Bassett Residential Care

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Christine Yee conducted an unannounced required Annual Inspection and used the CARE Inspection Tool to conduct today's visit. LPA Yee initially met with Emma Arutiunian, Administrator but she had prior plans and could not participate in the visit. She contacted Laura Hovhannisyan, Staff to conduct the visit. She arrived at 11:09am to begin the visit. The reason for today's visit was provided. The facility is a single storey family home consisting of a living room, dining room, a kitchen, a family room, 7 bedrooms of which one is designated as a staff room/Office, a laundry room, 4 full bathrooms. Located behind the laundry room is a single room used by staff. Located in the back is also a storage shed. The facility is fire cleared for 2 AMBULATORY and 4 NON-AMBULATORY. On today's visit, all 12 domains of the Care Inspection Tool was reviewed, 6 resident and 6 staff files were reviewed and a tour of the entire facility, inside and outside, was inspected. The following was observed: the living room, dining room, kitchen and family room were furnished with the appropriate furniture for its designated used for 6 residents. The fireplace located in the living room did not have a fire screen. all 6 resident bedrooms were furnished with a hospital bed, a night stand, a lamp, a chair, a dresser in bedroom #1, #3, #6 and a built-in closet. No dressers were observed in bedroom #2, #4 and #5. Each room has a wall mounted television. Window dressings were observed. Bedroom #6 has an outside exiting door and no auditory device was observed. continued on LIC809-C Page 2. the bed located in bedroom #4 was observed with a full bed rail and the resident is not on hospice. Resident in bedroom #4 was observed on oxygen via a oxygen concentrated and no signs indicating "no smoking, oxygen in use" were posted. Resident #2 and Resident #6 who are determined to be non-ambulatory were observed housed in bedroom #1 and #2 which is for ambulatory use only. All three bathrooms, 2 private bathrooms are equipped with a walk in shower, a sink and a toilet. Slip resistant mats and grab bars were observed in the shower and by the toilet. The water temperature taken in the common bathroom, located by bedroom #2 read 109.9 degrees, the private bathroom between bedroom #3 and #5 read 110.4 degrees and the private bathroom between bedroom #4 and #6 read 112.8 degrees Fahrenheit. Bed linens, blankets and towels were observed in the linen closet. The only fire extinguisher purchased on 3/23/26 is located in the kitchen. The first aid kit containing the required tweezer, scissors, thermometer and dressings and first aid manual was observed. Medications are centrally stored in a locked filing cabinet by the staff room. Sufficient perishable for a minimum of 2 days and non-perishable for a minimum of 7 days was observed maintained on the premises. The facility has hardwired smoke detectors in all the 7 bedrooms and combination smoke/carbon monoxide detectors are located in the resident hallway, family room, in front of bedroom #2. They were operational when tested. The fire rated door located in the resident hallway was operational also. The facility has current general liability insurance with the required Title 22 limits. The laundry room contained a washer and dryer. tables and chairs with umbrellas were observed outside. The facility needs to put away cleaning buckets, mops and roll up hoses. Overall, the facility, inside and outside, were observed to be clean. Licensee will ensure that the roll away bed stored in the family room is removed or picked up as advised. continued on LIC809-C Page 3. Deficiencies cited under California Code of Regulations, Tile 22, Division 6, Chapter 8. Civil Penalties were assessed. Exit interview was conducted, APPEALS RIGHTS were discussed and a copy was provided.the state’s words, verbatim · CDSS document, Jul 22, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Sandra Urena arrived unannounced at the facility to conduct the required annual inspection. The LPA was greeted by the Administrator Emma Arutiunian and Administrator -Designee Laura Hovhannisyan, and the LPA explained the reason for the visit. The LPA and the Administrator 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. COMMON AREAS: At the time of the visit, living room and dining room furniture was observed to be in good condition. The facility maintained a comfortable temperature. Smoke detector (s) and carbon monoxide detectors were tested and operational at the time of the visit. The fire extinguisher was fully charged and purchased on 03/25/2025. The LPA observed required postings throughout the common space. Administrator will email picture of the Licensing poster per the regulations. KITCHEN: Knives and cleaning supplies are stored inaccessible. Kitchen appliances were in operable condition. The facility has a sufficient supply of perishable and non-perishable food. The hot water temperature measured at 112.8 degrees Fahrenheit. BEDROOMS: There are six (6) residents’ bedrooms, which were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. There is one designated staff room, which was locked at the time of the visit. There was a linen closet in the hallway with extra towels and linens. Seven-day supply of food and water is located on one side of the linen closet. LIC 809C... BATHROOMS: Bathrooms were clean and sanitary and in operating condition with grab bars and non-skid surfaces. The bathrooms were sufficiently stocked with soap and paper towels. The hot water temperature measured within the regulations. The bathroom located between bedrooms #4 and # 6 needs to have the small section of the bottom wood panel fixed or replaced as it appears to be peeling. Additionally, a toilet paper holder needs to be added. The administrator will email LPA pictures of the corrections. WASHER/DRYER: The washer and dryer are inaccessible in the washer and dryer room. Cleaning supplies and disinfectants are kept in locked cabinets. OUTDOOR AREA: The backyard has a covered outdoor area equipped with furniture for client use. No bodies of water noted. Additionally, the facility has a shaded sitting area in front of the facility. RECORDS: Records review began at 12:45 p.m. Residents’ records were reviewed for, but not limited to care plans, medical records, admissions agreement, 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. All files were in order. MEDICATIONS: Medications review began at 01:45 p.m.; medications are centrally stored and locked in a cabinet in the common area; medications are labeled and checked for expiration dates. Medications are properly documented on the centrally stored medications and destruction record. No errors observed during the medication review. The LPA reviewed the following documents: - LIC500 Personnel Report - LIC9020 Client Roster - Certificate of Liability of Insurance _ Emergency Drill Logs No citations were issued. Exit interview conducted. A copy of the report was issued.the state’s words, verbatim · CDSS document, Jul 17, 2025

Type of visit: Required - 1 Year

At 9:45 a.m. Licensing Program Analyst (LPA) Valeria Conway arrived at the facility to conduct the required annual inspection. LPA met with administrator Emma Arutiunian and explained the reason for the visit. At 11:30 a.m. back up administrator Ruzanna Manukyan arrived at he facility and joined the visit. The LPA and the administrator conducted a tour of the physical plant at approximately 10:15 a.m. There are (6) bedrooms for residents and (1) bedroom for staff use only. At 10:52 a.m. smoke alarms and carbon monoxide detector were functioning at time of the visit. The LPA observed all required postings in the entry area. The facility serves residents with dementia, the auditory alarms on the exit doors were tested and functioned properly at the time of visit. Fire extinguisher was fully charged and purchased in April 11th 2024. KITCHEN: The kitchen appeared clean and the appliances and fixtures functional during the time of visit, sharp objects are stored in lock box that was kept on the kitchen counter. The LPA observed box to be locked at this time. Some cleaning supplies and disinfectants were observed stored under the sink. The LPA observed the usage of a snap hook carabiner instead of lock. LPA explained Licensee the importance of having a lock to prevent access to cleaning supplies and toxins to residents with dementia. The LPA observed a sufficient amount of perishable and a seven-day supply of non-perishable food at the facility properly stored. Continued on LIC 809-C Continued from LIC 809 BEDROOMS: The residents’ bedrooms were properly furnished with at least one chair, nightstand, and sufficient lighting for each resident. The bedrooms had appropriate and adequate and clean bedding and linens such as sheets, pillowcases, and blankets. During today’s visit LPA observed Resident #1 (R1), a hospice patient, in room #4 unable to reposition in bed, after checking physician report for R1, it revealed that R1 is bedridden. R1 is being retained in a room that does not have bedridden fire clearance. Also, LPA observed two (2) non-ambulatory residents in ambulatory rooms and two (2) ambulatory residents in non-ambulatory room. LPA explained licensee that they all need to be rearrange. Also, licensee will have to communicate with family member and/or responsible parties of these changes. BATHROOMS: The LPA observed all three (3) bathrooms were clean, properly supplied and had functional fixtures. LPA observed grab bars and non-skid mats in the bathroom. Residents have sufficient amounts of supplies for personal hygiene properly stored inaccessible to residents. Between 10:27 a.m. and 10:32 a.m., the hot water was measured in each bathroom during physical plant tour and measured within the required limit of 105-120 degrees Fahrenheit in all three (3) bathrooms. COMMON AREAS: The common areas were checked for cleanliness and furniture was checked for functionality during time of visit. Laundry room is located right outside the hallway pass bedrooms #5 and #6. The LPA observed laundry detergent and supplies in cabinets above washer and dryer. Such cabinets were secured with a snap hooks carabiner instead of using a lock. LPA explained Licensee the importance to have these items stored inaccessible to residents with dementia. There is an attached locked garage accessible from the outside and the laundry room. LPA observed garage to store an extra fridge and freezer for perishable foods. Extra medical supplies and furniture was also observed in the garage. Continued on LIC 809-C Continued from LIC 809-C SURROUNDING GROUNDS (Outdoors): LPA observed two (2) non-working vehicles that are obstructing the two (2) pathways leading to the emergency exits. Licensee agreed to have vehicles removed to prevent a potential hazard in case of an emergency. When checking emergency exits, LPA observed a back gate which was shut closed. LPA asked licensee to open the gate, however licensee was unable to so. Licensee agreed to ensure that side gate facing back alley is repaired so it can be opened and closed properly. There was an area with proper furniture for outdoor use in the area located outside of living room to the left of the property for residents to enjoy. There are no bodies of water on the premises. RECORDS: Records review began at 2:00 p.m. Residents’ records were reviewed for, but not limited to care plans, medical records, admissions agreement, 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. All files were in order. Last emergency drill (Fire drill) was conducted on 07/02/2024. MEDICATIONS: Medications review began at 3:12 p.m., medications are centrally stored and locked in a cabinet in the hallway; medications are labeled and checked for expiration dates. Medications are properly documented on the centrally stored medication log. Per California Code of Regulations (CCR), Title 22, Division 6, Chapter 8, the following deficiencies are cited (Refer to LIC 9099-D). Exit Interview Conducted. Failure to correct the deficiencies may result in civil penalties. A Civil Penalty in the amount of $1,000 was assessed during today's visit. Appeal Rights Discussed. A Copy of Report Issued.the state’s words, verbatim · CDSS document, Jul 17, 2024