A-1 Ascended Senior Care 2

Allegation investigated: Staff do not provide adequate supervision resulting in resident eloping

Licensing Program Analyst (LPA) Mariana Agban conducted an unannounced initial complaint visit regarding the above allegation. LPA arrived at the facility and was granted entry by facility staff. The purpose of the visit was explained. Administrator Harut Topchyan was contacted and arrived shortly thereafter.LPA requested and reviewed pertinent records, including, but not limited to, the staff roster, resident roster, and Resident #1's (R1) file. LPA also conducted a physical plant tour to ensure that residents' health and safety needs were being met and that the facility was operating in compliance with applicable Title 22 regulations. During the visit, LPA interviewed the Administrator, three (3) staff members, and one (1) resident. LPA also attempted to interview four (4) additional residents. Regarding the Allegation: Staff do not provide adequate supervision resulting in resident eloping It is alleged that on 05/22/2026, at approximately 7:15 PM, Resident #1 (R1) was observed traveling unassisted in a wheelchair on a public street. (Continue on 9099C) Substantiated Staff #1 (S1) stated that R1 exited the facility through the side door located in the backyard on 05/22/26 afternoon. S1 mentioned that staff were unaware that R1 had left the facility until a neighbor knocked on the front door and informed staff that R1 was outside on the street. S1 further stated that R1 subsequently returned to the facility through the same side door. Interview with the Administrator confirmed the incident and stated that the side door remained unlocked as part of the facility's emergency evacuation procedures. The Administrator further indicated that R1 appeared to have taken advantage of a time when only one staff member was on duty. Administrator stated that S1 mentioned that R1 was gone for 10 minutes or less near the front door. LPA attempted to interview R1; however, R1 was not present at the facility during the visit. LPA reviewed R1's Medical Assessment dated 06/24/2025, which indicated that R1 was not capable of leaving the facility unsupervised due to physical and cognitive limitations. Based on interviews conducted and records reviewed, there is sufficient evidence to support the allegation that the facility failed to provide adequate supervision to prevent R1 from leaving the facility unsupervised. Therefore, the allegation is deemed Substantiated at this time. An exit interview was conducted. A citation was issued pursuant to Title 22, California Code of Regulations, as referenced on the LIC 9099-D. A copy of this report was reviewed with and provided to the facility Administrator.the state’s words, verbatim · CDSS document, Jun 1, 2026 · control 31-AS-20260526085332

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87468.2(4) · Plan of correction due date: Jun 2, 2026

Additional Personal Rights To care, supervision, and services that meet their individual needs and are delivered by staff that are sufficient in numbers, qualifications, and competency to meet their needs. This requirement is not met as evidenced by: Based on interview and records reviews, licensee did not comply with the section cited above. Facility failed to provide adequate supervision to prevent R1 from leaving the facility unsupervised. This poses an immediate health, safety or personal rights risk to persons in carethe state’s words, verbatim · CDSS document, Jun 1, 2026

Plan of correction: Administrator agreed to conducted in service training for all staff. Staff attendance sheet will be submitted to LPA by 06/03/26. In addition, Administrator will update R1's Appraisal Needs and service plan and submitted to the LPA by 06/03/26.

Allegation investigated: Staff do not provide adequate supervision resulting in resident eloping

Licensing Program Analyst (LPA) Mariana Agban conducted an unannounced initial complaint visit regarding the above allegation. LPA arrived at the facility and was granted entry by facility staff. The purpose of the visit was explained. Administrator Harut Topchyan was contacted and arrived shortly thereafter.LPA requested and reviewed pertinent records, including, but not limited to, the staff roster, resident roster, and Resident #1's (R1) file. LPA also conducted a physical plant tour to ensure that residents' health and safety needs were being met and that the facility was operating in compliance with applicable Title 22 regulations. During the visit, LPA interviewed the Administrator, three (3) staff members, and one (1) resident. LPA also attempted to interview four (4) additional residents. Regarding the Allegation: Staff do not provide adequate supervision resulting in resident eloping It is alleged that on 05/22/2026, at approximately 7:15 PM, Resident #1 (R1) was observed traveling unassisted in a wheelchair on a public street. (Continue on 9099C) Substantiated Staff #1 (S1) stated that R1 exited the facility through the side door located in the backyard on 05/22/26 afternoon. S1 mentioned that staff were unaware that R1 had left the facility until a neighbor knocked on the front door and informed staff that R1 was outside on the street. S1 further stated that R1 subsequently returned to the facility through the same side door. Interview with the Administrator confirmed the incident and stated that the side door remained unlocked as part of the facility's emergency evacuation procedures. The Administrator further indicated that R1 appeared to have taken advantage of a time when only one staff member was on duty. Administrator stated that S1 mentioned that R1 was gone for 10 minutes or less near the front door. LPA attempted to interview R1; however, R1 was not present at the facility during the visit. LPA reviewed R1's Medical Assessment dated 06/24/2025, which indicated that R1 was not capable of leaving the facility unsupervised due to physical and cognitive limitations. Based on interviews conducted and records reviewed, there is sufficient evidence to support the allegation that the facility failed to provide adequate supervision to prevent R1 from leaving the facility unsupervised. Therefore, the allegation is deemed Substantiated at this time. An exit interview was conducted. A citation was issued pursuant to Title 22, California Code of Regulations, as referenced on the LIC 9099-D. A copy of this report was reviewed with and provided to the facility Administrator.the state’s words, verbatim · CDSS document, Jun 1, 2026 · control 31-AS-20260526085332

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87468.2(4) · Plan of correction due date: Jun 2, 2026

Additional Personal Rights To care, supervision, and services that meet their individual needs and are delivered by staff that are sufficient in numbers, qualifications, and competency to meet their needs. This requirement is not met as evidenced by: Based on interview and records reviews, licensee did not comply with the section cited above. Facility failed to provide adequate supervision to prevent R1 from leaving the facility unsupervised. This poses an immediate health, safety or personal rights risk to persons in carethe state’s words, verbatim · CDSS document, Jun 1, 2026

Plan of correction: Administrator agreed to conducted in service training for all staff. Staff attendance sheet will be submitted to LPA by 06/03/26. In addition, Administrator will update R1's Appraisal Needs and service plan and submitted to the LPA by 06/03/26.

Type of visit: Case Management - Deficiencies

In conjunction to the complaint 31-AS-20260526085332 LPA Mariana Agban conducted a Case Management- Deficiencies visit. During the course of the investigation, it was determined that Resident #1 (R1) eloped from the facility on 05/22/26. The investigation further revealed that the facility did not submit a Special Incident Report (SIR) to Community Care Licensing (CCL) as required. The Administrator acknowledged that the incident was not reported to CCL within the required time frame.During the visit, the Administrator provided the LPA with a copy of the completed Special Incident Report regarding the incident. Exit interview conducted, citation issued, copy of this report signed and delivered.the state’s words, verbatim · CDSS document, Jun 1, 2026

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87211(a)(1) · Plan of correction due date: Jun 1, 2026

Reporting Requirements: A written report shall be submitted to the licensing agency and to the person responsible for the resident within seven days of the occurrence of any of the events specified in (A) through (D) below. This requirement is not met as evidenced by Based on interviews and records reviwes, Licensee did not comply with the section cited above.R1's incident was not reported to CCL within the required time frame. This poses a potential health, safety or personal rights risk to residents in carethe state’s words, verbatim · CDSS document, Jun 1, 2026

Plan of correction: Administrator provided the LPA with a copy of the completed Special Incident Report regarding the incident.

Type of visit: Required - 1 Year

At 1:15pm Licensing Program Analyst (LPA), Angela Panushkina, conducted an unannounced annual inspection at the facility mentioned above. LPA met with the Administrator and explained the reason for the visit. At 1:20am, LPA conducted a tour of the facility and the following was observed: Facility is approved for six (6) Non-ambulatory, of which six (6) may be Bedridden. Facility also has a hospice waiver granted for six (6) residents. The facility maintains a comfortable temperature at 71°F. Kitchen: At approximately, 1:25pm LPA toured the kitchen area and observed enough supplies of staple non-perishable for minimum 1 week and perishable for 2 days at the facility. All knives and sharps are observed to be locked in a kitchen drawer and inaccessible to residents. There is a fire extinguisher by the kitchen area and it was last serviced on 02/19/2026. Medications: At approximately, 1:30am LPA observed medications are centrally stored and locked in the kitchen cabinet and inaccessible to residents in care. The first-aid kit has been inspected which has at least the following: tweezers, scissors, antiseptic, bandages, gauze, thermometer; including a current First Aid manual. Bedrooms: There are six (6) bedrooms designated for residents use and have sufficient lighting. All bedrooms are properly furnished, clean and have appropriate bedding and linens. Auditory alarms were tested and observed to be operational. Facility has awake staff at night. Continue on LIC809-C Bathrooms: The facility has three (3) and 1/2 (half) bathrooms. LPA observed all bathrooms have non-skid mat, soap, paper towels and hand washing signs. Extra towels and linens were readily available. The hot water temperature measured at 120°F Common Areas: These include a dining area and a living room. The common areas are furnished with adequate furniture to accommodate a maximum capacity of six (6) residents. Dual smoke and carbon monoxide detectors were located throughout the facility, and at 1:40pm they were tested and observed to be operational. Laundry: Laundry area is located by the garage and LPA observed it to be locked and inaccessible to residents in care. There were no visible immediate hazards. Outside areas: At approximately, 1:45pm LPA toured the outside area of the facility. LPA also observed a clean covered patio and backyard furniture to accommodate the six (6) residents. There is a swimming pool that is fenced all around with a gate that will be kept locked at all times. The fence surrounding the swimming pool is approximately 5 feet high all around. You will need a key to gain entry to the swimming pool as it is kept locked at all times. Between 1:50pm to 2:30pm, LPA reviewed records of five (5) residents and two (2) staff. Resident and staff records appeared to be complete and updated. LPA collected Certificate of Liability Insurance and LIC500. No citations were issued during this visit. Exit interview conducted and copy of this report signed and delivered.the state’s words, verbatim · CDSS document, Apr 15, 2026

Type of visit: Required - 1 Year

At 9:45am, Licensing Program Analyst (LPA) Angela Panushkina arrived at the facility to conduct an unannounced annual inspection. Upon arrival, LPA met with Staff #1, who granted access to the facility. The Administrator arrived shortly after and LPA explained the reason for the visit. At 10:00am LPA conducted a tour of the physical plant and observed the following: Facility is licensed for capacity of six (6) Bedridden and an approved hospice waiver for six (6) residents. Facility has an awake staff. Facility maintains a temperature of 75°F. LPA observed there to be sufficient stock of one-week perishable foods and two-day non-perishable foods. Frozen foods are properly wrapped and stored appropriately. Food storage and preparation areas are clean and inaccessible to pests. All knives were observed to be locked in the kitchen drawer. The fire extinguisher is located in the kitchen and dining areas and were last serviced on 02/19/2025. Facility maintains a temperature of 72°F. Medications were stored in the kitchen cabinet and observed to be locked and inaccessible to residents in care. Resident/staff files are kept in a metal cabinet, located in the dining area and kept locked. There is a complete first-aid kit in the cabinet with all required supplies and with the first aid manual. There are six (6) bedrooms designated for residents’ use, and three (3) and 1/2 (half) bedrooms. Bedrooms are appropriately furnished and have appropriate lighting. Bathrooms have soap, paper towels and all trash cans have a lid. Extra towels and linens were readily available. The hot water temperature measured at 106.2°F. Laundry is located by the garage. Continue on LIC809-C The washer/dryer appear to be in good condition. Laundry supplies, chemicals and detergents are kept locked in the garage and inaccessible to residents in care. Smoke detectors and carbon monoxide monitors were tested at 10:50am and observed to be functional. At 11:00am, LPA observed appropriate outdoor furniture, with a covered shaded area for residents. There is a swimming pool that is fenced all around with a gate that will be kept locked at all times. The fence surrounding the swimming pool is approximately 5 feet high all around. You will need a key to gain entry to the swimming pool as it is kept locked at all times. Between 11:10am to 12:10pm, LPA reviewed records of four (4) residents and two (2) staff. Resident and staff records appeared to be complete and updated. Annual fee paid in full. LPA collected Certificate of Liability Insurance and LIC500. No citations issued during this visit. Exit interview conducted and copy of this report signed and delivered.the state’s words, verbatim · CDSS document, Mar 27, 2025

Type of visit: Prelicensing

At 10:00am Licensing Program Analysts (LPAs) Perchui Milena Khurshudyan and Angela Panushkina conducted an announced Pre-Licensing visit to the above facility and met with Administrator, Harut Topchyan. Fire Clearance was approved on 1/29/2024 for a maximum capacity of six (6) bedridden residents, Facility was also approved for a Hospice waiver for six (6) residents. The purpose of today’s visit is to inspect the facility to ensure that the facility is in compliance with rules and regulations under California Code of Regulations, Title 22, Division 6. The facility is a single-story building. Today's site visit consisted of team touring the physical plant inside and outside and observed the following: KITCHEN: The kitchen is equipped with a refrigerator, microwave oven and sink. At 10:150am, LPAs observed adequate supplies of perishable and nonperishable food and dining ware to accommodate a maximum capacity of six (6). All knives and sharps are observed to be locked in a kitchen drawer and inaccessible to residents. Fire Extinguisher was last serviced on 04/06/23. BEDROOMS: There are six (6) bedrooms designated for client use. Bedroom #4 was furnished with bed, dressers and required bedding and linen. The bedrooms have sufficient closet space and have sufficient lighting. Auditory alarms were tested and observed to be operational. Facility will have awake staff. BATHROOMS: At 10:30am the team observed three and a half (3.5) bathrooms are clean and in good repair. Properly supplied with toilet papers, soap and paper towels. The hot water temperature measured between 120F. observed appropriate grab bar and had non-skid mat. Continue on LIC809-C COMMON AREAS: The facility maintains a comfortable temperature at 71°F. The living room and dining appeared clean and were properly furnished. No obstructions and or tripping hazards throughout the facility. The fireplace located in the dining room is adequately closed and inaccessible. MEDICATION: The medications will be kept in the kitchen cabinet and LPAs observed the cabinet kept locked and inaccessible to residents in care. SMOKE DETECTORS/CARBON MONOXIDE. Smoke detectors and carbon monoxide were located throughout the facility. At 11:00am they were tested and observed to be operational. SURROUNDING GROUNDS: In the back of the facility has sufficient yard space. LPAs observed appropriate outdoor furniture, with a covered shaded area for clients. There is a pool in the backyard which is fenced and has proper locking system. LPAs discussed the importance of maintaining the care and supervision to meet the needs of clients. There are no bodies of water. GARAGE: The attached garage is currently being used for storage. The team observe the garage locked and inaccessible to residents in care. In addition, the team observed laundry room is in a separate locked area before entering the garage. The washer/dryer appear to be in good condition. Laundry supplies are kept inaccessible when not in use with supervision. Component III was conducted with the Administrator. Licensee was encouraged to sign up for sit alerts and guardian for future use and notifications. The Administrator was informed to notify the LPA regarding the first client/resident being admitted to the facility. Facility is in compliance with Title 22 Regulations at this time. This report will be forwarded to the Centralized Application Bureau (CAB) and be notified by the CAB Analyst when your license has been approved. Exit interview was conducted and with a copy of this report was provided to the Applicant/Administratorthe state’s words, verbatim · CDSS document, Apr 12, 2024

Type of visit: Office

Facility Type: RCFE Application Type: Initial Capacity: 6 Census (if any clients in care): 0 COMP II Participants: Topchyan, Harut - Applicant/Administrator Interview Method: Virtual interview (Skype, Go To Meeting, etc) On 03/28/2024, applicant/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/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, Mar 28, 2024