Amazing Senior Care

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Leslie Ngo-Castaneda conducted an annual required visit and inspection of the facility. LPA met with staff, Karine Zakaryan, and explained the reason for the visit. At 9:00 AM administrator,Yelena Aladadyan, arrived and was explained the reason for the visit. At 9:58 AM, with the assistance of administrator, LPA took a tour of the physical plant. Required postings were observed in the entry area. At 10:33 AM smoke alarms were tested and are operational. There are carbon monoxide detectors that functions properly. The fire extinguisher is in between the dining area and the office with a charge date of 1.24.2025. During the visit the facility is at 72 degrees Fahrenheit. The facility is fire cleared for six (06) non-ambulatory residents; one (1) may be bedridden; hospice waiver for six (6). Kitchen: The kitchen appliances and fixtures were functional. The kitchen has a working gas stove, faucet, freezer, refrigerator, and microwave. LPA found enough at least two (2) days perishable and seven (7) days non-perishable food at the facility that is properly stored. Frozen foods are wrap, dated, and stored properly as well. Knives were stored in a locked drawer in the kitchen. Properly labeled medications were locked in the office area cabinets. Bedrooms: There were four (4) bedrooms designated for residents' use. Four (4) of the that are in use by the residents were properly furnished with appropriate dresser, beddings, and linens with sufficient lighting. Bedroom #1 and #2 are properly furnished and is for private used. Bedroom #3 and bedroom #4 are shared. Continue to LIC 809-C Bathrooms: There are two (2) bathrooms designated for residents' use. Bathrooms were properly supplied and had functional fixtures. Hot water temperature was measured at 107.2 degrees Fahrenheit for bathroom #1 located in the hallway in the hallway the entrance of the facility. Bathroom #2 measured 110.1 degrees Fahrenheit inside bedroom #2. Towels and washcloths are not shared. There was enough clean linen available in the cabinets in the hallway. Common Areas: These included the living room and dining area for residents. The common areas were properly furnished. The auditory alarms on all exit doors were on and functional at the time of the visit. Residents dining table fits enough for six (6). Office space is by the dining area and kitchen. Fireplace is block-off, non-operational and inaccessible to residents. Surrounding Grounds: Entry and exits were free of obstruction. There was furniture appropriate for outdoor use. The outdoor area was free of hazards. The laundry area and detergents are located by the laundry room by the kitchen that is kept secured. Cleaning supplies are being stored in a locked cabinet in the laundry room. The facility does have a swimming pool or body of water, this is fenced, blocked off, and locked. The garage is attached and is used for storage. Resident Files: LPA conducted a file review of resident records to ensure compliance of licensing forms. Staff Files: LPA also conducted a file review of staff records to ensure forms and training are up to date and compliance with licensing forms. Medications: Medication and Medication Records (MMR) were review for proper documentation. Pursuant to Title 22 Division 6 of the CA Code of Regulations, no deficiencies were observed during the visit. Exit interview conducted and a copy of the report issued.the state’s words, verbatim · CDSS document, Sep 10, 2025

Type of visit: Case Management - Annual Continuation

Licensing Program Analyst (LPAs) Leslie Ngo-Castaneda and Huma Rahimi conducted an continuation annual required visit and inspection of the facility. At 11:40 AM Yelena Aladayan who is the administrator met with LPA, explained the reason for the visit. At 11:45 AM, with the assistance of administrator, LPAs took a tour of the physical plant. Required postings were observed in the entry area. The smoke alarms are operational that are located each bedroom, the hallway and kitchen. There are carbon monoxide detectors that functions properly. The fire extinguisher is in the kitchen. The charge date is 11/01/2023. During the visit the facility is at 74 degrees Fahrenheit. The facility is fire cleared for six (06) non-ambulatory residents. Kitchen: The kitchen appliances and fixtures were functional. The kitchen has a working gas stove, faucet, freezer, refrigerator, and microwave. LPAs found enough at least two (2) days perishable and seven (7) days non-perishable food at the facility that is properly stored. Frozen foods are wrap, dated, and stored properly as well. Knives were stored in a locked drawer in the kitchen. Food storage and preparation areas are clean and inaccessible to pests. Garbage cans have tight fitting covers. Cleaning supplies, pesticides or toxic cleaning supplies were stored and not locked away in the kitchen. Citation will be issued in LIC 809-D. Bedrooms: There were four (4) bedrooms designated for residents' use. Bedroom #2 and bedroom #4 are private, but bedroom #1 and bedroom #3 are shared. All of the bedrooms are used by residents were properly furnished with appropriate dresser, beddings, and linens with sufficient lighting. Continue to LIC 809-C Bathrooms: There are two (2) bathroom designated for residents' use. The bathrooms were properly supplied and had functional fixtures. Hot water temperature was measured at 109.6 degrees Fahrenheit for bathroom #1 located in the hallway beside room #1. Bathroom #2 is inside bedroom #3. Hot water temperature was measured at 112.8 degrees Fahrenheit. There was enough clean linen available in the cabinets in the hallway. Common Areas: LPA toured all common areas of the facility. These included the living room and dining area for residents. The common areas were properly furnished. Residents dining table fits enough for six (6). LPA observed common areas to be very clean and tidy. LPA observed the floors to be in very good condition. No obstructions and or tripping hazards throughout the facility. Furniture in common area was observed to be in good repair. There are no issues with Fire Clearance. Infection control: Facility mitigation plan to make sure licensee was following current infection control recommendations. LPA obtain a copy and reviewed the infection control plan during this visit. Surrounding Grounds: Entry and exits were free of obstruction. There was furniture appropriate for outdoor use. The outdoor area was free of hazards. The facility has a swimming pool, it is locked and fenced up. The garage is attached and is used for storage. LPA found expired medication from previous resident who had passed. Deficiency will be cited on LIC 809-D. Laundry service: There is enough linen available to change weekly or more if need. LPA found cleaning supplies are being stored in an unlocked cabinet in the laundry area and is located beside the kitchen. Deficiency will be cited on LIC 809-D. Staff Files: LPA also conducted a file review of staff records to ensure forms and training are up to date and compliance with licensing forms. Office space is beside the dining table. Records were checked for expired or missing certificates and clearances: LPA conducted a file review of staff for criminal record clearances and current First Aid. LPA did a record review for S4 file and their missing a current CPR training. Citation will be issued in LIC 809- D. The administrator file was reviewed for current first aid, fingerprint clearance, administrator certificate, and HIV/AIDS and TB training. Continue to LIC 809-C Medications: LPAs observed that the medication are kept in the living room in a locked cabinet and inaccessible to residents in care, however, review of R1's random medication revealed that the facility was supposed to start Quetiapin Fumarate 25 MG (schizophrenia and bipolar disorder) a new bubble pack on 10/20/2024. During today's visit LPAs counted R1's medication and it was discovered that there was a discrepancy, and three (3) extra pills were in the bubble pack. LPA asked the Administrator and the staff for explaining and both staff could not provide any answers. Additionally, LPAs also observed Centrally Stored Medication (LIC 622) records for R5 and did not observe staff filling the form when the medication start date. A deficiency will be cited. First-aid has all proper items and is current. Resident records were reviewed for requirements and legibility: Planned activities are offered. LPA reviewed six (6) of the six (6) records and LPA found all files to be complete. Facility is within CA code of Regulations Title 22 or Health and Safety Code. Deficiencies were found, exit interview conducted, copy of report has been issued and discussed.the state’s words, verbatim · CDSS document, Nov 7, 2024

Type of visit: Required - 1 Year

Licensing Program Analysts (LPA), Leslie Ngo-Castaneda conducted an unannounced Required 1-year inspection at this facility at approximately 12 NN LPA were greeted by staff, Shake Sargysyan and was explained the reason for the visit. at 12:10 PM the administrator arrived and was disclosed the purpose of the visit. LPAs conducted a tour of the physical plant at approximately 12:04 PM to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. Common areas were observed for the ability to safely serve the needs residents. These included the kitchen, dining room area and living room. The common areas were checked for cleanliness and furniture was checked for functionality. Common areas observed to be furnished appropriately. LPA reviewed the food service areas, food storage and supply (perishable and nonperishable foods). The kitchen food supply was observed and sufficient for the five (5) residents currently residing there. Two (2) days of perishable food observed. The freezer is stocked with meats and frozen vegetables. Sharps are stored in locked kitchen drawer. The resident medications are locked in office cabinets near the kitchen. The medications were observed to be inaccessible to residents. There is one (1) fire extinguishes located in the kitchen. Fire extinguishers observed to be charged at 11.1.2023. Laundry room beside the kitchen and has an attached garage. The appliances observed to be functional. Due to time constraints this required annual will be completed at a later time. Exit interview conducted/Copy of report giventhe state’s words, verbatim · CDSS document, Sep 18, 2024

Allegation investigated: Staff are unable to communicate with residents. Staff do not ensure residents are served food of good quality.

On 02.21.2024 License Program Manager (LPM) Nichelle Gillyard and Licensing Program Analysts (LPA) Leslie Ngo-Castaneda arrived at the facility to conduct an unannounced subsequent visit to deliver the determination on the above allegations. LPA was greeted by Staff #1 (S1) who granted access. S1 contacted the administrator Yelena Aladadyan (S2) to advised that LPA was at the facility. Administrator arrived at 9:28 AM, LPA explained the purpose of the visit. At 9:10 AM LPM and LPA conducted a physical plant tour to ensure the health and safety of the residents in care. Allegation #1: Staff are unable to communicate with residents. Continue to LIC 9099-C Substantiated Licensing Program Analyst (LPA) Leslie Ngo-Castaneda conducted a subsequent complaint visit. Regarding the allegation above it is alleged that facility staff are unable to communicate with residents due to a language barrier. On 02-14-2024 LPAs investigated this complaint. LPAs conducted interviews and concluded that the one and only staff on duty at the time of this investigation was unable to effectively communicate with the residents of which the majority speak English. Staff used a translator to attempt to communicate. Staff was unable to effectively communicate on how to address an emergency should one happen. Staff on duty was unable to effectively communicate in English. At 9:30 AM LPA initiated interviews with six(6) residents. Four (4) out of six (6) residents have trouble communicating with staff for their basic needs. LPA then asked a series of questions to S1 regarding basic needs and care for the residents. S1 was confused, unable to respond or answer any of the questions. This complaint allegation, Staff are unable to communicate with residents is substantiated. Allegation #2: Staff do not ensure residents are served food of good quality. To investigate this allegation, License Program Analyst (LPA) Leslie Ngo-Castaneda conducted toured the home, observed food service, conducted file reviews, and interviewed residents at 9:38AM. LPA observed there to be 2 days of non-perishable and one week of perishable foods. Foods observed were high is sodium and sugar. Foods included frozen pizza, mini-sausages, pizza, cans of soup canned corn, canned peas, pasta and Sunny D. LPAs observed minimal fresh fruit and or vegetables. LPAs reviewed resident’s records and per the resident’s physicians reports 6 out of 6 resident are on modified diets. LPA interviewed four (4) out of six (6) residents who stated the LPAs that the facility does not provide fresh food and the food is mostly canned with too much salt. Residents gave sample of food that was serve: microwaved soggy pizza that is un-edible, canned corn/ peas, or spaghetti with ketchup. During the visit, LPA observed canned chicken noodle soup, mini-sausages, untoasted one (1) slice of white bread smeared with butter, and bottled sunny-d orange juice was served for lunch. Moreover, an interview with staff confirmed that the facility does not follow the sample food menu posted in the kitchen to provide quality food to the residents. LPA requested staff training regarding food service and modified diets. There was no training. Based on the information gathered, there is sufficient evidence to conclude allegation is substantiated. Exit interview conducted. Copy of this report issued To investigate the allegation License Program Analysts (LPAs) Leslie Ngo-Castaneda & Perchui Khurshudyan conducted an initial visit on 02.14.2024. LPAs reviewed six (6) out of six (6) Centrally Stored Medication and Destruction Records (CSMDR). Records indicated the name and quantity of medication when R1 arrived at facility on 1.29.2024, this is then accounted for during LPAs visit. Base on LPA observation, medication was accounted for all the residents on CSMDR and medication in the facility. Based on medication records, interviews and observation, there is not enough evidence that medications were not given or misplaced. Therefore, the allegation is deemed UNSUBSTANTIATED at this time. Exit interview conducted and copy of report given to administrator.the state’s words, verbatim · CDSS document, Feb 21, 2024 · control 31-AS-20240205143554

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87411(d)(3) · Plan of correction due date: Feb 21, 2024

Personnel Requirements - General (d) (3) Skill and knowledge required to provide necessary resident care and supervision, including the ability to communicate with residents. This requirement is not met as evidenced by: Based on an interview with the Administrator, during a previous visit conducted by the staff did not comply with the section cited above by not having staff that could communicate with residents, which poses and immediate Health and Safety and personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Feb 21, 2024

Plan of correction: Facility will have to train and ensure staff to have staff to properly comnunicate with the residents. This will be submitted to regional by 3.6.2024

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87555(a) · Plan of correction due date: Feb 21, 2024

General Food Service Requirements: The total daily diet shall be of the quality and in the quantity necessary to meet the needs of the residents and shall meet the Recommended Dietary Allowances of the Food and Nutrition Board of the National Research Council. All food shall be selected stored, prepared, and served in a safe and healthful manner. This requirement is not met as evidenced by: Based on observation facility did not served healthy food to the residents, which poses and immediate Health & Safety and personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Feb 21, 2024

Plan of correction: Facility will need to have a new menu available for residents for breakfast, lunch, snacks and dinner. This will be submitted to regional office by: 3.6.2024

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87411(d)(1) · Plan of correction due date: Feb 21, 2024

All personnel shall be given on the job training or have related experience in the job assigned to them. This training/ related experience shall provide knowledge of and skill in the following, as appropriate for the job assigned and as evidenced by safe and effective job performance: (1) Principles of good nutrition, good food preparation and storage, and menu planning. This requirement is not met as evidenced by: Facility was serving canned and frozen food.the state’s words, verbatim · CDSS document, Feb 21, 2024

Plan of correction: Facility will need to have a new menu available for residents for breakfast, lunch, snacks and dinner. This will be submitted to regional office by: 3.6.2024.