Ararat Board and Care

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Quoc Huynh arrived at the facility unannounced to conduct a required annual visit at 9:44AM. The LPA met with the Licensee Mariam Panadzhyan and informed them of the reason for the visit. Entrance interview conducted. Beginning at 9:49AM, the LPA and Licensee toured the physical plant areas inside and outside to ensure there were no health and safety hazards, and facility is in compliance with Title 22 Regulations. The following was observed: BEDROOMS/RESTROOMS: There were four (4) total bedrooms: one (1) private resident bedroom and three (3) shared resident bedrooms. Bedrooms #1 and #4 had direct exits to the outside and Bedroom #1 was approved for one (1) Bedridden resident. Bedrooms were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. Extra linens were stored in a cabinet located in the living room. Additionally, there was one (1) locked staff room that was utilized as an office and contained medications and files. There were four (4) total restrooms in the facility: two (2) common resident restrooms, one (1) private staff restroom, and one (1) private resident restroom. Restrooms were clean, sanitary, and in operating condition with grab bars and non-slip surfaces. All restrooms were sufficiently stocked with soap, paper products, and displayed hand washing signs. Hot water was tested and measured between 109.6 degrees F and 118.8 degrees F, which is within the required range per regulation. Additionally, the facility measures the water temperatures weekly. Report Continued on LIC 809-C COMMON AREAS: At the time of the visit, living room and dining room furniture was observed to be in good condition. Required postings were observed in the entryway walls. The facility maintained a comfortable temperature throughout the visit. The LPA observed nightlights throughout the hallways. KITCHEN: The LPA observed knives stored inaccessible in the office/staff room. Kitchen appliances were clean and in operable condition. The facility had a supply of perishable and non-perishable food. Food in the refrigerator and freezer were observed to be properly stored with labels and dates. OUTDOOR AREA: The surrounding grounds had a shaded patio area equipped with furniture in good condition for residents and visitor use. The front yard had a driveway with a remote operated gate as well as a door for everyday use. There was one (1) emergency exit located on the side of the facility that was self-latching and led to the front yard. The other side of the facility had a locked shed that contained general storage/equipment. All exits and passageways were free of obstruction. The LPA observed an additional shed in the backyard that contained general storage and emergency food and water. RECORDS: Record review began at 10:21AM. Resident records were reviewed for, but not limited to care plans, physician's report, admissions agreement, and consent forms. All records were in order. Personnel records were reviewed for, but not limited to health assessments, criminal record clearances, first aid/CPR training, and the appropriate training. One (1) staff did not have a health screening and TB test on file. The Staff and Licensee stated it was provided, however were unable to provide the LPA with the documentation. INFECTION CONTROL/EMERGENCY DISASTER PLAN: During today's visit, LPA reviewed the facility's infection control plan and emergency disaster plan. Both documents were observed to be complete and reviewed annually as required. Emergency disaster drills are conducted quarterly, with the last documented drill on 07/05/2025. Smoke and carbon monoxide detectors were tested at 10:12AM and were operational. Additionally, the facility tests the smoke and carbon monoxide detectors monthly. Two (2) fire extinguishers were observed and were purchased on 08/16/2025. Report Continued on LIC 809-C MEDICATIONS: Medication review began at 11:50AM. Medications were centrally stored and kept inaccessible. Medications were observed for two (2) residents. Medications were labeled and checked for expiration dates and were properly documented on the centrally stored medications and destruction record. No errors observed during the medication review. Pursuant to Title 22 CA Code of Regulations and/or Health and Safety Code, the following deficiency was cited (Refer to LIC 809-D). Exit interview conducted. A copy of the Appeal Rights and report was reviewed and provided.the state’s words, verbatim · CDSS document, Sep 10, 2025

Allegation investigated: . Staff did not keep facility free of cigarette smoke. 2. Staff are not allowing a resident in care to close their bedroom door. 3. Staff yells at residents in care and calls them inappropriate names. 4. Staff did not provide a meal to a resident in care

Licensing Program Analyst (LPA) Christine Yee conducted a subsequent unannounced complaint visit to conduct further investigation and to deliverr the findings of the above allegations and met with Mariam Panadzyan, Licensee. The reason for today's visit was explained. On the initial visit conducted on 4/8/25, LPA Yee conducted an interview with the Witness #1 at 11:13am via telephone, Licensee at 12:20pm, Staff #1 at 12:32pm, Resident #1 at 1:50pm, Resident #2 at 1:46pm, Resident #3 at 1:20pm, Resident #4 at 1:24pm, Resident #5 at 1:24pm and Witness #2 via telephone at 2:30pm. Prior to conducting today's visit, LPA Yee also conducted an interview with Resident #6 on 4/7/25. No documents were collected on today's visit since Resident #6 lived at this home for about 3 days and no files were created. Resident #6's documents were requested from Witness 2 to be emailed over to LPA. continued on LIC9099-D Unsubstantiated Page 2 Per interviews conducted on today's visit, LPA Yee has determined that additional investigation is needed to make a finding for the above allegation. Exit interview was conducted. On today's visit, LPA Yee conducted another interview with Mariam Panadzyan at 10:47am, Staff #1 at 10:37am and Resident #4 at 11:13am to obtain additional information and to clarify information that was provided during the initial visit conducted on 4/8/25. Per information received regarding allegation #1 - Staff did not keep facility free of cigarette smoke, it is alleged that facility staff are smoking at the front door and the smoke is coming into their room. Per Resident #6, who lives in Bedroom #3, they are taking an amino immunal modular medication and cannot be exposed to the smoke. Per interviews conducted related to the allegation, staff deny smoking by the front door. The Administrator is a non-smoker and Staff #1 admits to smoking about 5-6 cigarettes a day. Per Staff #1. they smoke in the designated smoking area located in the backyard by the food storage building and once in a while will smoke a cigarette by the trash cans located by the front gate. The designated smoking area and the trash cans are not located close to Bedroom #3. Per the Administrator, another staff who works on weekends about 4 times a month smokes some times. All staff smoke in the designated smoking area. Per the Administrator, none of the residents smoke. Residents who were interviewed deny smelling smoke in their rooms. However, per the Administrator, she observed something that resembled smoke coming from Bedroom #3, twice when Resident #6 lived here for 3 days. The smoke was sweet smelling. Per interview conducted with Witness #2, Resident #6 does marijuana and edibles. Per interview with Resident #6, they deny that they smoke. Per information obtained during the investigation, there is insufficient evidence to support the allegation that staff did not keep facility free of cigarette smoke, therefore the allegation is unsubstantiated at this time. Per investigation into Allegation #2 that - Staff are not allowing a resident in care to close their bedroom door interviews reveal that the residents are encouraged to close their bedroom doors. Resident #1, who has dementia, wanders into everyone's room. Residents interviewed also confirm that they have never been told not to close their door. The Administrator and Staff #1, who work at the facility regularly, deny that the Page 3 residents are told that cannot close their doors. During the tour of the facility and Bedroom #3 conducted on 4/8/25 and today, LPA Yee observed that all the residents were in their rooms with their doors closed. Bedroom #3 was locked to secure Resident #6's belongings as they no longer reside at the facility. Per the Administrator and Staff #1, they have to knock on the residents' doors to enter the room. Based on the information obtained during the investigation, there is insufficient evidence to support the allegation that Staff are not allowing a resident in care to close their bedroom door, therefore the allegation is unsubstantiated at this time. Per LPA Yee's investigation into Allegation #3 - Staff yells at residents in care and calls them inappropriate names, interviews with the Administrator and Staff #1 they both deny yelling and calling the residents names. They are respectful with the residents. They both state that it is Resident #6 that uses bad language. Resident #6 curses at them and calls them names. There was an incident at the facility on 4/3/25 when Resident #6 hit Staff #1 on the head with their cane twice. The police were called out to the home and removed the resident. During that incident, Resident #6 called them names and cursed them out. The f... word was used liberally. Residents interviewed deny that staff yell at them and call them inappropriate names. Based on the information obtained during the investigation, there was insufficient evidence to support the allegation that Staff yells at residents in care and calls them inappropriate names, therefore the allegation is unsubstantiated at this time. LPA Yee also investigated Allegation #4 - Staff did not provide a meal to a resident in care and the investigation revealed that Resident #6 moved into the facility in the late afternoon of 3/31/25 and was transferred on the afternoon of 4/3/25 to the hospital psychiatric unit, for observation after hitting Staff #1 with their cane . The resident was being transferred from a skilled nursing facility. The nursing home did not advise the Administrator that the new resident preferred a vegan diet. Staff would offer Resident #6 food and they would refuse to eat it because it was not vegan. The social worker of the nursing home purchased food for Resident #6 on the first day since they had gone to lunch. On the second day, Resident #6 requested oatmeal cooked with water and sugar for breakfast and did not eat much of it. On the second and third day, Resident #6 ate their own food that the nursing home had delivered, including the extra food from the Page 4 nursing home kitchen. Per the nursing home social worker, they buy their food in bulk and was able to give some to Resident #6. Per the Administrator, they continued to give Resident #6 a facility meal. The resident kept refusing their food. On 4/3/25 Staff #1 took lunch to Resident #6's room and this resulted in staff getting hit on the head by resident's cane. As a result of this behavior, Resident #6 was removed for observation in the psychiatric unit of the local hospital at the request of the police. File review was not conducted since the Facility was not able to collect any documents in the short time Resident #3 was at the facility. Per information provided by Witness #2, Resident #6 will get violent when they don't get their way and has attacked nursing home staff when they don't get their way and will only eat vegan food. Per the social worker, Resident #6 has a history of fabrication. Per information gathered during the investigation, there was insufficient evidence to support the allegation that Staff did not provide a meal to a resident in care, therefore the allegation is unsubstantiated at this time. Exit interview was conducted and a copy of this report was provided.the state’s words, verbatim · CDSS document, Jun 18, 2025 · control 29-AS-20250403164233

Allegation investigated: . Staff refused to accept resident for re-admission 2. Staff does not ensure facility bathroom is in good repair

Licensing Program Analyst (LPA) Christine Yee conducted an unannounced complaint visit to investigate the above allegations and was let into the home by Gayane Adamyan, Staff. Mariam Panadzyan, Licensee, was contacted by telephone and she returned to the facility shortly after the call. The reason for today's visit was explained. On today's visit, LPA Yee conducted an interview with Mariam Panadzyan, Licensee at 11:01am, toured the 4 bathrooms at 11:38am. Prior to today's visit, LPA Yee also conducted an interview with the Reporting Party at 1:40pm, Resident #1 at 2:38pm and Witness #1 at 3:16pm. Per information provided from interviews conducted, regarding allegation that staff refused to accept resident for re-admission - Resident #1, who had been relocated to this home from a skill nursing facility on 3/31/25 Unfounded and then was relocated to Providence Saint Joseph on 4/3/25 by local law enforcement for psychiatric observation because Staff had called 911 an alleged that Resident #1 had hit a facility staff twice on the head with a cane. Resident #1 denied hitting anyone. Resident #1 informed the hospital social worker that they did not like this home and did not want to return to the facility and new placement would have to be located upon discharge. Per information provided, Witness #1 was in the process of locating a new facility for the resident and had located a new home. Transportation arrangements were made by staff of the new location and Resident #1 was transported directly from Providence Saint Joseph to the new location. Resident #1 does not know the name of the home they were taken to. Per interview conducted with Witness #1 on 4/10/25, Resident #1 refused to enter the relocation home and they were transferred to LA General Hospital and was placed in the observation unit. Per interview conducted with Resident #1, they did not return to Ararat Board and Care or wanted to return to this facility and did not contact this facility to advise staff that they wanted to re-admitted when they were discharged for Providence Saint Joseph Hospital. The Licensee also confirms that Resident #1 did not call her at any time to say that they wanted to return to the facility. Based on the information received from interviews conducted, there is no evidence to support the allegation that Staff refused to accept resident for re-admission, therefore the allegation is unfounded at this time. Regarding allegation #2 - Staff does not ensure facility bathroom is in good repair, per interview with Resident #1, they never told anyone that the bathroom at Ararat was in disrepair. The only complaint with the bathroom was that the bathroom would be occupied when they needed it. Per interview conducted with the Licensee, the bathrooms are working well and does not need repairs. A tour of all the bathrooms was conducted at 11:38am, also confirms that the bathrooms are working well. There is insufficient evidence to support the allegation that Staff does not ensure facility bathroom is in good repair, therefore the allegation is unfounded at this time. Exit interview was conducted and a copy of this report was provided.the state’s words, verbatim · CDSS document, Apr 14, 2025 · control 29-AS-20250409102933

Type of visit: Case Management - Deficiencies

Licensing Program Analyst, Christine Yee conducted an unannounced case management visit due to the deficiencies observed during a visit to the facility today. LPA Yee met with Mariam Panadzyan, Licensee and the reason for this visit was explained. The following was observed on today's visit: Vagan Alikyan, son of the Licensee is not a staff at the facility but is frequently at the facility to assist with any issues that arise at the facility. Mr. Alikyan was last at the facility on 4/3/25 to handle an incident involving a resident who hit staff and the police had to be called in to remove the resident. Per review of the facility roster, he does not have a completed criminal record clearance. The associate status currently reads "invalid". Deficiency cited under California Code of Regulations, Title 22, Division 6, Chapter 8. Civil Penalties were assessed. Exit interview was conducted, APPEALS RIGHTS WERE DISCUSSED and copy was given.the state’s words, verbatim · CDSS document, Apr 8, 2025

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87355(e) · Plan of correction due date: Apr 9, 2025

e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1569.17(b) shall prior to working, residing or volunteering in a licensed facility: This requirement was not met as evidenced by: Vagan Alikyan, son of the Licensee does not have a clear criminal record clearance as of ths visit. The Associate status reads "invalid" Civil Penalties in the amount of $500 were assessed.the state’s words, verbatim · CDSS document, Apr 8, 2025

Plan of correction: The Licensee will ensure that all staff, volunteers or family members who are at the facility regularly will have submitted to a criminal record clearance and is associated to the facility prior to being present at the facility. Evidence that Vagan Alikyan has received a valid and clear criminal record clearance prior to being at the facility by 4/9/25

Type of visit: Required - 1 Year

Licensing Program Analysts (LPA) Erica Mosley arrived at the facility unannounced to conduct a required annual visit and entered the facility at 12:40 p.m. Upon arrival, LPA Mosley was greeted by staff and co-administrator and informed them of the visit. The LPA met with Co-Administrator Mariam Panadzhyan and explained the reason for the visit. The LPA 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 12:57 p.m. Knives and sharps were observed in the locked staff room adjacent to the kitchen. Kitchen appliances were in operable condition. The facility has a sufficient supply of two (2) day perishable and seven (7) day non-perishable food. Refrigerator and food pantry were checked for proper labels and expiration dates. Nonperishable foods including peanuts, ketchup and mac and cheese in food pantry area were expired dating 04/03/2024; 01/23/2024 and 01/25/2024.The expired food poses a potential health and safety risk to persons in care. Administrator was made aware, and food was immediately removed. The kitchen faucet was measured for hot water temperature, and it measured 115.5 degrees Fahrenheit at 12:57 p.m. There is a washer and dryer on premises in the kitchen area. Laundry detergent was observed in the staff room adjacent to the kitchen. COMMON AREAS: At the time of the visit, furniture in the common areas was observed to be in good condition. The facility maintained a comfortable temperature. At 3:45 p.m., hardwired, smoke detector(s) and carbon monoxide detector were tested and operational at the time of the visit. The fire extinguisher was observed, fully charged, and purchased on 03/31/2024. The LPA observed required postings throughout the common space. The last emergency disaster drill took place on 07/06/2024. Activities were observed in the common areas. Report Continued on LIC 809C... Report Continued from LIC 809... RESTROOMS: There are four (4) total restrooms. Two (2) for resident use, one (1) for staff use which remains locked at all times in the staff room, and one (1) guest half restroom that can also be used by residents if needed. The two (2) resident restrooms were clean and sanitary and in operating condition with grab bars and non-skid surfaces. The bathrooms were sufficiently stocked with supplies and paper towels. The hot water temperature was measured; the first resident restroom measured at 107.4 degrees Fahrenheit at 12:54 p.m., the second resident restroom measured at 118.0 degrees Fahrenheit at 12:57 p.m. and the guest half restroom measured 105.6 at 1:17 p.m. All restrooms measuring within the required range. BEDROOMS: There are 5 (five) total bedrooms in the facility; Four (4) are designated as resident rooms, and one (1) as a locked staff room. Of the four (4) resident rooms two (2) are designated as shared rooms, and two (2) are designated as private resident rooms. All resident rooms were observed to be furnished appropriately with clean linens, appropriate furnishings, and sufficient lighting. BACKYARD/OUTDOOR AREA/ SHEDS: The outdoor area has a storage area which previously housed the washer and dryer and is used as storage for emergency food and PPE supplies. There is a locked shed on the side of the home that stores cleaning supplies and chemicals. The shed is maintained locked at all times. LPA observed an adequate amount of emergency food and water. Cleaning supplies are kept locked and inaccessible to residents in care. The backyard has a covered patio area with patio furniture including a table and chairs for resident use. All passageways were observed to be clear. LPAs observed one (1) self-latching gate. There were no bodies of water noted at the time of the visit. Report Continued from LIC 809C... Report Continued from LIC 809C... MEDICATIONS: Medications review began at approximately 3:47 p.m. The medications are locked in the staff room filing cabinet adjacent to the kitchen. Medications for five (5) clients were reviewed. Medications reviewed were found to be self-administered as prescribed and documented on the centrally stored medication and destruction records. RECORDS: Resident Records were reviewed beginning at 2:10 p.m. and personnel records at 3:24 p.m. Five (5) resident files were reviewed for, but not limited to, the following: signed admission agreements, current medical assessments with TB results, LIC627(c) Consent for Treatment form, and current needs and services plan. Four (4) personnel files including the Administrator’s file were reviewed for, but not limited to: personnel records, health assessments, criminal record clearances, first aid/CPR training, and the appropriate training. All records were in order. INTERVIEWS: Two (2) staff interviews were attempted, due to language barriers only one (1) was conducted. Five (5) resident interviews were attempted, three (3) were conducted. One (1) visitor/ family member interview was conducted. Deficiencies were cited during today’s inspection. Exit interview conducted. A copy of the report and appeal rights were provided.the state’s words, verbatim · CDSS document, Sep 18, 2024