Mina's Elderly Care Home @ Vasona

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Type of visit: POC

Licensing Program Analyst Manuel Monter conducted a POC case management visit to clear deficiencies cited on July 3, 2026. LPA met with Administrator Mina Abbasvand and explained the purpose of the visit. The facility was cited the following Type A deficiency on July 21, 2026 87608 Postural Supports (a)(5)(B), POC due date July 22, 2026 LPA received plan of corrections for type A deficiency by POC due date. Deficiency cleared during todays visit. POC cleared letter provided to ADM No deficiency was cited during todays visit. This report was reviewed with Administrator Mina Abbasvand. A copy of this report was provided.the state’s words, verbatim · CDSS document, Jul 29, 2026

Type of visit: Case Management - Other

Licensing Program Analysts (LPAs) Manuel Monter, Simi Rai, Coryse Ngangmenyi and Licensing Program Manager (LPM) Romeo Manzano, conducted an unannounced case management visit - other and met with Administrator Mina Abbasvand. During today's visit, LPA's and LPM noted that Resident R1, in bedroom #5 had a bed with full bed rails. ADM confirmed that resident R1 is not under hospice and required full bed rail due to safety and history of falls. LPAs' and LPM observed during the tour that the facility designated exits door knobs in bedroom #6 (staff bedroom based on the physical floor plan) has a main door leading to the main exit door. Both door knobs did not have a single action mechanism to access door in case in a fire emergency. All 6 residents (R1 to R6) have neurocognitive disorders who may not be able to operate or open the door with two separate locking mechanism. LPAs and LPM suggested that bedroom#6 main door must be open or unlocked at all times and the main exit to have a single action mechanism. Noted that Bedroom #6 is a staff bedroom, staff must locked their personal items that could posed safety hazard such as prescription or non-prescription medications and toxins for the safety of residents in care. LPAs' and LPM also noted that the main entrance door has two locking mechanism. LPAs' and LPM suggested that the main entrance door should have a single action mechanism. ADM stated that she will ensure all designated exit doors will replaced to a single action door locking mechanism. ADM agreed and understood. Page 1. See page 2 of 2 Continuation LPAs and LPM also reviewed R1 facility file. LPAs and LPM noted that R1 history of fall is not noted on the Appraisal Needs and Services based on ADM's statement that the facility has awake night staff, and that R1 is being checked throughout the day and night while in bed utilizing full bed rails. ADM stated that R1's full bed rail has a Medical Note for safety use only. LPAs and LPM discussed the difference between 1/2 rail is for mobility only and full bed rails is prohibited unless the resident is under hospice care. Also the difference between Palliative Care and Hospice. ADM stated that R1's family is in discussion with R1's PCPs regarding Palliative care for R1. ADM stated that R1's Appraisal Needs and Care Plan will be updated including reviewing all of their residents'. Deficiencies are cited during today's visit, see LIC809-D. Exit interview was conducted with Administrator Mina Abbasvand and a copy of this report was provided.the state’s words, verbatim · CDSS document, Jul 21, 2026

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87608(a)(5)(B) · Plan of correction due date: Jul 22, 2026

87608(a)(5)(B) Bed rails that extend the entire length of the bed are prohibited except ... receiving hospice care ...for full bed rails. This requirement was not met as evidenced by: Based on interview and observation, LPA's and LPM noted that reisdent R1 has a hospital bed with full railing, in bedroom #5. ADM confirmed that R1 was not under hospice care but he/she needs it due to fall risk and also, has neurocognitve disorder.the state’s words, verbatim · CDSS document, Jul 21, 2026

Plan of correction: Licensee/Administrator will updated R1's physican's report, noting that he/she requires the half side rail for mobility. ADM stated she will add a bed alarm on R1' bed. ADM stated she will also updated Resident R1's care plan. ADM stated she will send plan of correction to LPA by POC due date 7/22/2026. (Continue) This poses/posed a potential health safety, personal rights risk to residents in care.

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Steve Chang conducted an pre licensing inspection visit and met with Administrator (ADM) Mina Abbasvand. LPA toured the facility inside and out with ADM. Living room, dining room, kitchen, 6 resident rooms, 2 staff live-in rooms, 4 restrooms, laundry area, and garage were inspected. Medication closet was observed locked. Knives closet, and dish washing soap closet were observed locked. Room temperature was at 73 degree F, and hot water temperature was at 106 degree F in facility. Fire extinguisher was serviced on 7/7/2025. The facility was equipped with fire alarm system, smoke and carbon monoxide detectors. Carbon monoxide detectors were tested, and were working. First aid box, night lights, and flash lights were observed in the facility. All the doors of the facility were observed with door alarms. Each resident room was observed with all button. Front yard and backyard were inspected. There was no obstruction block the walkway to exit gates. No citation noted today. Component III was conducted with ADM. Exit interview was conducted with ADM. A copy of the report was provided to ADM for signature. A copy of the report was provided to ADM.the state’s words, verbatim · CDSS document, Sep 23, 2025