Ataraxis Homes #1

Type of visit: Case Management - Other

A Non-Compliance Conference (NCC) was held at the El Segundo Adult and Senior Care Program Regional Office on 4/15/26. Participants in this meeting included the following: Janae Hammond, Interim Regional Manager; Eva Alvarez, Licensing Program Manager; Alfonso Iniguez, Licensing Program Analyst; and Lori and James Buckman/Licensees. The purpose of this conference is to discuss the citations issued on 3/11/26 for the licensee failing to maintain control of property at Ataraxis Homes #(1 98320108) located at 6732 Wooster Ave, Los Angeles, CA, 90056. Additionally, the licensee failed to report the loss of control of property. The department was made aware that the licensee had been served an eviction order on 3/3/26 and concluded the investigation on 3/11/26. The department issued deficiencies on 3/11/26 for violations of additional personal rights and reporting requirements. On 3/17/26, the licensees relocated the facility and its residents to Ataraxis #1 (198320688), located at 5644 S. Garth Ave, Los Angeles, CA 90056. The licensure date for the new location is 3/11/26. The Licensees stated the following plans in order to bring the facility into compliance: · Licensee will agree to provide proof of rental payment for Ataraxis #1 198320108 from January 2025 to July of 2025. . Copy of the initial eviction letter given to the families back in August/September 2025 An exit interview and a copy of this report were provided to Lori and James Buckman/Licensees.the state’s words, verbatim · CDSS document, Apr 15, 2026

Allegation investigated: Licensee lost control of property. Licensee failed to report lost control of property to the department.

On 3/11/2026, LPA Alfonso Iniguez conducted an unannounced subsequent complaint visit. LPA Iniguez met with Shirley Bladen/Facility staff. LPA Iniguez explained the purpose of this visit. Investigation Consisted of: LPA conducted the following interviews: Licensee Interview (A#1 and L#1). LPA gathered the following documents: copy of notice to vacate the property dated:1/15/2026, copy of new rental agreement dated:11/11/25, copy of new application process LIC 200 dated: 12/18/25, copy if email sent to the regional office as “Urgent Request” dated:3/4/26 and copy of court order issued by the Superior Court of California, County of Los Angeles. Evaluation Report continues LIC 9099-C Substantiated Investigation Revealed the Following: Allegation: Allegation: Licensee lost control of property. The details of the complaint alleged that the licensee lost control of property. On 3/5/2026 at approximately 10:00 a.m., during a records review, the department was provided with a court order notice to vacate, issued by the Superior Court of California, County of Los Angeles (dated: 1/15/2026). The order indicates the licensee must vacate the property no later than 3/16/26. The notice was served to the Licensee/Administrator James Buckman (A#1) by LA County Sheriff Court Services Division on 2/14/2026. On 3/5/2026 at approximately 10:00 a.m., the department conducted and a telephone interview with Lori Buckman Licensee (L#1), she stated that the facility property lease expired in September 2024 and an agreement between the licensee and the property owner could not be reached. (L#1) confirmed a court order to vacate the property has been served to (A#1). (L#1) stated plans to relocate to a new facility address are in progress as the licensees have submitted an application to the CCL Central Applications Bureau. (L#1) states the facility plans to relocate prior to 3/16/26. Allegation: Licensee failed to report lost control of property to the department. The details of the complaint alleged that the licensee failed to report they lost the loss of control of property to the department. The details of the complaint alleged that the licensees (A#1 and L#1) did not report the court order notice to vacate the property served on 2/14/2026. On 3/5/2026 at approximately 10:00 a.m., during a records review, the department obtained and reviewed a copy of a court order to vacate, issued by the Superior Court of California, County of Los Angeles (dated: 1/15/2026). The order to vacate was served by the LA County Sheriff Court Services Division on 2/14/2026. The department was not contacted by licensees (A#1 and L#1) to report the notice to vacate. Evaluation Report continues LIC 9099-C On 2/25/2026, the department contacted and conducted an interview with the licensees (A#1 and L#1). The licensees confirmed a judgment was in place and licensees were ordered to vacate the facility premises no later than 3/16/2026. During this investigation, LPA found sufficient evidence to support the above-mentioned allegation. Based on the evidence gathered, interviews conducted, and records reviewed, the preponderance of evidence standard has been met; therefore, the above-mentioned allegation is found to be SUBSTANTIATED. California Code of Regulations (Title 22, Division 6, Chapter 8), the above-mentioned deficiency was observed, and citation issued (ref. LIC 9099D). An exit interview was conducted, and a copy of the Facility Evaluation Report was provided to Shirley Bladen/Facility staff designee by Licensee to receive report.the state’s words, verbatim · CDSS document, Mar 11, 2026 · control 11-AS-20260303163842

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87468.2(a)(20) · Plan of correction due date: Mar 13, 2026

87468.2 Additional Personal Rights of Residents in Privately Operated Facilities 87468.2(a)(20)(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... This requirement was not met as evidence by: Based on observations, interviews, and record review, the licensee failed to ensure the resident's rights were protected when they initiated an involuntary transfer.This poses a potential health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Mar 11, 2026

Plan of correction: Licensee will adhere to Title 22 at all times. As a plan of correction, the licensee will create a written plan and be in compliance with the department. A proof of correction will be sent to LPA Iniguez via email before the POC due date.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87211(d)(2) · Plan of correction due date: Mar 13, 2026

87211 Reporting Requirements 87211(d)(2)The licensee shall notify the Department, the State Long-Term Care Ombudsman, all residents, and, if applicable, their representatives ... This requirement was not met as evidence by: Based on observations, interviews, and record review, the licensee failed to notify the department in a timely manner upon receiving the unlawful detainer on 2/14/26. This poses a potential health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Mar 11, 2026

Plan of correction: Licensee will adhere to Title 22 at all times. As a plan of correction, the licensee will create a written plan and be in compliance with the department. A proof of correction will be sent to LPA Iniguez via email before the POC due date.

Type of visit: Case Management - Health Checks

On 3/11/2026, at approximately 9:30 AM, Licensing Program Analyst-LPA Alfonso Iniguez conducted a Case Management visit/Change of Location (CHOL). LPA was greeted by Brianne Bunch/Facility staff, who explained the purpose of the visit. The licensee has applied for a Change of Location (CHOL). LPA Iniguez will review the records and conduct a Health and Safety Check of the facility. Currently the home has (6) clients. The facility is a single-story family home located in a residential neighborhood. The facility consisted of the following: Living room, dining room, kitchen, 6 bedrooms, 2 bathrooms, office area, laundry room, shaded area, indoor/outdoor activity areas, and attached garage. The front and back yard landscape is in good condition at the time of the visit. LPA Iniguez and facility staff toured the inside and outside of the facility. All client rooms were checked. Mattresses and box springs were in good condition, adequate lighting was observed, plenty of dresser and closet space was observed. Bed linens, comforters and bath towels were adequately stocked at the time of visit. Bathrooms were found to be within Title 22 regulation. Toilets and water faucets worked properly. Shower was free of mold/mildew, there was adequate lighting, and sufficient toiletries accessible to clients. The water temperature properly measured between 105F°-120F° degrees. Evaluation Report continues LIC 809-C Perishable and non-perishable food supply was checked and adequately stocked at time of visit. Carbon monoxide/Smoke detectors were observed and operational. Fire extinguishers were fully charged; toxins and knives were locked and inaccessible to clients. Medications were centrally stored and properly locked, first aid kit was checked and fully stocked. Last facility fire drill was 1/13/2026. LPA conducted a records review of (3) client records, (3) staff records and reviewed the facility disaster plan. The facility disaster plan was current and in compliance with Title 22 at the time of visit. LPA reviewed (3) Client Medication Administration Records (MAR) and did not observe any discrepancies at the time of visit According to the California Code of Regulations (Title 22, Division 6, Chapter 8), LPA did not observe deficiencies therefore no citations were issued at this time. An exit interview was conducted, and a copy of the Facility Evaluation Report was provided to Brianne Bunch/Facility staff.the state’s words, verbatim · CDSS document, Mar 11, 2026

Type of visit: Case Management - Deficiencies

On 3/11/2026, LPA Alfonso Iniguez conducted an unannounced Case management/Deficiency visit. LPA Iniguez met with Shirley Bladen/Facility staff and explained the purpose of this visit. On 3/5/2026, the Department learned that the licensee had received a court-ordered notice to vacate the property on which the facility operates. The notice, served on 2/14/2026, requires the licensee to vacate the premises described in the writ by 3/16/2026. During this process, the licensee failed to give the resident’s power of attorney-POA a 60-day written notice of eviction notice due to change of use of facility. Deficiency cited under California Code of Regulations, Title 22, Division 6, Chapter 8. See details below: Note: *Citations not cleared by the due date will be a $100 fine assessed for each citation until it is cleared. Civil penalties will continue to accrue until Proof of Corrections (POC) is cleared. * An exit interview was conducted, and a copy of the Facility Evaluation Report was provided to Shirley Bladen/Facility staff designee by Licensee to receive report.the state’s words, verbatim · CDSS document, Mar 11, 2026

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87244(a)(5)(A)(1) · Plan of correction due date: Mar 13, 2026

87224 Eviction Procedures (a)(5)(A)(1) (a) The licensee may evict a resident for one or more of the reasons listed in Section 87224(a)(1) through (5). Thirty (30) days written notice to the resident is required... This requirement was not met as evidence by: Based on observation, record review and interviews, the licensee failed to ensure to give 60-day eviction notices to resident's POA when they received an unlawful detainer.This poses a potential health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Mar 11, 2026

Plan of correction: Licensee will adhere to Title 22 at all times. As plan of correction the licensee will create the 60 day notice and send a copy to LPA Iniguez and the department by POC due date.

Type of visit: Required - 1 Year

On 11/01/25 at 9:15AM, Licensing Program Analyst (LPA) Gina Saucedo, arrived to conduct an unannounced, annual inspection at the facility. Upon arrival, LPA Saucedo met with caregiver, Tenishia Palacio and the Administrator, Brianna Brunch was called and arrived shortly after. LPA asked for the census, resident, and staff files. A physical tour was conducted at 10:05am and observed the following: The Kitchen area was toured, and LPA observed there to be sufficient seven (7) day supply of non-perishable foods and perishable food for all residents. The kitchen area was clean at the time of the tour. There are two (2) refrigerators and a stove that are operable. There is extra/canned food in the kitchen cabinets. The knives are locked and inaccessible to the residents on your left-hand side of the kitchen. There is one (1) washer and dryer located next to the living/dining room area. The chemicals and toxins are kept in this area locked and inaccessible to the residents. Next to where the washer and dryer is located there is an empty room where you can access the garage. Outside/Backyard: The outside/backyard has furniture for residents with proper seating. The facility has a jacuzzi that is covered and does not have any water in it. There is a garage that is detached from the house and used as a storage area. LIC 809C-continued The medication is locked and inaccessible to the residents in a black cabinet next to the dining/living room area. There are several fire extinguishers in the house. One (1) is located against the wall on your left-hand side of the hallway fully charged and the others in the dining/living room area. Bedrooms and Bathrooms: There are seven (7) bedrooms and four (4) bathrooms. All bedrooms are single occupied. One (1) bathroom is down the hallway and three (3) bedrooms have their private bathroom. All bedrooms and the bathroom were toured and were properly furnished and have appropriate bedding, linens, toiletry and lightning. The bathrooms have proper toiletry. The bathroom's water temperature are within regulations reading between 105 and 107 degrees Fahrenheit. The dining area/living room area has enough seating for the residents and the staff. There is a television in the living room. The carbon monoxide and smoke detectors are located throughout the facility and are operable and interconnected. The house temperature is set at 73 and 75 degrees. Administrative: The insurance plan is updated and is dated 07/24/2026. Against the wall of the facility by the dining hall area there is a YES sign and Ombudsman sign. There are theft and Loss, Personal Rights of the Elderly and Disaster Plan at the entrance of the facility. There is a signal system. Staff and Resident Files were reviewed. LPA reviewed six (6) resident files and two (2) staff files were reviewed. 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, Nov 1, 2025

Type of visit: Required - 1 Year

On 09/06/2024, Licensing Program Analyst’s (LPA’s) Yolanda Rosser and Alfonso Iniguez conducted unannounced annual required visit using the CARE Inspection Tool. LPA’s met with Brianne Bunch \Administrator. LPA’s explained the purpose of today’s visit. The facility is licensed to serve (6) elderly adults ages 60 and above, of which (6) can be non-ambulatory of which 1 may be bedridden room #2 only. The facility has an approved hospice waiver for (3). The facility is a single-story-family home located in a residential neighborhood.the facility which consisted of the following: Living room, dining room, kitchen, 6 bedrooms, 2 bathrooms, office area, laundry room, shaded area, indoor/outdoor activity areas, and attached garage. The front and back yard landscape is in good condition at the time of the visit. LPA’s Rosser, Iniguez and the Administrator toured the physical plant. There were no bodies of water or obstructions on the premises. LPA inspected a total of (6) bedrooms and (2) bathrooms. The beds and bedding supplies were in good condition, adequate lighting was provided, and storage for the residents’ personal belongings was observed. The bathrooms were found to be within Title 22 regulations and were operational. Smoke and carbon monoxide detectors were in operable condition. The water temperature ranged from 109.4°F to 109.5°F, and the room temperature ranged from 83°F to 83.5°F. The evaluation Report continues on the next page, LIC 809-C, providing further details of the inspection findings. During the visit, LPA’s Rosser, Iniguez observed that the facility was clean, sanitary, and appropriately furnished. Storage areas for personal hygiene were in place. Sharp objects were stored in a way that made them inaccessible to residents in care. The kitchen was inspected, and there was sufficient perishable and non-perishable food available, which was adequately maintained. All fire extinguishers were charged and operable. The last Fire/Disaster Drills were conducted on 07/05/24. A review of (2) residents' service files and (2) staff personnel files was maintained in order. LPA’s reviewed (2) Medication Administration Records (MARs) and found no discrepancies. LPA’s observed the facility's infection control practices. All mandated inspection control posters were displayed throughout the facility. A copy of liability insurance was emailed to LPA. Facility Annual Fees current. Deficiency cited under California Code of Regulations, Title 22, Division 6, Chapter 8. See details below: -LPA’s observed unlocked cleaning solutions underneath kitchen sink. -LPA’s observed broken sink in the residence restroom. Note: *Citations not cleared by the due date will be a $100 fine assessed for each citation until it is cleared. Civil penalties will continue to accrue until Proof of Corrections (POC) is cleared. * An exit interview was conducted, and a copy of the Facility Evaluation Report was provided to / Administrator.the state’s words, verbatim · CDSS document, Sep 6, 2024

Allegation investigated: Licensee does not ensure that staff has a criminal clearance.

On 10/13/2023, Licensing Program Analyst (LPA), Antonine Richard conducted an unannounced complaint visit to initiate the investigation on the above-mentioned complaint allegation. LPA met with Administrator Assistant Brianne Bunch and the purpose of the visit was explained. The investigation consisted of the following: During todays visit, LPA Richard conducted a tour of the facility, inside to observe any signs of neglect, or abuse. interviewed the assistant Administrator S3, Administrator Staff S2, Staff S3,and S5. LPA interviewed the Licensee S1, and residents (R1-R3). LPA reviewed Staff and residents records. Evaluation Report Continues LIC9099C Unsubstantiated INVESTIGATION REVEALED THE FOLLOWING: Allegation: Licensee does not ensure that staff has a criminal clearance. The details of the complaint reported that licensee does not ensure that staff has a criminal clearance. The complainant stated there are undocumented staff working at the facility. LPA reviewed/audited personnel staff (S1-S5) and it revealed that (S1-S5) does have Criminal Background Clearance on file. The Licensee stated the individuals stated in the complaint came one month ago for an interview was told and given the hire package to complete before they could be hire. Since then she has not spoken to them about employment status. S5 has been employed at this facility since 10/03/23, and is included in (CCL) Facility Personnel Report Summary (LIS) as cleared. Based on the information gathered, Records reviewed, interviews, the allegation listed above is not supported. Based on record reviews, observation and interviews conducted, the Department did not find sufficient evidence to support the allegation. Licensee does not ensure that staff has a criminal clearance. Although the allegation (s) may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. Therefore, the above allegation is found to be Unsubstantiated. Exit interview was conducted and a copy of the report was provided to Licensee Lori Buckman.the state’s words, verbatim · CDSS document, Oct 13, 2023 · control 11-AS-20231012124542