Cotton Villa RCFE

Allegation investigated: Staff do not safeguard residents personal belongings Staff does not ensure resident is served nutritious meals Staff serve resident expired food Staff do not ensure resident's basic needs are being met Facility is not sufficiently staffed to meet the needs of residents in care Staff do not ensure resident is provided prescribed medications as needed

Licensing Program Analyst (LPA) Seo Jeon conducted an unannounced visit to the facility to deliver findings of the above allegations. LPA met with Ben Zhumanazarov, Caregiver, and informed them of the purpose of the LPA’s visit. The Department’s investigation involved interviews with staff and resident and review of records. On August 23, 2026, Community Care Licensing (The Department) received a complaint report with the following allegations: Staff do not safeguard resident’s personal belongings. Staff do not ensure resident is served nutritious meals. Staff serve resident expired food. Staff do not ensure resident’s basic needs are being met. Facility is not sufficiently staffed to meet the needs of residents in care. Staff do not ensure resident is provided prescribed medications as needed. (Continued on LIC9099-C) Unfounded Information received indicated that Resident #1 (R1) did not receive assistance with activities of daily living (ADL) from staff members. LPA conducted an interview with R1, who stated that they did not require staff assistance with ADL. R1 provided a tour of the room and stated that R1 could cook and manage their own medications. R1 did not express any concerns with their ADL. R1 expressed their concern with rent payment. R1 did not understand why they must pay monthly rent. LPA conducted an interview with Staff #1 (S1), who stated that R1 was a tenant at an independent studio of the facility building, not a resident of the licensed facility. LPA and S1 conducted a tour of the facility. LPA observed that R1 did not have access to any part of the facility, including the backyard. S1 pointed out that R1’s room was not a part of the facility. Based on interviews conducted and observations, R1 was not a resident at the facility. This allegation is Unfounded. A finding of Unfounded means the allegation could not have happened, is false, and/or is without a reasonable basis. An exit interview was conducted where a copy of this report was provided.the state’s words, verbatim · CDSS document, Sep 17, 2026 · control 18-AS-20260823110640

Type of visit: Office

Licensing Program Manager (LPM), Jazmond Harris and Licensing Program Analysts (LPAs), Jacqueline Shaw-Ross and Imaculada Vasquez, met with Licensee/Administrator, Anahit Mesropyan at the Riverside Adult and Senior Care Regional Office for the purpose of discussing a concern reported on July 2, 2026 regarding an unlicensed operation. Title 22 Regulations and Health and Safety Code sections were provided: Unlicensed allegations. Section 80064 Administrator Qualifications and Duties, pertaining to knowledge of and ability to comply with applicable law and regulation. Licensee agreed to cooperate with Department investigations and inspections, including at unlicensed addresses where the Department may have received allegations of unlicensed care. Licensee provided additional documentation and information regarding the unlicensed investigation. An exit interview was conducted and a copy of this report and regulations were provided to Licensee, Anahit Mesropyan.the state’s words, verbatim · CDSS document, Jul 7, 2026

Allegation investigated: Staff is not meeting resident's care needs.

Licensing Program Analyst (LPA), Ivashia Wright, conducted an unannounced visit to deliver findings for a complaint investigation regarding the above allegation. LPA Ivashia met with Caregiver Beknazar Zhumanazarov and explained the purpose of the visit. On March 25, 2026, Community Care Licensing Division (CCLD) received a complaint alleging Staff is not meeting resident's care needs. During the investigation, the LPA inspected the facility, reviewed R1's records, and conducted interviews with staff and residents. Regarding the allegation that Staff is not meeting resident's care needs., it was reported that Resident 1 (R1) vital signs had not been taken. Continued on LIC 9099-C Unsubstantiated Interview with Licensee, Administrator Anahit Mesropyan stated R1 was receiving hospice care services twice a week and R1’s vitals were checked during each visit. It was also advised that the facility staff check residents’ vital signs every morning. Information obtained from interviews with additional staff corroborated the information obtained from Administration. Information obtained from an interview with Hospice Nurse, Danielyan Ashkhen confirmed that services included ensuring vital signs were taken for R1. LPA was not able to obtain any additional information regarding the allegation due to R1’s inability to communicate. A review of records indicated that vital signs were taken during hospice visits. Based on staff interviews, resident interviews, facility records, hospice records, and R1's files, staff not recording vitals; no documentation available and the inability to interview R1, the allegations that staff is not meeting resident's care needs due to staff not taking R1’s vitals is deemed unsubstantiated. This means that although the allegations may have happened or are valid, the preponderance of evidence requirement has not been met to prove that the alleged violations did or did not occur. An exit interview was conducted and a copy of this report, 9099C, 9099D, appeal rights were reviewed and provided to Caregiver, Beknazar Zhumanazarov.the state’s words, verbatim · CDSS document, May 1, 2026 · control 18-AS-20260325142446

Type of visit: Case Management - Other

On April 10, 2026, Licensing Program Analyst (LPA), Jarred Torres, arrived at the facility unannounced to amend a LIC 809 - Facility Evaluation Report regarding the annual inspection that LPA conducted on April 9, 2026. LPA met with Administrator (AR), Anahit Mesropyan, and explained the purpose of the visit. LPA amended the LIC 809 - Facility Evaluation Report during this visit. A copy of this report and the amended LIC 809 - Facility Evaluation Report were reviewed and provided to Administrator, Anahit Mesropyan, whose signature on this form confirms receipt.the state’s words, verbatim · CDSS document, Apr 10, 2026

Type of visit: Required - 1 Year

On April 9, 2026, Licensing Program Analyst (LPA), Jarred Torres, arrived at the facility unannounced to conduct an annual inspection and met with Administrator, Anahit Mesropyan. A facility file review was conducted at the regional office and additional records were requested and reviewed at the facility. Their files were stored in a secure location. The facility is licensed for six elders and was operating at a census of four elders. The LPA toured the facility along with the Administrator and made observations pertaining to the annual inspection. The LPA inspected the facility inside and outside. There were no obstructions on the indoor and outdoor passageways at the time of this visit. Additionally, there were no bodies of water on the premises. During the tour of the premises, the LPA observed the facility phone to be operable. The facility's phone number is 818-807-1338. The LPA observed the residents' bedrooms which were equipped with the required furniture as stated in Tittle 22 of the California Code of Regulations (CCR). The furniture in all areas of the facility was observed to be in good condition. The facility's appliances were observed to be operational at the time of this visit. Required postings regarding safety, personal rights, and emergency exits were posted in the home. Sharp items were kept locked and inaccessible to residents in care. Continued on LIC 809-C... The facility's cooling and heating system is operational and the air temperature was at 76 degrees Fahrenheit (F) and the hot water was measured at 119 F. The LPA observed the medications to be locked and inaccessible to clients in care. The medication supply was sufficient for the four clients in care. There were no discrepancies with the centrally stored medications. In the kitchen, the food supply of non-perishable and perishable foods consisted of, but not limited to, bread, eggs, pasta, frozen meats, vegetables, juice, water, and fruits. The facility goes grocery shopping two times per week and maintains an appropriate food supply for the four clients in care. Adequate staff was present for the supervision of the four residents in care. The facility has a designated area for storing activity supplies and activities are conducted in the living room. Telephone numbers and floor plans were posted in the facility. The Administrator showed proof that they are on the list of active administrators; however, the Administrator has not received their new certificate in the mail yet. Client files and staff files were reviewed and no deficiencies were observed. The LPA reviewed the emergency disaster plan and fire clearance. The last fire drill was on January 2, 2026. The fire alarms and carbon monoxide detectors were tested and operational. The fire extinguishers were in good condition and were purchased on April 4, 2026. The emergency disaster plan meets the department's standards. The LPA inspected the bathrooms and observed the hand washing stations to be stocked with soaps, bath tissue, and single-use hand towels. Furthermore, the bathrooms are free of dust and debris. Additionally, the facility has an approved infection control plan in their files. An exit interview was conducted and this report was reviewed with and provided to Administrator, Anahit Mesropyan.the state’s words, verbatim · CDSS document, Apr 9, 2026

Allegation investigated: Staff neglected the resident in care Staff got angry with resident in care

Licensing Program Analyst (LPA) Kimberly Ramirez conducted an unannounced subsequent complaint investigation visit on 03/23/2026 regarding the above allegations. On 12/20/2023, LPA Mixon conducted an unannounced initial complaint investigation, and a need further investigation was documented. During today’s visit LPA Ramirez was greeted by Administrator Mesropyan and explained the purpose of the visit. The investigation consisted of the following: LPA Ramirez requested and obtained copies of Resident/Client Roster, Staff Roster (LIC 500), Staff#1 - 4 interviews (S1 – S4), Resident#2-3,5 interviews (R2-R3, R5), attempted interview of R4, copies of R1’s hospice care plan, resident appraisal (LIC 603A), preplacement appraisal information (LIC 603), identification and emergency information (LIC 601), physician’s report (LIC 602A), appraisal/needs and services plan (LIC 625), death report (LIC 624A), copy of staff#5 (S5) personnel record, and physical plant tour. SEE 9099-C Unsubstantiated The investigation revealed the following: regarding the allegation “Staff neglected the resident in care.” It is alleged staff neglected R1. Three (3) out of the three (3) residents interviewed by LPA Ramirez denied this allegation. Resident interviews revealed residents in care do not feel neglected by staff. Four (4) out of the four (4) staff interviewed denied this allegation. R1 is no longer at the facility and was not interviewed during LPA’s visit. During record review, LPA did not observe incident reports which indicated R1 was neglected while in care. During facility tour, LPA Ramirez toured three (3) occupied resident rooms and did not observe any deficiencies. LPA Ramirez observed residents in care to be well groomed and alert. On 12/20/2023, hospice staff interview conducted by LPA Mixon revealed that in December of 2023, facility staff did notify hospice staff about R1’s leaky ileostomy bag and hospice staff arrived to change R1’s bag and leave additional supplies. This interview also revealed that hospice staff trained facility staff on how to change R1’s ileostomy bag and hospice staff observed facility staff properly complete this task. On 12/20/2023, resident interview conducted by LPA Mixon did not corroborate this allegation. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED. “Staff got angry with resident in care.” It is alleged S5 got angry with R1. Three (3) out of the three (3) residents interviewed by LPA Ramirez denied this allegation. Residents interviewed corroborated they felt “safe” at the facility and felt “respected” by staff. Four (4) out of the four (4) staff interviewed denied this allegation. R1 is no longer at the facility and was not interviewed during LPA’s visit. Interview with Administrator Mesropyan revealed R5 no longer works at the facility and resigned in December of 2024 to move back to their country. LPA attempted to contact R5 via telephone, but all attempts were unsuccessful. On 12/20/2023, resident interview conducted by LPA Mixon did not corroborate this allegation. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED. No deficiencies were cited. Exit interview was conducted. A copy of this report was provided.the state’s words, verbatim · CDSS document, Mar 23, 2026 · control 18-AS-20231215142712

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Abdoulaye Zerbo conducted an unannounced visit for a required annual inspection. The LPA was greeted by Licensee/Administrator ANAHIT MESROPYAN , notified them of the purpose for the visit and was allowed to enter the facility to conduct the inspection. Facility Overview: The facility is a single story building with three(3) residents bedrooms, one(1) staff bedroom, two(2) bathrooms, a dinning room, a family room, a kitchen and a garage. There is no gated pool and there are no firearms on the premises. Infection Control: LPA observed that hygiene and cleaning supplies were available for regular facility maintenance. The facility’s infection control plan was reviewed and found to meet department's requirements. Physical Plant: The physical plant, including floors, windows, and doors, was clean and well maintained. Fixtures and furniture were in good repair. Laundry equipment was in good working condition. Sharp and dangerous objects were securely locked in the kitchen and inaccessible to residents. The smoke detector and carbon monoxide detector were in good working condition. LPA observed fire extinguishers to be in compliance with the department's requirements and with an expiration date of April, 2026. The water temperature was tested within regulations measuring at 108.8 F Continued 809-C...... Care & Supervision/Administration: Adequate staff were present to supervise residents during the visit. The administrator holds a current administrator’s certificate with expiration date of September 18, 2026 and a CPR certification with the expiration date of September 18, 2026 Record Review and Resident/Staff Files: LPA reviewed files for two(2) staff members, confirming criminal clearance, updated training, and CPR/First Aid certification. Two (2) residents' files were reviewed and contained all required documentation. LPA observed first kit to be locked and inaccessible to the residents in care. The residents and staff files were kept in the dining room area and inaccessible to unauthorized individuals Health-Related Services/Incidental Medical Services: All residents' medications were securely locked in a cabinet and located in the dining room area. LPA reviewed medications for four(4) residents, confirming that all medications were listed and accounted for. Disaster Preparedness: LPA reviewed the facility’s emergency and disaster plan, including documentation of the last emergency drill conducted on 01-29-2025, which met department requirements. All facility exits were clear of obstructions. No deficiencies were cited during the visit. An exit interview was conducted, during which this report was reviewed, and a copy was provided to Licensee/Administrator ANAHIT MESROPYAN.the state’s words, verbatim · CDSS document, Apr 4, 2025

Allegation investigated: Staff hit resident

On 5/2/2024, Licensing Program Analyst (LPA) Janette Romero made an unnanounced visit at the facility to investigate the allegation listed above. LPA met with Administrator, Anahit Mesropyan. It was alleged that facility staff hit Resident 1 (R1) when R1 does not comply with staff's requests. Staff 1 (S1) and Staff 2 (S2) were listed as possible suspected abusers. S1 and S2 were interviewed and denied hitting any residents or observing R1 ever being hit by staff. During today's visit, LPA toured the facility, conducted staff and resident interviews and obtained copies of pertinent documentation. There are three (3) residents currently residing in the facility, which were interviewed by LPA. Unsubstantiated Two (2) of three (3) resident interviews conducted reported they have never been physically and/or mentally abused by facility staff. Two (2) of three (3) resident interviews reported witnessing R1 verbally abuse S1 during one (1) occasion and denied observing S1 physically/verbally abuse R1. Although the allegation may have happened or is valid, there is no preponderance of evidence to prove the alleged violation did or did not occur; therefore, the allegation is unsubstantiated. An exit interview was conducted, and a copy of this report was provided to Administrator, Mesropyan.the state’s words, verbatim · CDSS document, May 2, 2024 · control 18-AS-20240425162329

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Crystal Colvin arrived at the facility unannounced for the purpose of conducting the annual inspection. LPA Colvin met with Administrator/Licensee Anahit Mesropyan and informed her of the purpose of today's inspection. Below is a summary of what was observed: Infection Control: LPA Colvin observed that the facility has an updated Infection Control Plan on file and is demonstrating best practices in the facility to maintain a healthy environment for staff and residents. Physical Plant: LPA Colvin toured the facility and observed that there a sufficient bedrooms and bathrooms for both staff and residents. LPA Colvin observed the required furniture and linen to be present and in good condition in resident bedrooms. LPA Colvin measured the hot water in the bathroom faucets to be 136.5 degrees. Deficiency cited. LPA Colvin tested the facility's carbon monoxide alarm and smoke detectors and found them to be operational. LPA Colvin toured the backyard and confirmed that no exits or pathways were blocked. LPA Colvin observed sufficient supply of perishable and non-perishable food and utensils and dishes for the residents in care. Knives are kept locked in a drawer in the kitchen and away from resident reach. Operational Requirements: The facility has a licensed capacity of 6 non-ambulatory residents, one of which may be bedridden. Facility has a hospice waiver for 6 residents. LPA Colvin observed the facility to be operating within these parameters. Staffing & Staff Records: LPA Colvin confirmed that there are sufficient staff present to meet the needs of residents. LPA Colvin additionally confirmed that the facility has an Administrator present at the facility and that their Administrator Certificate is current. LPA Colvin reviewed staff records and confirmed current CPR/First Aid Certification as well as training relevant to the facility and residents' needs. Resident Records: LPA Colvin reviewed the files for all 3 current residents to confirm that they have the required information present in their files, including Physician's Report, Admissions Agreement, and current Needs & Services Plan. All resident files contained required documents for residents' care. Incidental Medical Services: LPA Colvin observed that resident medication is locked in a cabinet and inaccessible to residents. LPA Colvin confirmed that the facility is not retaining any residents with prohibited health conditions. Planned Activities: LPA Colvin confirmed that the facility provides activities for residents to engage in. Emergency Disaster Preparedness: LPA Colvin confirmed that the facility has an Emergency Disaster Plan on file and is conducting regular Emergency Disaster Drills. An exit interview was conducted with Administrator/Licensee Anahit Mesropyan and a copy of this report, LIC809D, and appeal rights were provided.the state’s words, verbatim · CDSS document, Apr 24, 2024

Allegation investigated: Staff handled resident in a rough manner, resulting in an injury. Staff threatened resident.

Licensing Program Analyst (LPA) Jesse Gardner conducted an unannounced subsequent complaint visit to the facility. LPA met with Licensee/Adminitrator Anahit Mesropyan, and informed them of the purpose of this visit. LPA then toured the facility. During this investigation, the Department conducted interviews with staff and clients; obtained supportive documentation for review to assist with determining the findings for the above noted allegations. The following was determined. Allegation# 1 - Staff handled resident in a rough manner, resulting in an injury. Concerns were expressed that Resident One (R1) had sustained a skin tear on their arm, and that staff (who spoke through a phone application translator) allegedly admitted to causing the skin tear by using force to get R1 to wash their hands. Unsubstantiated The Department’s investigation consisted of staff, resident, and witness interviews. Interview with R1 was attempted, but due to cognitive state, LPA was not able to retrieve much relative information. However, R1 revealed that they weren’t sure if anything happened to their arm, but that staff are nice and take care of them. A Witness interview stated that they saw Staff One (S1) with R1 in relation to the incident, and that it did not appear as if staff was “forcing” R1 to wash their hands, only that staff was assisting R1 with a bandage after sustaining an injury. Witness interview further stated that they believed that R1 could have sustained the injury due to R1 constantly scratching their head, neck and arms. Based on witness and staff statements of the incident, the allegation was Unsubstantiated. Allegation #2 – Staff threatened resident. The allegation received stated a caregiver told R1 that the caregiver would break R1’s arm if R1 went into the refrigerator for food. The statement provided further alleged that the threat was read out loud by R1 to the caregiver after the caregiver utilized a communication application on their phone to communicate with R1. LPA conducted interviews with R1, staff, and witnesses. Interview with R1 revealed that despite R1’s cognitive state, R1 enjoys staff and feels cared for. An additional resident interview revealed that staff are nice, and they also feel cared for. A Witness interview to the alleged incident denied knowledge of any statement related to staff threatening to break R1’s arm if they went into the refrigerator. Additionally, a Witness stated that staff assist residents with retrieving items from the refrigerator and will routinely go into the refrigerator at night and ask if residents would like anything. Based on resident interviews, the allegation is Unsubstantiated. A finding of Unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. An exit interview was conducted where a copy of this report was discussed with and provided, along with a copy of the LIC811 (confidential names list).the state’s words, verbatim · CDSS document, Jan 3, 2024 · control 18-AS-20231130143231