Encino Gardens

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Tihesha Smith conducted a case management visit in conjunction with a complaint visit:31-AS-20260410162348. LPA review of LIC 500 Personnel report has new staff at facility. Discussion with lead staff reveal the facility had a change in ownership. LPA Smith unable to locate any documents that the Regional department was contacted prior to the change. Deficiency cited on 809D Exit interview conducted/copy of report given.the state’s words, verbatim · CDSS document, Apr 17, 2026

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87205(a) · Plan of correction due date: Apr 24, 2026

Accountability of Licensee Governing Body. The licensee... shall exercise general supervision over the affairs of the licensed facility and establish policies concerning its operation... welfare of the individuals it serves. This requirement is not met as evidenced by: the licensee failed to notify the Department at least 30 days prior to the sale/transfer of the facility, as required by Title 22 which poses a potential risk to residents in carethe state’s words, verbatim · CDSS document, Apr 17, 2026

Plan of correction: The facility will immediately submit all required documentation related to the recent ownership change to the Department for review. POC: 04/24/26

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Leslie Ngo-Castaneda conducted an annual required visit and inspection of the facility. LPA was greeted by Rodrigo Woco who is the designee and was explained the reason for the visit. At 11:45 AM, with the assistance of designee, LPA took a tour of the physical plant. Required postings were observed in the entry area. At 11:14 AM the smoke alarms were tested are operational that are located each bedroom, the hallway and kitchen. There are carbon monoxide detectors that functions properly. The fire extinguisher is in the hallways and kitchen. The charge date is 7/7/2025. During the visit the facility is at 74 degrees Fahrenheit. The facility is fire cleared for six (06) non-ambulatory residents. Hospice waiver for six (6); one maybe bedridden. Kitchen: The kitchen appliances and fixtures were functional. The kitchen has a working gas stove, faucet, freezer, refrigerator, and microwave. LPA found enough at least two (2) days perishable and seven (7) days non-perishable food at the facility that is properly stored. Frozen foods are wrap, dated, and stored properly as well. Knives were stored in a locked cabinet in the kitchen. Food storage and preparation areas are clean and inaccessible to pests. Garbage cans have tight fitting covers. Cleaning supplies, pesticides or toxic cleaning supplies were stored and locked away in the kitchen cabinet. Bedrooms: There were seven (7) bedrooms designated for residents' use. Bedroom #1, bedroom #2, bedroom #3, bedroom #4, bedroom #5, and bedroom #6 are all private used for residents, the bedrooms were properly furnished with appropriate dresser, beddings, and linens with sufficient lighting. Bedroom #7 is for staff used and is located in between the kitchen and dining table. Continue to LIC 809-C Bathrooms: There are four (4) bathroom designated for residents' and staff use. The bathrooms were properly supplied and had functional fixtures. Hot water temperature was measured at 117.5 degrees Fahrenheit for bathroom #1 located in the hallway inside bedroom #1. Hot water temperature was measured at 111.5 degrees Fahrenheit for bathroom #2 located across bedroom #1. Hot water temperature was measured at 105.6 degrees Fahrenheit for bathroom #3 located inside bedroom #2. There was enough clean linen available in the cabinets in the hallway. Bathroom #4 is located inside the staff bedroom and is only designated only for staff. Common Areas: LPA toured all common areas of the facility. These included the living room and dining area for residents. The common areas were properly furnished. Residents dining table fits enough for six (6). LPA observed common areas to be very clean and tidy. LPA observed the floors to be in very good condition. No obstructions and or tripping hazards throughout the facility. Furniture in common area was observed to be in good repair. There are no issues with Fire Clearance. Infection control: Facility mitigation plan to make sure licensee was following current infection control recommendations. LPA obtain a copy and reviewed the infection control plan during this visit. Surrounding Grounds: Entry and exits were free of obstruction. There was furniture appropriate for outdoor use. The outdoor area was free of hazards. The facility does not have a swimming pool or bodies of water. There is no garage only a car port in front of the facility entrance. Laundry service: There is enough linen available to change weekly or more if need. Cleaning supplies are being stored in a locked cabinet in the laundry area and is located beside the kitchen. Staff Files: LPA also conducted a file review of staff records to ensure forms and training are up to date and compliance with licensing forms. Records were checked for expired or missing certificates and clearances: LPA conducted a file review of staff for criminal record clearances and current First Aid. The administrator file was reviewed for current first aid, fingerprint clearance, administrator certificate, and HIV/AIDS and TB training. Continue to LIC 809-C Medications are in a centrally stored and locked place, including over-the-counter medicines; medications are properly labeled and checked for expiration dates. Each centrally stored prescription and PRN medication has been logged in the medications log with proper documentation from the clients’ doctor. Proper medication dispensing instruction are followed and checked for contamination. First-aid has all proper items and is current. Resident records were reviewed for requirements and legibility: LPA reviewed client’s files for current appraisal. Planned activities are offered. Facility is within CA code of Regulations Title 22 or Health and Safety Code. No deficiencies were found, exit interview conducted, copy of report has been issued and discussed.the state’s words, verbatim · CDSS document, Jul 7, 2025

Allegation investigated: Staff are not abiding to the admission agreement Staff are not providing comfortable and healthful accommodations for the residents Staff did not provide a notice of alterations to the facility Staff did not prevent the residents from having accessing to harmful items Staff did not properly notify change of ownership/control of the facility

On 12/03/24, at 9:15am, Licensing Program Analyst (LPA) Gina Saucedo arrived at the facility to conduct an unannounced, initial complaint visit and was greeted by Caregiver, Rod Wycoco. The administrator was called but there was no answer. The administrator's brother arrived about an hour after LPA's arrival-Sevak Arutyunyan. LPA explained the purpose of this visit was to gather information, interview staff and residents and deliver findings for this complaint. On 12/03/24, LPA Saucedo asked for the census, staff, and resident rosters. On 12/03/24, LPA Saucedo conducted a physical tour and interviewed staff and residents. LIC 9099C-continued Substantiated Regarding the allegation: Staff are not abiding to the admission agreement. It is being alleged that there has been a rent increase in which the residents did not receive sixty (60) days’ notice and have also been told they need to be out of the facility by 12/1/24 if they are not willing to pay. During LPA's interview with the caregiver, the caregiver admitted that there was four (4) residents living at the facility but two (2) were moved out 12/01/24 and does not know where they were moved to. LPA interviewed two (2) residents that confirmed they will also be moving out soon. One (1) resident confirmed they will be moving out today-12/03/24. Therefore, based on the LPA's observations, staff, and resident interviews the above allegation(s) above is SUBSTANTIATED at this time. Regarding the allegation: Staff are not providing comfortable and healthful accommodations for the residents. It is being alleged that because construction is being conducted at the facility residents have experienced paint fumes, hammering and excessive noise. During LPA's physical tour, LPA observed construction in the hallway in between the rooms with excessive noise. One (1) staff did confirm that there is construction being conducted. Two (2) residents confirmed that there is excessive noise. Therefore, based on the LPA's observations, staff, and resident interviews the above allegation(s) above is SUBSTANTIATED at this time. Regarding the allegation: Staff did not provide a notice of alterations to the facility. It is being alleged that there is construction being done inside the facility. During LPA's physical tour, LPA observed construction in the hallway in between the rooms. LPA took pictures of the construction being conducted. LPA also confirmed that Community Care Licensing department was not notified of the altercations to the facility being conducted. One (1) staff did confirm that there is construction being conducted. Two (2) residents confirmed that there has been construction to the above facility since the facility has been bought and has new owners. Therefore, based on the LPA's observations, staff, and resident interviews the above allegation(s) above is SUBSTANTIATED at this time. LIC9099C-continued Regarding the allegation: Staff did not prevent the residents from having access to harmful items. It is being alleged the residents have access to knives and tools while there is construction being conducted. During LPA's physical tour, LPA observed construction in the hallway in between the rooms with tools exposed to the residents. LPA took a picture of the tools being exposed. One (1) staff did confirm that there is construction being conducted. Two (2) residents confirmed that since new management bought the house there has been construction being conducted. Therefore, based on the LPA's observations, staff, and resident interviews the above allegation(s) above is SUBSTANTIATED at this time. Regarding the allegation: Staff did not properly notify change of ownership/control of the facility. It is being alleged that there is new ownership/administration/control of the facility. Two (2) residents were interviewed and confirmed that the above facility has been sold and there is also a new administrator. One (1) staff confirmed that they are new to the above facility and is taking care of two (2) residents and is unaware of what was being done and the future intentions of the above ownership/control of the facility. Therefore, based on the LPA's observations, staff, and resident interviews the above allegation(s) above is SUBSTANTIATED at this time. An exit interview was conducted, citation(s) were issued and a civil penalty for the above allegation(s), appeal rights were given and a copy of this report was given to the Administrator's brother.the state’s words, verbatim · CDSS document, Dec 3, 2024 · control 31-AS-20241125125419

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87507(4)B) · Plan of correction due date: Dec 17, 2024

(4) Modification conditions, including the requirement for the provision of at least 60 days prior written notice to the resident of any rate or rate structure change..(B) The conditions under which a licensee may increase or change rates shall be specified in the admission agreement..This requirement is not met by: Based on the observation and record review of the facilities' admission agreement page 71, the licensee did not comply with the section cited above which poses an immediate health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Dec 3, 2024

Plan of correction: Administration/Licensee will need to abide by their admission agreement page 71 and send notification to LPA of where the residents were transferred to. POC Due Date: 12/17/24

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87202(a) · Plan of correction due date: Dec 17, 2024

(a) All facilities shall maintain a fire clearance...Prior to accepting or retaining any of the following types of persons, the applicant or licensee shall notify the licensing agency and obtain an appropriate fire clearance approved by the city, county, or city and county fire department or district providing fire protection services, or the State Fire Marshal: This requirement is not met as evidenced by: Based on the observation and record review, the licensee did not comply with the section cited above in several (areas) of the facility which poses an immediate health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Dec 3, 2024

Plan of correction: Administration/Licensee will need to contact the fire department to receive immediate fire clearance and send notification to LPA. POC Due Date: 12/17/24

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87208(a) · Plan of correction due date: Dec 17, 2024

(a) Each facility shall have and maintain a current, written definitive plan of operation...Any significant changes in the plan of operation which would affect the services to residents shall be submitted to the licensing agency for approval. The plan and related materials shall contain the following:This requirement is not met as evidenced by: Based on the observation, interview and record review, the licensee did not comply with the section cited above in submitting a written declaration stating that there will be structural changes to the facility which poses/posed a potential health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Dec 3, 2024

Plan of correction: The licensee/administrator will submit a written declaration explaining the steps that they are going to take to complete the project and notify the LPA. POC Due Date:12/17/24

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87305(a) · Plan of correction due date: Dec 17, 2024

Prior to construction or alterations, all facilities shall obtain a building permit. This requirement is not met as evidenced by: Based on the observation, interview and record review, the licensee did not comply with the section cited above in structural changes which poses/posed a potential health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Dec 3, 2024

Plan of correction: The licensee/administrator will submit a copy of the payment and new facility sketch submitted to the building permit department and notify LPA POC Due Date:12/17/24

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87303(a) · Plan of correction due date: Dec 17, 2024

(a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors. This requirement is not met as evidenced by: Based on the observations, the licensee did not comply with the section cited above in the areas of construction being clean, safe and sanitary for residents which poses/posed a potential health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Dec 3, 2024

Plan of correction: The Administration/Licensee will need to keep all areas of construction clean, safe and sanitary at all times for residents and notify LPA when repairs will need to be completed. POC Due Date: 12/17/24

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87355(e)(1) · Plan of correction due date: Dec 4, 2024

Criminal Clearance 87355(e)(1) 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: (1)Obtain a California clearance or a criminal record exemption as required by the Department This requirement is not met as evidenced by: Licensee failed to obtain criminal clearance/background association for an indvidual that is currently working as a staff which poses an Immediate Health, Safety or Personal Rights risks to persons in care.the state’s words, verbatim · CDSS document, Dec 3, 2024

Plan of correction: LPA requested adminstrator to remove the individual from the facility area as soon as possible. Within 24 hours licensee must inform RO that the individual is removed and will not return to facility without criminal record clearance and association. A $300.00 civil penalty will be assessed at the time of this visit.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87407(k)(1) · Plan of correction due date: Dec 17, 2024

(k) Whenever a certified administrator assumes or relinquishes responsibility for administering a residential care facility for the elderly, he or she shall provide written notice, within thirty (30) days, to: (1) The local licensing office responsible for receiving information regarding personnel changes at the licensed facility..This requirement is not met as evidenced by: Licensee/Administrator failed to notify Community Care Licensing Department of any changes of ownership/administration changes which poses an Immediate Health, Safety or Personal Rights risks to persons in carethe state’s words, verbatim · CDSS document, Dec 3, 2024

Plan of correction: The licensee/administrator will notify Community Care Licensing Deparment of administration/ownership changes and qualifications of changes to the above facility. POC Due Date:12/17/24

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Abeye Duguma met with Zoey Gevorkian for a Required One (01) Year visit. LPA explained the reason for the visit. A tour of the physical plant was conducted at 09:00 AM and the following was noted: There is one entrance being utilized at the facility. The facility has a total of six (06) bedrooms and four (04) bathrooms. The facility is fire cleared for six (06) non-ambulatory. The facility is currently occupying four (04) non-ambulatory residents. The facility has outdoor furniture with a covered shaded area for residents and visitors. The facility does not have a swimming pool/body of water. Laundry detergents, cleaning agents and other toxins are locked away. Kitchen is sufficiently stocked with at least two (02) days perishable and seven (07) days non-perishable food. Frozen foods are wrapped and stored appropriately. Food storage and preparation areas are clean and inaccessible to pests. Knives and sharps are observed to be locked and inaccessible to residents. The living and dining room are neat and clean. The facility maintains a comfortable temperature at 72°F. The smoke and carbon monoxide detectors are hardwired, interconnected and observed to be operational. Fire extinguisher is located in the kitchen, observed to be fully charged. (continued on LIC 809-C) The residents' rooms are adequately furnished with appropriate lighting system. Hallways are well lit. Residents have enough personal hygiene product provided by the licensee. The bathroom was checked for cleanliness and proper operations. The hot water temperature was measured at 117.3°F. Towels and washcloths are not shared. There was enough clean linen available in the cabinets. LPA observed medication and first aid kit to be locked and inaccessible to residents. No health and safety hazards noted during the visit. Exit interview conducted. Copy of this report issued.the state’s words, verbatim · CDSS document, May 3, 2024