A Paradise in the Valley

Type of visit: Required - 1 Year

On 07/28/25 at 9:05AM, Licensing Program Analyst (LPA) Gina Saucedo conducted an unannounced, Annual Inspection and met with Arsen Der-Aprahamian, Administrator. The physical plant was toured inside and out at 9:35 am. Living/Dining Room Area: LPA observed the living room furniture to be clean and in good repair. The living room has a large television. The facility maintains a comfortable temperature at 75 degrees Fahrenheit. Bedroom: There are four (4) bedrooms for residents. One (1) of the bedrooms has a private bathroom. There is an upstairs bedroom that can be accessed via a door that is locked and inaccessible to the residents where the washer and dryer are located. The upstairs bedroom is for staff only. There is a private bathroom upstairs also. LPA observed rooms to have bedding sheets, pillowcase, blankets, nightstands, televisions, and sufficient lighting for each of the resident’s room. In between one (1) of the rooms down the hallway is a linen pantry. Bathrooms: There are two (2) bathrooms that are separated. One (1) is located in between down the hallway and the other bathroom is next to the kitchen area. The hot water temperatures were measured and were within regulations of 105 degrees. The showers have non-slip bathmats and grab bars. Medications were kept in a locked pantry on the left-hand side of the kitchen locked and inaccessible to the residents. All medications were properly labeled. The first aid kit and the files are kept also in the medication area. LIC809C-continued Kitchen Area: LPA inspected the kitchen area. There is one (1) refrigerator which was clean and in good operation in this area. LPA observed sufficient supply of seven (7) day non-perishable and perishable foods in the cabinets. The knives/sharps are in the kitchen on your left-hand side, inaccessible to the residents. There is a pantry area full of non-perishables. The telephone line is on the counter. There is one (1) fire extinguisher fully charged and is dated 04/2025. Outside: LPA toured the outside area. LPA observed a covered shaded area for residents and appropriate outdoor furniture. The facility has no bodies of water on the premises. There is one (1) gate that is unlocked leading to the outside area towards the street. There is a shed at the entrance of the facility on your left-hand side next to a large barbecue grill. The carbon monoxide and the smoke detector were tested, and they were operable, interconnected. There is a garage outside and the ADU is located next to it. There is another washer and dryer in this area. Let it be noted, the ADU is not occupied and there is storage items inside of it. There is a current building permit that was received 03/28/24 and updated on 09/16/24. The facility sketch has been updated but not approved by the city and/or CCLD-Community Care Licensing Department. LPA was able to tour and observe the ADU. The facility has a signal system. Administration: The Liability Insurance was reviewed and will be expire in 12/2025. There are several Covid 19 signs on the wall, hygiene sanitation signs, and the Ombudsman sign against the walls of the facility, YES, Bill of Rights, Facility Sketch, and Personal Rights at the entrance of the facility. The Emergency Disaster Plan and Mitigation Plan were in a binder. The last fire drill was conducted in May 2025. An exit interview was conducted, no citation(s) were issued, and a copy of this report was given to the administrator.the state’s words, verbatim · CDSS document, Jul 28, 2025

Type of visit: Required - 1 Year

On 08/07/24 at 8:40 AM, Licensing Program Analyst (LPA) Gina Saucedo conducted an unannounced, Annual Inspection and met with Caregiver, Julieta Avagyan. LPA asked for the census, staff and resident files. The Administrator arrived about fifteen (15) minutes later. The physical plant was toured inside and out at 9:05 am. Living/Dining Room Area: LPA Saucedo observed the living room furniture to be clean and in good repair. The living room has a large television. The facility maintains a comfortable temperature at 79 degrees Fahrenheit. Bedroom: There are four (4) bedrooms for residents. One (1) of the bedrooms has a private bathroom. There is an upstairs bedroom that can be access via a door that is locked and inaccessible to the residents where the washer and dryer are located. The upstairs bedroom is for staff only. There is a private bathroom upstairs. LPA observed rooms to have bedding sheets, pillowcase, blankets, nightstands, televisions, and sufficient lighting for each of the resident’s room. In between one (1) of the rooms down the hallway is a linen pantry. Bathrooms: There are two (2) bathrooms that are separated and were checked to make sure bathrooms were clean and in good repair that in the hallway. There is a total of four (4) bedrooms in the house. The hot water temperatures were measured within regulations of 112 degrees. The showers have non-slip bathmats and grab bars. The ADU has one (1) bathroom inside and another bathroom on the side. Medications were kept in a locked pantry on the left-hand side of the kitchen locked and inaccessible to the residents. All medications were properly labeled. The first aid kit and the files are kept also in this pantry. LIC809C-continued Kitchen Area: LPA inspected the kitchen area. There is one (1) refrigerator which was clean and in good operation in this area. LPA observed sufficient supply of seven (7) day non-perishable and perishable foods in the cabinets. The knives/sharps are in the kitchen on your left-hand side, inaccessible to the residents. There is a pantry area full of non-perishables. The telephone line is on the counter. There is one (1) fire extinguisher fully charged. Outside: LPA toured the outside area. LPA observed a covered shaded area for residents and appropriate outdoor furniture. The facility has no body of water on the premises. There is one gate that is unlocked leading to the outside area towards the street. There is a shed at the entrance of the facility on your left-hand side next to a large barbecue grill. The washer and dryer are located inside a closed door next to the kitchen area leading to the upstairs. The chemicals are in this area inaccessible to the residents. The carbon monoxide and the smoke detector were tested, and they were operable, interconnected. There is a garage outside and a storage area that was converted to an unauthorized ADU with a kitchen and bathroom and on the side of the ADU is two (2) side doors-one (1) is a bathroom and (1) is a washer and dryer room. There is a current building permit that was received 03/28/24. Let it be noted, there has been changes to the original facility sketch. LPA was able to tour and observe the ADU. There is a signal system for the facility. Administration: The Liability Insurance was reviewed and will be expire in 12/2024. There are several Covid 19 signs on the wall, hygiene sanitation signs, and the Ombudsman sign against the walls of the facility, YES, Bill of Rights, Facility Sketch, and Personal Rights at the entrance of the facility. The Emergency Disaster Plan and Mitigation Plan were in a binder. An exit interview was conducted, no citation(s) were issued, and a copy of this report was given to the administrator.the state’s words, verbatim · CDSS document, Aug 7, 2024

Allegation investigated: Staff caused injury to resident in care Staff did not change resident's clothing for multiple days Staff restrained residents in care Staff do not provide adequate supervision to residents in care

On 01/08/24, at 9:25am, Licensing Program Analyst (LPA) Gina Saucedo arrived at the facility to conduct an unannounced, subsequent, complaint visit and was greeted by housemanager Narine Petikyar (S2). LPA asked for the census, staff, and resident files. Administrator Arsen Der-Aprahamian (S1) arrived about 20 (twenty) minutes later. Regarding the allegation: Staff caused injury to resident in care. It is being alleged that R1 and R2 sustained an injury to R1’s eye earlier this year because staff hit them. Based on the resident, staff interviews and LPA record review, staff do no cause injury to residents in care. R3 states, “they treat me like a family member, they went out to eat the other day and brought me some food.” LPA did not observe any injuries to residents in care. LIC 9099-C continued Unsubstantiated Regarding the allegation: Staff did not change resident's clothing for multiple days. It is being alleged that the residents wear the same clothes for several days and are not changed by staff. Based on the resident, staff interviews and LPA observation staff change the resident’s clothing often. R1 states, “I can choose what to wear that day.” LPA did not observe the same clothing on the residents during LPA’s subsequent visit. Regarding the allegation: Staff restrained residents in care. It is being alleged that R1 and R2 are being tied down to their beds and wheelchairs with cloth straps. RP states there is no doctor’s order for the straps. LPA reviewed the record files and observed that there is a doctor’s order for the straps (postural support) and for the bed rails dated on 05/18/23, 07/21/23 and 09/29/23. Regarding the allegation: Staff do not provide adequate supervision to residents in care. It is being alleged staff intimidate the residents. Based on resident, staff interviews and LPA observation adequate supervision is provided. LPA observed R1 spends their time in the kitchen area with staff, R2 and R3 are in their room with a signal alarm button to call staff if they need anything. In addition, R1 states, “my husband is sick.” LPA observed R2 and R3 in their room due to limited mobility. LPA also observed music being played for R2 in their room. LPA did not observe inadequate supervision to residents in care. Based on the LPA's interviews, observations, and record reviews all four allegations above are unsubstantiated at this time. All copies of record/files were obtained. An exit interview was conducted, no citations were issued for the four (4) above allegations, and a copy of this report was given to the administrator.the state’s words, verbatim · CDSS document, Jan 8, 2024 · control 31-AS-20231214143834

Allegation investigated: Staff do not accord reasonable level of privacy to residents in care

On 12/19/23, at 09:30am, Licensing Program Analyst (LPA) Gina Saucedo and Tihesha Smith arrived at the facility to conduct an unannounced, initial complaint visit and was greeted by a staff. Administrator, Arsen Der-Aprahamian arrived later. LPA’s requested the census, staff, and resident files. Regarding the allegation: Staff do not accord reasonable level of privacy to residents in care. It is alleged that there is a camera in the room on top of the table or sometimes on top of the dresser. At 10:05 am, LPA's conducted the physical tour and observed a camera to be in Resident #1 (R1) and Resident #2 (R2)'s room on top of the dresser. Therefore, based on LPA's observations there is a preponderance of evidence to substantiate the above allegation(s). Per the California Code of Regulations, Title 22, deficiency is cited on the attached LIC-9099D. An exit interview was conducted, citation given, appeal rights, and a copy of this report was given to the administrator. Substantiatedthe state’s words, verbatim · CDSS document, Dec 19, 2023 · control 31-AS-20231214143834

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87468.2(a)(1) · Plan of correction due date: Dec 19, 2023

87468.2 Additional Personal Rights of Residents in Privately Operated Facilities (a)In addition to the rights listed in Section 87468.1, Personal Rights of Residents in All Facilities, residents in privately operated residential care facilities for the elderly shall have all of the following personal rights: This requirement is not met as evidenced by: Based on the observation and interviews the licensee/administrator did not ensure two out of three residents at the facility to have privacy thus violating their personal rights which poses immediate Health, Safety or Personal Rights risks to person in care.the state’s words, verbatim · CDSS document, Dec 19, 2023

Plan of correction: The licensee/administrator immediately removed the camera from the top of the dresser. POC 12/20/23 Defiency cleared at time of visit.

The state marks this report as 3 pages; the online copy we transcribed has 2. You can request the full file from the county licensing office.

Type of visit: Case Management - Deficiencies

Licensing Program Analysts (LPAs), Tihesha Smith and Gina Saucedo conducted a case management visit in conjunction with a complaint visit at this facility. Licensing staff conducted a tour of the physical plant at approximately 10:05 am and reviewed resident and facility records. LPA Smith discussion with Administrator at approximately 11:15 am revealed that no changes or corrections deficiencies noted during visit on 9/28/23 have been addressed. Administrator states have obtained an agreement with a contractor. LPA requested a copy and Administrator emailed copy to email LPA Smith. Deficiencies are cited and noted on LIC 809D. Exit interview conducted, appeals, and copy of report provided.the state’s words, verbatim · CDSS document, Dec 19, 2023

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87307(a) · Plan of correction due date: Dec 22, 2023

7307(a) Personal Accommodations and Services. Living accommodations and grounds shall be related to the facility's function. The facility shall be large enough to provide comfortable living accommodations and privacy for the residents, staff, and others who may reside in the facility. This requirement is not met as evidenced by: Based on physical plant inspection Licensing staff observed: bed in storage room, staff accommodations in room identified as a garage, and staff room in ADU structure area which is not designated as staff rooms in the plan of operation or on facility sketch.the state’s words, verbatim · CDSS document, Dec 19, 2023

Plan of correction: With in 24 hours the Licensee will provide written documentation certifying that no individual will be living/sleeping in the storage room or other areas on the property that does not have approved permits from appropriate government agencies. Remove bed or provide documentation that areas previously discussed are not apart of the facilities. Poc due date:12/22/2023

From the deficiency page — Deficiency type: Type A · Section cited: CCR87608(a)(3) · Plan of correction due date: Dec 20, 2023

A written order from a physician indicating the need for the postural support shall be maintained in the resident’s record. The licensing agency shall be authorized to require other additional documentation if needed to verify the order. This requirement is not met as evidenced by: Based on observation the licensee failed to ensure that Resident has a written order for postural support placed on Residents bed. This poses an immediate health and safety risk to the residents in care.the state’s words, verbatim · CDSS document, Dec 19, 2023

Plan of correction: The Licensee/Administrator will contact resident physicians to obtained required medical documentation for postural supports. POC due date:12/20/23

Type of visit: Case Management - Annual Continuation

Licensing Program Analysts (LPAs), Tihesha Smith and Gina Saucedo with Licensing Program Manager (LPM) Naira Margaryan conducted an unannounced 1-year inspection continuation visit at this facility at approximately 10:35 am. Licensing staff were greeted by staff and disclosed the purpose of the visit. The administrator was contacted and arrived later. Licensing staff conducted a tour of the physical plant at approximately 10:45 am to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. The property has an upstairs area used as staff/family live-in accommodations. The storage area where toxins are stored had bed used for family of staff sleeping area. Attached garage converted to live-in staff accommodations. There is also a sunroom added to the property. Each bathroom has posted “wash your hands” signs and the following items available: hand soap, paper towels, and trash cans. The hot water temperature was measured for the two (2) residents’ bathrooms to ensure it is within the required range for residents’ comfort and safety. The water temperature range was between 110.8- and -110.58-degrees Fahrenheit. Smoke detectors/carbon monoxide detector (interconnected) were tested and operable at time of initial visit on 09/12/23. Backyard has the following: Four Covered patio areas with four (4) tables and chairs. Patio furniture observed to be in good repair with sufficient seating for the residents. There is an unapproved structure on property in back area consisting of a detached garage, staff live-in accommodations, laundry and storage room, and an additional bathroom. (Cont from 809) At approximately 12:50 pm, LPAs conducted record review and staff interviews. Resident files included but not limited to physicians’ assessment, admission agreements, personal rights, and centrally stored medications. Staff files reviewed for three (3) staff. Staff files had TB screenings, caregiver trainings and current First aid/AED/CPR certificates. Citations issued, exit interview conducted, appeals and copy of report provided to Licensee.the state’s words, verbatim · CDSS document, Sep 28, 2023

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87608(1) · Plan of correction due date: Sep 29, 2023

(1) Postural supports shall be limited to appliances or devices such as braces, spring release trays, or soft ties, used to achieve proper body position and balance, to improve a resident's mobility and independent functioning, or to position rather than restrict movement including, but not limited to, preventing a resident from falling out of bed, a chair, etc. This requirement was not met as evidenced by: Based on observation the licensee did not comply with the section cited above by using a cloth strap to restrict resident’s movement such as falling out a chair which poses an immediate health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Sep 28, 2023

Plan of correction: The Licensee/Administrator will contact resident physicians to obtained required medical documentation for postural supports. POC due date:09/29/2023 This citation was corrected at time of visit. Administrator received postural support precription from doctor and verifyed by LPM Margaryan.

From the deficiency page — Deficiency type: Type A · Section cited: CCR87305(a) · Plan of correction due date: Sep 29, 2023

87305 (a) Prior to construction or alterations, all facilities shall obtain a building permit. This requirement was not met as evidenced by: Based on observation and admission of Licensee/administrator he did not comply with the section cited above by making changes to facility without notifiying CCLD or obtaining required permits.the state’s words, verbatim · CDSS document, Sep 28, 2023

Plan of correction: Within 24 hours the Licensee will provide a written plan of action explaining the steps they will follow to bring physical plant to compliance. POC due date: 09/29/23.

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87307(a) · Plan of correction due date: Sep 29, 2023

87307(a) Personal Accommodations and Services. Living accommodations and grounds shall be related to the facility's function. The facility shall be large enough to provide comfortable living accommodations and privacy for the residents, staff, and others who may reside in the facility. This requirement is not met as evidenced by: Based on physical plant inspection Licensing staff observed: bed in storage room, staff accommodations in room identified as a garage, and staff room in ADU structure area which is not designated as staff rooms in the plan of operation or on facility sketch.the state’s words, verbatim · CDSS document, Sep 28, 2023

Plan of correction: With in 24 hours the Licensee will provide written documentation certifying that no individual will be living/sleeping in the storage room or other areas on the property that does not have approved permits from appropriate government agencies. Poc due date:09/29/23