inspection. There was a supply of hygiene products and paper products available for residents. All resident’s bedrooms have lighting & appropriate furnishings and bedding items. Residents that were awake during the inspection were observed interacting with staff, fellow residents and visitors in the common areas, or in their bedrooms resting. The facility encourages regular family visits and utilizes a wide variety of activities with LPA observing staff engaging continuously with residents, offering activities based on individualized preferences and abilities. LPA found that staff and resident engagement is well practiced with activity calendars developed on a monthly basis. Residents were observed to have a positive and personable relationship with staff and Executive Director. There are multiple outdoor patios for resident use, all equipped with appropriate shading Continued onto LIC809-C LPA conducted a sample file review for 10 residents and found all items to be in order. Upon a spot check of five (5) staff files, LPA found that caregiver staff have current 1st aid and CPR and annual training completed. Lastly, A spot check of medications in both assisted living and memory care was conducted and found that all medication counts and records are in order. Katherine Raukhman's Administrator Certificate 7007732740 is currently active through 12/26/2024. LPA requested the following documents be sent to CCL by COB 9/4/2024: LIC 308 Designated Facility Responsibility LIC 500 Personnel Summary LIC 610 Emergency Disaster Plan Liability Insurance No deficiencies cited during today's visit.the state’s words, verbatim · CDSS document, Aug 21, 2024

Type of visit: Case Management - Other

On May 23, 2024, at 8:45 AM, Licensing Program Analyst (LPA) John Calandra conducted an unannounced visit. LPA Calandra met with Executive Director, Katherine Raukhman and explained the purpose of today’s visit. LPA Calandra delivered an immediate exclusion letter to exclude a private companion who worked in the facility before. The private companion is not on shift today and the Executive Director was advised that they are not allowed to work in the facility. The letter was given to and reviewed by the Executive Director, Katherine Raukhman. This report is reviewed and discussed, and a copy is provided.the state’s words, verbatim · CDSS document, May 23, 2024