College Town Senior Retirement Villa

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Dang Nguyen made an unannounced visit to conduct a Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was welcomed by, identified himself to, and discussed the purpose of the visit with Caregivers Susana Salazar and Wendy Gomez. LPA also spoke via phone with Licensee/Administrator Anna Petrosyan during the visit. During today’s visit, LPA toured the facility, reviewed staff and resident records, and interviewed staff and residents. No deficiencies were cited during today’s visit. Due to time constraints, a return visit on a subsequent day is needed to complete the annual inspection. An exit interview was conducted with Licensee/Administrator Anna Petrosyan and Caregiver Wendy Gomez. A copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided to Licensee during the visit.the state’s words, verbatim · CDSS document, Dec 31, 2025

Allegation investigated: Neglect to resident resulting in serious bodily injury.

Licensing Program Analyst (LPA) Tiffany Holmes conducted an unannounced visit to deliver findings for a complaint investigation regarding the above-mentioned allegation. LPA identified herself and met with Miguel Sanchez, Caregiver, to discuss the purpose of the visit and elements of the complaint. The Department's investigation included interviews and a review of pertinent records. It was alleged that Neglect/Lack of Supervision resulted in serious bodily injury. On 11/07/22 the San Diego Adult and Senior Care Program received a complaint via a SOC341. Interviews with an outside source revealed Resident 1 (R1), was taken to Sharp Memorial Hospital on 11/01/22, where R1 was found to have urosepsis, fractured ribs, and a facial fracture. A record review of hospital records document that R1 had abrasions to their nose and left knee, dried blood on their fingers, and wound to knees in various stages of healing. Interviews revealed on 11/03/2023 that Staff 1 (S1) at the facility did not know R1 sustained the injuries. Interviews revealed that R1 was found on the floor on 11/01/22 and was sent to the hospital. R1 was also sent to the Hospital ER on these other dates of 10/19/22, 10/20/22, and 10/21/22 for claims of nausea and vomiting with blood. Unsubstantiated Interviews with the licensee, staff, and staff at St. Paul’s Pace, including medical personnel, was conducted. It was determined College Town licensee and staff had contacted St. Paul’s Pace on several occasions prior to R1’s last hospitalization while at College Town to request he be transferred to another facility that could provide a higher level of care to R1. Interviews revealed that College Town had reported a change in behavior and declining health to St. Paul’s Pace due to R1 not being able to stand and being more prone to falls. Interviews with outside source revealed a social worker from St. Paul’s Pace confirmed this and provided documentation. Interviews revealed that although several injuries were documented there wasn’t any documentation of concern for neglect, abuse, or non-accidental injuries were noted. The investigation did not produce substantiating evidence or supporting witness statements to substantiate the allegation of neglect or lack of supervision therefore the allegation is unsubstantiated. An exit interview was conducted with Miguel Sanchez, Caregiver. A copy of this report and Licensee's Rights (LIC 9058 03/22) were provided and their signature on this report confirms receipt of the Licensee Rights.the state’s words, verbatim · CDSS document, Jan 21, 2025 · control 08-AS-20221107101801

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA's) Amy Rodgers and Angelica Boyles conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was greeted by, identified themselves to, and discussed the purpose of the visit to Caregiver Gomez. LPA Rodgers also discussed the visit over the phone with licensee Anna Petrosyan. According to the facility’s license, the facility has a maximum capacity of six (6) residents all of whom can be non-ambulatory, and a waiver for four (4) residents on hospice. During today's inspection, there were a total of six (6) residents in care, of which one (1) received hospice care. This facility does not feature a secured perimeter or delayed egress doors. Required licensing postings were observed in visible areas of the facility. LPA, accompanied by Caregiver Gomez, toured the interior and exterior of the facility, and inspected each room. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Resident bedrooms contained the required furnishings. Doors, windows and screens, toilets, and showers were in working order. Extra linens, hygiene supplies, and Personal Protective Equipment (PPE) were present. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and resident activities. The facility’s ambient internal temperature was compliant. The facility's hot water temperature for faucets used by residents measured at 118 F. (continued on 809-C) There was no pool or large bodies of water on the premises. According to Caregiver Gomez, no firearms or ammunition are kept at the facility. Smoke alarms, carbon monoxide detectors, emergency lighting, and facility landline telephone were all working. Fire extinguisher was present. First aid kit and first aid manual were complete and readily accessible. Required licensing postings were observed in visible areas of the facility. LPA interviewed staff and reviewed multiple staff and client records/files. The interviews did not raise any licensing concerns. The resident and staff files contained the required documents. Confidential records, medications, and toxins were inaccessible to residents in care. During today's visit, no deficiencies were observed. An exit interview was conducted with Caregiver Gomez, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided during the visit.the state’s words, verbatim · CDSS document, Dec 19, 2024

Allegation investigated: Resident sustained unexplained bruising while in care

Licensing Program Analyst (LPA) Renita Hall, conducted an unannounced visit to open a complaint and deliver findings regarding the above-mentioned allegation LPA was allowed entry by Nvard Bebekyan, Administrator. LPA identified herself and disclosed the purpose of the visit and elements of the findings to the Administrator. On January 30, 2024, the Department received a complaint that: resident sustained unexplained bruising while in care. The Department investigated the complaint allegation. The investigation consisted of a tour of the facility, an interview with staff and residents, and a records review. The complainant did not provide any specific information regarding the allegation. A review of records indicated that Resident 1 (R1) is non-ambulatory and required a two-person assist to be transferred due to limited mobility and weakness on one side of the body. Staff and residents were interviewed and did not witness any willful neglect that would cause unexplained bruising while in care. Continued on 9099C Unsubstantiated There was insufficient evidence found to support the allegation that: Resident sustained unexplained bruising while in care. Due to a lack of evidence, the allegation is deemed to be unsubstantiated. An unsubstantiated finding means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. An exit interview was conducted with Nvard Bebekyan, Administrator. A copy of this report and Licensee's Rights (LIC 9058 03/22) were provided to the Administrator and her signature on this report confirms receipt of the Licensee Rights.the state’s words, verbatim · CDSS document, Feb 2, 2024 · control 08-AS-20240130163437

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Debbie Correia conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was greeted by, identified themselves to, and discussed the purpose of the visit to Caregiver Bebekyan. According to the facility’s license, the facility has a maximum capacity of six (6) residents all of whom can be non-ambulatory, and a waiver for four (4) residents on hospice. During today's inspection, there were a total of four (4) residents in care, of which one (1) received hospice care. This facility does not feature a secured perimeter or delayed egress doors. Required licensing postings were observed in visible areas of the facility. LPA, accompanied by Caregiver Bebekyan, toured the interior and exterior of the facility, and inspected each room. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Resident bedrooms contained the required furnishings. Doors, windows and screens, toilets, and showers were in working order. Extra linens, hygiene supplies, and Personal Protective Equipment (PPE) were present. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and resident activities. The facility’s ambient internal temperature was compliant, at 73 F. The facility's hot water temperature for faucets used by residents measured at 112 F. There was no pool or large bodies of water on the premises. According to Caregiver Bebekyan, no firearms or ammunition are kept at the facility. Smoke alarms, carbon monoxide detectors, emergency lighting, and facility landline telephone were all working. Fire extinguisher was present. First aid kit and first aid manual were complete and readily accessible. Required licensing postings were observed in visible areas of the facility. LPA interviewed staff and reviewed multiple staff and client records/files. The interviews did not raise any licensing concerns. The resident and staff files contained the required documents. Confidential records, medications, and toxins were inaccessible to residents in care. During today's visit, no deficiencies were observed. An exit interview was conducted with Caregiver Bebekyan, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided during the visit.the state’s words, verbatim · CDSS document, Dec 18, 2023