A'One Villa Assisted Living

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Angela Barutyan arrived at the facility unannounced to conduct a required annual visit at 01:30PM. LPA was greeted at the door by staff and the reason for the visit was explained. Administrator could not be present for today’s visit. Entrance interview conducted. At 01:58PM, the LPA along with staff toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. KITCHEN: The LPA inspected the kitchen/food service area at 01:58PM. Kitchen appliances appeared clean and were in operable condition at the time of the visit. The facility had a sufficient supply of perishable and non-perishable food. Food labels were inspected and checked for expiration dates and food labels had expiration date clearly marked. At 2PM, LPA observed the knife drawer lock inoperable. Staff repaired the lock immediately. At 02:05PM, LPA observed expired milk dated 02/11/2026, cottage cheese dated 01/03/2026, and expired bell peppers. Staff discarded all items immediately. Fire extinguishers were fully charged and last serviced 12/28/2025. BEDROOMS: There are seven (7) bedrooms total of which six (6) are for single resident-use and one (1) is for staff-use. LPA observed resident bedrooms to be furnished appropriately with clean linens, appropriate furnishings, and sufficient lighting. Staff locked staff room during visit. At 02:17PM, LPA observed the smoke detector in Bedroom #5 was inoperable as it was detached and on the night stand. Staff stated that Bedroom #5 is currently vacant. Staff re-installed the smoke detector and LPA observed the detector to be operational. LPA observed bedroom exits to the exterior not equipped with auditory exit alarms. Report Continued on LIC 809-C RESTROOMS: There are seven (7) restrooms of which six (6) are either attached/adjacent to resident rooms and one (1) is in the hallway for staff and visitors. Restrooms were clean, sanitary, and in operating condition with grab bars and slip-resistant surfaces. Hot water temperatures were measured in restrooms and were between 115.2-117.7 degrees F, which is within the required range. COMMON AREAS: At the time of the visit, living room and dining room furniture were observed to be in good condition. The facility maintained a comfortable temperature. At 02:28PM, smoke detector(s), carbon monoxide detector, and fire doors were tested and were operational at the time of the visit. Auditory exit alarms were functioning. LPA did not observe required postings such as the Ombudsman Poster, DSS Complaint Poster, and facility sketch throughout the common spaces. OUTDOOR AREA: LPA observed the back and front patio which has a covered outdoor area for resident use. The property is gated. Passageways were free and clear from obstruction. There are no bodies of water on the premises. There are two (2) locked storage sheds. RECORD REVIEW: Will be reviewed during annual continuation. MEDICATION REVIEW: Will be reviewed during annual continuation. INFECTION CONTROL/EMERGENCY DISASTER PLANNING: Will be reviewed during annual continuation. Due to time constraints, LPA will return at a later date to continue the inspection. The following deficiencies were observed (See LIC 809-D) and cited from the California Code of Regulations, Title 22 and/or California Health and Safety Code. Civil penalties were issued in the amount of $500 for fire clearance violation. Administrator was informed that failure to correct deficiencies may result in additional civil penalties. Exit interview conducted. Appeal rights and a copy of the report was provided.the state’s words, verbatim · CDSS document, Feb 18, 2026

The state marks this report as 7 pages; the online copy we transcribed has 5. You can request the full file from the county licensing office.

Allegation investigated: Illegal Eviction

Licensing Program Analyst (LPA) Angela Barutyan arrived at the facility unannounced to conduct a subsequent complaint investigation at 10:30AM. Upon arrival, LPA met with construction workers who called Administrator Granie Pangilinan at 10:33AM. LPA called Licensee Jagdeep Singh at 10:36AM who arrived at 12:58PM. Administrator was unable to be present during the visit. Entrance interview conducted. During today’s visit, LPA Barutyan interviewed the Licensee telephonically and observed the facility currently under construction with no residents. During the initial visit on 07/29/2025, LPA conducted a physical plant tour and observed no residents residing at the facility, conducted interviews, reviewed and obtained copies of pertinent documents relevant to the investigation, and discussed allegation with Licensee telephonically. Report Continued on LIC 9099-C. Substantiated It was alleged that Resident #1 (R1) was issued an unlawful eviction notice on 06/30/2025. LPA reviewed the eviction notice dated 06/30/2025 which states, “This letter is to inform you that the ownership of A 'One Villa Assisted Living is in the process of being transferred to new management. As part of the Change of Ownership procedure, the new members are required to apply to the California Department of Social Services (CDSS). Due to this transition, we are issuing a 30-day notice for you to vacate the facility, effective June 30, 2025. We kindly ask that you arrange to relocate by July 30, 2025, to accommodate this required process.” R1 moved out of the facility on 07/25/2025. Per regulation, a change of ownership (CHOW) does not meet eviction criteria. A CHOW for a facility with admitted residents does not require current residents to be relocated; the same residents can be retained by the prospective new licensee. The facility also did not notify the Department of the issued eviction notice, which was cited on a separate report, and the eviction notice did not include statements required by the Health and Safety Code, including: a statement informing residents of their right to file a complaint with the licensing agency including contact information for the licensing office with whom the licensee normally conducts business, and the State Long Term Care Ombudsman office; AND the exact statement as specified in Health and Safety Code Section 1569.683(a)(4) regarding the facility’s requirement to file an unlawful detainer action in superior court should a resident remain after the effective date of the eviction. Interviews conducted with R1’s responsible party and staff confirmed that a corrected notice was not issued and that the reason for eviction was due to the CHOW and not any of the valid reasons that meet eviction criteria, such as nonpayment of rent or failure of the resident to comply with general policies of the facility. Based on interview and record review, the allegation “Illegal Eviction” is deemed SUBSTANTIATED at this time. The following deficiency was observed (See LIC 9099-D) and cited from the California Code of Regulations, Title 22 and/or California Health and Safety Code. Licensee was informed that failure to correct the deficiency may result in civil penalties. Exit interview conducted. Appeal rights and a copy of the report were provided.the state’s words, verbatim · CDSS document, Sep 4, 2025 · control 29-AS-20250723152952

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87224(a) · Plan of correction due date: Sep 11, 2025

87224 Eviction Procedures (a) The licensee may evict a resident for one or more of the reasons listed in Section 87224(a)(1) through (5)... This requirement is not met as evidenced by: Based on record review and interview, the licensee did not comply with the section cited above as a resident was issued an eviction notice for reasons not listed in eviction criteria which posed a potential health, safety, and personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Sep 4, 2025

Plan of correction: Resident relocated on 07/25/2025. Licensee agreed to issue a refund to the resident/resident’s responsible party for the remaining days of July 2025 in which the resident was not residing at the facility and send proof to CCLD by the due date.

Type of visit: Case Management - Deficiencies

Licensing Program Analyst (LPA) Angela Barutyan conducted a Case Management - Deficiencies visit in conjunction with a complaint visit (Complaint Control #29-AS-20250723152952). The purpose of the visit is to issue a citation for a deficiency observed during the initial complaint investigation. During the visit on 09/04/2025, record review and interview with Licensee confirmed that on 06/30/2025, an eviction notice was issued to Resident #1 (R1) effective 07/30/2025 without notifying the licensing agency. Per regulation, a written report of any eviction shall be sent to the licensing agency within five (5) days of issuance. The resident relocated from the facility on 07/25/2025. LPA explained to the Licensee that eviction notices must be reported to the Department for review and corrections if warranted. The eviction notice issued to R1 was unlawful and was not reviewed or approved by the Department. Deficiency was cited for the unlawful eviction on a separate report. The facility is currently under construction. LPA met with construction workers who called Administrator Granie Pangilinan at 10:33AM. LPA called Licensee Jagdeep Singh at 10:36AM who arrived at 12:58PM. Administrator was unable to be present during the visit The following deficiency was observed (See LIC 809-D) and cited from the California Code of Regulations, Title 22 and/or California Health and Safety Code. Licensee was informed that failure to correct the deficiency may result in civil penalties. Exit interview conducted. Appeal rights and a copy of the report were provided.the state’s words, verbatim · CDSS document, Sep 4, 2025

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87224(f) · Plan of correction due date: Sep 11, 2025

87224 Eviction Procedures (f) A written report of any eviction shall be sent to the licensing agency within five (5) days. This requirement is not met as evidenced by: Based on record review and interview, the licensee did not comply with the section cited above as the Department was not notified of an eviction notice issued to a resident which posed a potential health, safety, and personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Sep 4, 2025

Plan of correction: Licensee stated they will notify the Department moving forward and will submit a statement of understanding of the section cited to CCLD by the due date.

Type of visit: Prelicensing

On 12/10/2024, Licensing Program Analyst (LPA) Angela Barutyan conducted a subsequent pre-licensing visit. The LPA arrived at the facility at 10:15AM and met with Applicant Jagdeep Singh. This is a new facility application for a Residential Care Facility for the Elderly (RCFE). On 11/26/2024, the initial pre-licensing visit was conducted by LPA Barutyan. The LPA arrived at the facility and met with Applicant Jagdeep Singh and Applicant Representative Ravleen Kaur. The LPA, and the applicant toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. This is a new facility application for a Residential Care Facility for the Elderly (RCFE). Fire Clearance was approved on 10/21/2024 and all six (6) bedrooms are cleared for bedridden. The applicant has obtained fire clearance for a total capacity of six (6) residents. At 10:15AM, the LPA and the Applicant toured the facility to ensure the corrections were completed. Pre-Licensing deficiencies have been resolved. Pre-Licensing is now complete. This report will be sent to the Centralized Application Bureau (CAB). You will be notified by the CAB Analyst when your license has been approved. You are not allowed to begin operating until you have been notified that your license has been approved by the CAB Analyst. Failure to comply could affect approval of your license. Exit interview was conducted and reviewed with applicant. A copy of the report was issued.the state’s words, verbatim · CDSS document, Dec 10, 2024

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Angela Barutyan conducted a pre-licensing visit to the facility noted above at 10AM. LPA met with Applicant Jagdeep Singh and Applicant Representative Ravleen Kaur. The applicant has obtained fire clearance for a total capacity of six (6) residents. LPA inspected facility for Fire Safety, Personal Accommodations and Services, and Food Service. The facility is one story. The facility has six (6) private resident bedrooms and one (1) staff bedroom. All resident bedrooms are cleared for bedridden. The hard-wired smoke alarms and carbon monoxide detectors were tested and function properly. LPA observed one (1) fire extinguisher to be fully charged and purchased on 03/01/2024. LPA toured the kitchen area at approximately 10:02AM. The hot water temperature was measured in the kitchen sink, and it measured 108.1 degrees Fahrenheit. Appliances and all equipment appear to be clean and in good repair. The kitchen has a sufficient supply of plates, cups, cookware, and utensils. Kitchen knives and sharps will be locked in a drawer by the sink. LPA observed sufficient non-perishable food supply. Resident bedrooms are equipped with clean mattresses, pillows, and bedding. Bedrooms have sufficient lighting. There is a sufficient supply of linens, including blankets, bath towels and wash cloths. The facility has six (6) bathrooms for resident use. All bedrooms have an attached half-bathroom except for Bedroom #2 which has a full bathroom adjacent in the hallway for resident-use and showers. Bathrooms contained appropriate non-skid surfaces and grab bars. Hot water temperature was measured in all bathrooms, and they measured between 105 – 120 degrees Fahrenheit, which is within the required range. LPA observed trash cans with tight fitting lids at the time of the visit. Report Continued on LIC 809C... Report Continued from LIC 809C... The living areas and dining areas are clean and properly furnished. All window screens and coverings are in good repair. LPA observed enough seating for six (6) residents at the same time in the dining room table. A working telephone is present. There are activity supplies in the living room. There is one (1) fireplace which was observed adequately covered. Night-lights were present in the hallways. Medications will be stored and locked in a cabinet in the kitchen. Facility records and First aid kit will be by the office area adjacent to the kitchen and staff bedroom. First aid kit was observed to have bandages, thermometer, scissors, tweezers, and a current first aid manual. The garage is attached to the office area and is kept locked and inaccessible. Additional cleaning supplies, toxins, a washer and dryer, detergents, disinfectants, cleaning supplies, and an additional refrigerator and freezer were observed in the garage. There will be no firearms/ammunition stored on the property. The facility has required postings, including Emergency Exit Plan, Licensing Complaint Poster, Resident Personal Rights, and Theft and Loss Policy. The exterior passageways were not free of obstructions. Applicant stated they will remove obstructions from pathways. There are two (2) side gates, one (1) will be used for emergency use. Emergency side gate did not self-latch or self-close. There are no bodies of water on the premises at the time of the visit. LPA observed the backyard, which has a covered outdoor area with a table and chairs for client use. There is a shed containing additional supplies; the lock will be repaired. Cameras were observed in the outside perimeter and in common areas. Cameras do not contain an audio component. Auditory exit alarm in the hallway was missing batteries and will be replaced. Physical plant is consistent with the submitted facility sketch/floor plan. Comp III conducted with Applicant and Applicant Representative. Report Continued on LIC 809C... Report Continued from LIC 809C... Pre-Licensing is incomplete with deficiencies to be resolved by 12/10/2024. A follow up Pre-licensure LIC809 will be generated upon resolution of deficiencies. The following needs to be completed prior to licensure: - Free outdoor pathways from obstruction - Side gate used for emergency exit to be self-latching and self-closing - Repair outdoor shed lock - Functioning auditory exit alarms This report will be sent to the Centralized Application Bureau (CAB). You will be notified by the CAB Analyst when your license has been approved. You are not allowed to begin operating until you have been notified that your license has been approved by the CAB Analyst. Failure to comply could affect approval of your license. Exit interview conducted. The report was reviewed, and a copy was provided.the state’s words, verbatim · CDSS document, Nov 26, 2024