Bethany Home Concord

Type of visit: Required - 1 Year

On 11/19/2025 at 12:55 PM, Licensing Program Analyst (LPA) Ardalan Gharachorloo arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Administrator, Timea Yost and explained the purpose of the visit. LPA toured facility including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. A comfortable temperature is maintained at 72 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in the residents’ shared bathroom was measured at 113 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum of one week supply of non-perishable and 2 day of perishable foods. Centrally stored medication and sharps were locked and inaccessible to residents. Smoke detectors and carbon monoxide detectors were in operating condition during visit. Fire extinguisher was last serviced on 05/27/2025. Emergency Disaster Plan was last posted on 09/07/2025. First aid kit was observed to be complete. Emergency disaster drill was last conducted on 10/30/2025. LPA reviewed 3 residents records and 3 staff records; all were complete. LPA also reviewed a sample of resident’s medications. The following documents were reviewed during the visit: LIC 500 Personnel Report LIC 610E Emergency Disaster Plan, Liability Insurance, Current Administrator’s Certificate No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, Nov 19, 2025

Type of visit: Required - 1 Year

On 11/22/24 at 11:00 am Licensing Program Analysts (LPA) J. Clancy-Czuleger arrived unannounced to do an annual inspection. LPA meet with Administrator Telisha Clarke and explained the purpose of the visit. LPA inspected the facility inside out. There is no body of water. Physical plant is consistent with the facility sketch received by Central Application Bureau (CAB) and approved by the fire department. LPA inspected the living room, dining area, kitchen, bedrooms, hallways, bathrooms, side and backyards. Bedrooms were observed appropriately furnished with adequate lighting and drawers. Facility has sufficient towels, extra bed sheets and comforters. Equipment and supplies for residents' personal hygiene are available and on site. Dinner and silver wares were observed sufficient for residents' use. Food supplies checked and observed good for seven days of non-perishables. Facility was observed equipped with refrigerator, microwave, dishwasher, washer and dryer. Cabinet for knives, cleaning supplies, and central storage for medications were observed with locks. Activity supplies were available. Outdoor activity space was observed furnished with tables, chairs and shade. The facility has a mitigation plan. Fire extinguishers were observed fully charge and tags showed serviced 03/21/2024. At 12:02 pm LPA reviewed 6 residents records. At 12:25 pm, LPA reviewed 3 staff records and 3 of 3 were fingerprint cleared and associated to the facility. No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, Nov 22, 2024

Allegation investigated: Staff not informing Responsible Party of resident’s changes in condition No Administrator at facility on a regular basis Administrator qualifications Facility does not have grab bars for resident in bathroom Staff not ensuring resident receiving proper medical care

On 05/29/2024 at 2:35 PM, Licensing Program Analysts (LPAs) J. Clancy-Czuleger arrived unannounced to deliver findings for the above allegations. LPA explained the purpose of the visit with House Manager Telesha Clarke. Licensee Arpad Nagy was called and joined later. During the course of investigation, LPA obtained information, collected documents, and interviewed staff and residents. On the allegation facility Staff not informing Responsible Party of resident’s changes in condition. Based on record review and interviews the facility did not inform R1’s responsible party that whenever there was a change of condition with R1 or a when they were having trouble getting a prescription from the pharmacy. Continued on LIC9099-C... Substantiated ...Continued from LIC9099 On the allegation No Administrator at facility on a regular basis. Based on record review and interviews the facility administrator does not come to the facility. Residents, staff, and residents’ families believe that S1 is the administrator, and most residents and resident families are unaware of who S3 is. On the allegation administrator qualifications. Based on record review the facility administrator is currently listed as administrator to a total of four licensed facilities and has an application in for a fifth. When LPA asked for the LIC 500 S3 was not listed having any hours at the facility or on the LIC 500 at all. On the allegation facility does not have grab bars for resident in bathroom. The facility was licensed with three bathrooms. One bathroom is in a private room, one is at the back of the house and one in by the front of the house. The bathroom at the back of the house has a non-permeant/movable grab bar, the front bathroom has a permeant grab bar across from the toilet that is out of reach. On the allegation facility staff not ensuring resident receiving proper medical care. Based on record review and interviews the facility has not taken R1 to get an updated annual physician’s report since June 2022. Based on LPAs interviews, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations (Title 22, Division 6, Chapter 8), is being cited on the attached LIC 9099D. Exit interview conducted. Appeal Rights and a copy of this report provided. ...Continued from LIC9099-A On the allegation facility Administrator yells at the staff and at the residents. Based on record review and interviews the administrator does not come to the facility. On the allegation facility administrator punishes resident. Based on record review and interviews the facility administrator does not come to the facility. On the allegation facility Staff not administering all doses of resident’s medications. Based on record review and interviews the facility does not have a medication log of each dosage given to the residents. On the allegation facility staff not bathing resident in an appropriate manner. Based on interviews R1 has requested that only female staff assist with bathing. In interview with S1 they state that they were never informed of this preference. Although the allegations may have happened or are valid, there are not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, May 29, 2024 · control 15-AS-20240409090155

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87405(b) · Plan of correction due date: May 31, 2024

The administrator of a facility or facilities shall have the responsibility and authority to carry out the policies of the licensee. This requirement is not met as evidenced by: Based on observation, the licensee did not comply with the section cited above by having the house manager preform the duties of administrator without an administrator license which poses an immediate health and safety risk to persons in care.the state’s words, verbatim · CDSS document, May 29, 2024

Plan of correction: The licensee agrees to review the responsibilities of the administrator with the administrator. Proof of correction will be sent to CCLD by POC date.

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87405(a) · Plan of correction due date: May 31, 2024

All facilities shall have a qualified and currently certified administrator... The administrator shall have sufficient freedom from other responsibilities and shall be on the premises a sufficient number of hours to permit adequate attention to the management and administration of the facility as specified in this section... This requirement is not met as evidenced by: Based on records review and observation, the licensee did not comply with the section cited above by not having the administrator at the facility for a sufficient number of hours which poses an immediate health and safety risk to persons in care.the state’s words, verbatim · CDSS document, May 29, 2024

Plan of correction: The facility has staff signed up for administrator coruses. The facility agrees to send proof that the staff is signed up for the classes. Proof of correction will be sent to CCLD by POC date

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87468.1(a)(8) · Plan of correction due date: May 31, 2024

Residents in all residential care facilities ... following personal rights: To have their representatives regularly informed by the licensee of activities related to care or services, including ongoing evaluations, as appropriate to their needs. This requirement is not met as evidenced by: Based on observation, the licensee did not comply with the section cited above by not informing R1’s responsible party of changes which poses an immediate health and safety risk to persons in care.the state’s words, verbatim · CDSS document, May 29, 2024

Plan of correction: Licensee agrees to review the regulations and send self-certification to CCLD by POC date.

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87705(c)(5) · Plan of correction due date: Jun 5, 2024

Each resident with dementia shall have an annual medical assessment as specified in Section 87458, Medical Assessment, and a reappraisal done at least annually, both of which shall include a reassessment of the resident’s dementia care needs. This requirement is not met as evidenced by: Based on observation, the licensee did not comply with the section cited above by not having an annual medical assessment for R1 since 2022 which poses an immediate health and safety risk to persons in care.the state’s words, verbatim · CDSS document, May 29, 2024

Plan of correction: Licensee agrees to review all residents Physicians reports and schedule appointments to updated all residents with a diagnoses of dementia. Proof of correction will be sent to CCLD by POC date.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87303(e)(4) · Plan of correction due date: Jun 28, 2024

Grab bars shall be maintained for each toilet; bathtub and shower used by residents. This requirement is not met as evidenced by: Based on observation, the licensee did not comply with the section cited above by having a grab bar that it out of reach for resident to use which poses an immediate health and safety risk to persons in care.the state’s words, verbatim · CDSS document, May 29, 2024

Plan of correction: The facility agrees to install grab bars in the bathrooms in reach of the toilets. Proof of correction will be sent to CCLD by POC date.

Type of visit: Case Management - Deficiencies

On 04/10/2024 Licensing Program Analysts (LPA) J. Clancy-Czuleger and A. Gharachorloo arrived unannounced to conduct a Case Management. LPA met with Telesha Clarke, House Manager. While LPA J. Clancy-Czuleger conducted a complaint investigation (15-AS-20240409090155) on 04/10/2024, LPA observed that there were two staff members listed on the LIC 500 that are not associated to the facility.. LPAs verified that S1 and S2 are fingerprint cleared but not associated. During the investigation LPAs observed S3 enter the house, S4 stated that they were a new hire and were doing on boarding. LPAs interviewed staff and residents and found that S3 has been at the facility working before today. During the investigation LPAs asked for the medication logs of each dosage given to the residents. S4 stated that they were behind on those logs as they were doing it electronically and the system crashed and she was having to print them out and do it by hand. The deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22 and/or Health and Safety Code Failure to correct deficiency by POC date may result in additional Civil Penalties. Exit interview conducted. A copy of this report and appeal rights provided.the state’s words, verbatim · CDSS document, Apr 10, 2024

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87355(e)(2) · Plan of correction due date: Apr 12, 2024

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: Request a transfer of a criminal record clearance as specified in Section 87355(c) Based on observation, the licensee did not comply with the section cited above by having two staff who are not associated and one staff who is not associated which poses an immediate health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Apr 10, 2024

Plan of correction: Manager will ensure staff has a fingerprint clearance and is associated to facility before returning to work. A civil penalty of $1000 has been assessed

From the deficiency page — Deficiency type: Type A · Section cited: CCR87355(d) · Plan of correction due date: Apr 12, 2024

All individuals subject to criminal record review shall be fingerprinted and sign a Criminal Record Statement (LIC 508 [Rev. 1/03]) under penalty of perjury.the state’s words, verbatim · CDSS document, Apr 10, 2024

Plan of correction: The individual has been removed from the facility and will not return until they are fingerprint cleared and associated to the facility. Proof of correction will be sent to CCLD by POC date A civil penalty of $500 has been assessed

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87465(d)(3) · Plan of correction due date: Apr 12, 2024

If the resident is unable to determine his/her own need for a prescription or nonprescription ... (3) The date and time the medication was taken, the dosage taken, ...shall be documented and maintained in the resident's facility record. Based on observation the licensee did not comply by not having a log of dosages taken for each resident.the state’s words, verbatim · CDSS document, Apr 10, 2024

Plan of correction: The facility agrees to review the regulation and complete the medication logs for all residents. Proof of correction will be sent to CCLD by POC date

Type of visit: Required - 1 Year

On 12/05/23 at 1:10 pm Licensing Program Analysts (LPA) J. Clancy-Czuleger arrived unannounced to do an annual inspection. LPA meet with Administrator Telesha Clarke and explained the purpose of the visit. LPA inspected the facility inside out. There is no body of water. Physical plant is consistent with the facility sketch received by Central Application Bureau (CAB) and approved by the fire department. LPA inspected the living room, dining area, kitchen, bedrooms, hallways, bathrooms, side and backyards. Bedrooms were observed appropriately furnished with adequate lighting and drawers. Facility has sufficient towels, extra bed sheets and comforters. Equipment and supplies for residents' personal hygiene are available and on site. Dinner and silver wares were observed sufficient for residents' use. Food supplies checked and observed good for seven days of non-perishables. Facility was observed equipped with refrigerator, microwave, dishwasher, washer and dryer. Cabinet for knives, cleaning supplies, and central storage for medications were observed with locks. Activity supplies were available. Outdoor activity space was observed furnished with tables, chairs and shade. The facility has a mitigation plan. At 1:20 pm LPA reviewed 4 residents records. At 2:05 pm, LPA reviewed 3 staff records and 3 of 3 were fingerprint cleared and associated to the facility. No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, Dec 5, 2023