Fallbrook Assisted Living

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Quoc Huynh arrived at the facility unannounced to conduct a required annual visit at 10:37AM. The LPA met with Administrator Yuliya Asatryan who arrived at 11:19AM. Entrance interview conducted. Beginning at 11:20AM, the LPA and 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. The following was observed: COMMON AREAS: At the time of the visit, two (2) living room and dining room furniture were observed to be in good condition. The LPA observed staff personal belongings in the dining room which included a medication bottle and pill organizer that was accessible to residents. The staff secured the items. Required postings were observed on the walls. The facility maintained a comfortable temperature throughout the visit. The first living room had a screened fireplace. There was a laundry area with secured cabinets containing cleaning supplies and detergent. KITCHEN: The LPA observed knives and cleaning supplies secured. Kitchen appliances were clean and in operable condition. The facility had a supply of perishable food and non-perishable food supply was not sufficient for seven (7) days. Food in the refrigerator and freezer were observed to be properly stored with labels and dates. The kitchen also contained centrally stored medications. There were two (2) cabinets and one (1) drawer that contained medications and only one (1) cabinet was secured. The Administrator stated they didn’t know the additional medication needed to be secured. Report Continued on LIC 809-C BEDROOMS/RESTROOMS: There were six (6) total bedrooms: four (4) private resident rooms, one (1) shared resident room, and one (1) secured staff room. Each resident bedroom had a direct exit to the outside with the facility approved for one (1) bedridden resident. Bedrooms were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. Extra linens and supplies were stored in the hallway closet. There were two (2) total restrooms in the facility, both shared restrooms located in the hallways. One (1) restroom contained secured staff hygiene products. Restrooms were clean and sanitary and in operating condition with grab bars and non-slip surfaces. All restrooms were sufficiently stocked with soap, paper products, and displayed hand washing signs. Hot water was tested and measured between 105.8 degrees F and 111.4 degrees F which is within the required range per regulation. OUTDOOR AREA: The surrounding grounds had multiple shaded patio areas equipped with furniture in good condition for resident and visitor use. There were two (2) emergency exit gates located on each side of the facility. Exits and passageways were free of obstruction. There was a gated driveway/carport that contained general storage and a shed. The LPA observed an accessible bag of medications belonging to a prior resident that was not destroyed. The Administrator stated the family planned to pick it up; however, has continued to push the date back. There was a cabinet that contained emergency food that the LPA observed to have expired canned and bottled items ranging between 2024 to 2025. RECORDS: Record review began at 12:03PM. Resident records were reviewed for, but not limited to care plans, physician's report, admissions agreement, and consent forms. Resident #1 (R1) and Resident #2 (R2) had incomplete files and R1 was admitted on 01/17/2026 and did not complete a Pre-Admission Appraisal. Three (3) residents did not have updated Appraisals, and two (2) residents did not have updated Physician’s Reports. Personnel records were reviewed for, but not limited to health assessments, criminal record clearances, first aid/CPR training, and the appropriate training. Report Continued on LIC 809-C One (1) staff did not have a health screening on file, and two (2) staff did not have a TB test on file. Staff annual training included two (2) hours of dementia and six (6) hours of medication with no training on postural support or restricted health conditions. The Administrator did not have knowledge of training requirements. INFECTION CONTROL/EMERGENCY DISASTER PLAN: During today's visit, LPA reviewed the facility's infection control plan and emergency disaster plan. Both documents were observed to be complete and were not reviewed annually as required. Fire extinguishers were observed throughout the facility and were last serviced on 03/24/2025. Emergency disaster drills are not conducted quarterly, with the last documented drill on 09/09/2025. Smoke and carbon monoxide detectors were tested at 1:15PM and were operational. MEDICATIONS: Medication review began at 1:31PM. Medications were centrally stored in the kitchen. Medications were observed for two (2) residents. R2 was prescribed Quetiapine Fumarate and instructed one (1) tab twice daily. The medication started on 01/01/2026 and had nine (9) tabs extra. The staff and Administrator stated R2 refused on one (1) occasion; however, there were no records of refusal. Resident #3 (R3) was prescribed Metoprolol and Magnesium Oxide and both instructed one (1) tab daily. Both medications started on 01/13/2026 and each had one (1) tab extra. The LPA observed the facility prepared medications two (2) days in advance and stated they can no longer do so per regulation. The Administrator disagreed with the regulation and stated that it would cause medication errors due to multiple staff handling medications. Pursuant to Title 22 CA Code of Regulations and/or the Health and Safety Code, the following deficiencies were cited (Refer to LIC 809-D). Exit interview conducted. A copy of the appeal rights and report was reviewed and provided.the state’s words, verbatim · CDSS document, Jan 29, 2026

The state marks this report as 14 pages; the online copy we transcribed has 10. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Angela Barutyan arrived at the facility unannounced to conduct a required annual visit at 01:48PM. LPA was greeted at the door by staff and Administrator Yuliya Asatryan. Entrance interview conducted. At 01:50PM, the LPA along with 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. BEDROOMS: There are six (6) bedrooms total of which four (4) are for single resident-use, one (1) is for shared resident-use, and one (1) is for staff-use. LPA observed resident bedrooms to be furnished appropriately with clean linens, appropriate furnishings, and sufficient lighting. RESTROOMS: There are two (2) restrooms. Restrooms were clean and sanitary and in operating condition with grab bars and slip-resistant surfaces. The restrooms were sufficiently stocked with supplies and paper towels; towels and washcloths are not shared. At 01:57PM, hot water temperature was measured at 105.6 degrees F, which is within the required range. KITCHEN: The LPA inspected the kitchen/food service area at 01:59PM. Kitchen appliances appeared clean and were in operable condition at the time of the visit. The facility has a sufficient supply of perishable food. Food labels were inspected and checked for expiration dates and food labels had expiration date clearly marked. Knives and chemicals were locked inaccessible in kitchen drawer and under-the-sink cabinet. Fire extinguishers were fully charged and last serviced on 03/13/2024. Report Continued on LIC 809-C OUTDOOR AREA: LPA observed the back and front patio which has areas for resident use. There is a self-closing and self-latching gate on the side of the house designated for an emergency exit. Passageways were free and clear from obstruction. There are no bodies of water on the premises. LPA observed the carport to contain a locked shed with a sufficient supply of non-perishable food, additional refrigerator/freezer, emergency water, and additional supplies. COMMON AREAS: At the time of the visit, living room and family room furniture were observed to be in good condition. The facility maintained a comfortable temperature. At 02:09PM, smoke detector(s) and carbon monoxide detector were tested and were operational at the time of the visit. Auditory exit alarms were functioning at the time of the visit. LPA observed required postings throughout the common spaces. Laundry unit was observed in the hallway by the back of the property. Detergents were stored locked and inaccessible. MEDICATION REVIEW: At 02:10PM, LPA reviewed medications for two (2) residents. Medications are centrally stored and locked in the kitchen. All medications including PRNs were labeled, stored, and locked inaccessible to residents. PRNs have physicians order on file. 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. RECORD REVIEW: Beginning at 02:32PM, LPA reviewed five (5) out of five (5) resident files and two (2) personnel files for documents including but not limited to: medical records, care plans, resident Admission Agreement, TB test, health screening, staff training and fingerprint clearance. All resident and personnel files were in order. During the visit, LPA obtained copies of liability insurance, LIC 500, and resident roster. INFECTION CONTROL/EMERGENCY DISASTER PLANNING: During today's visit, LPA reviewed the facility's infection control policy as well as the emergency disaster plan. The facility’s policies and procedures as it pertains to infection control are adequate. Emergency disaster plan is updated annually as required. Emergency drills are conducted quarterly as is required, with the last drill conducted on 11/06/2024. No deficiencies cited at this time. Exit interview conducted. A copy of the report was issued.the state’s words, verbatim · CDSS document, Jan 15, 2025

Type of visit: Case Management - Annual Continuation

Licensing Program Analyst (LPA) Valeria Conway arrived at the facility unannounced at 8:27 AM for a Case Management – Annual Continuation inspection. The LPA met with facility staff Florencio Aguilon. Administrator was contacted via phone and arrived at 9:26 AM. LPA explained the reason for the visit. During the Required 1-Year on 01/23/2024, LPAs toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility compliance of Title 22 Regulations. A brief tour of the physical plant was also conducted during today’s visit. No health and safety concerns were identified during today's tour. Administrator stated that on 03/20/2024 facility was approved for the Assisted Living Waiver (ALW). RECORD REVIEW: During today’s visit, LPA reviewed staff files at approximately 9:52 AM. Staff records were reviewed for documents including, but not limited to staff training, fingerprint clearance, health screening, TB test result, and SOC 341 form. Record review and interview conducted revealed that reliever caregivers used by the facility are missing a health screening form (LIC 503) under Falbrook Assistant Living. Staff #1 (S1) and Staff #2 (S2) provided a LIC503 form with a different facility name showing negative TB test for both S1 and S2. Licensee agreed to have a new LIC503 under Fallbrook Assisted Living. A Technical Violation was issued explaining the importance of having records in order for each hired staff. INFECTION CONTROL/EMERGENCY DISASTER PLANNING/EMERGENCY DRILLS: During today’s visit, the LPA reviewed the facility's emergency disaster plan. Plan was observed to be complete and updated annually, as required. Last emergency drill was conducted on 05/23/2024. Residential Infection Control Plan was reviewed. LPA observed this plan to be complete and updated as of 01/02/2024. Continued on LIC 809C Continued from LIC 809. MEDICATION REVIEW: The medication closet is locked and inaccessible to residents in care. Resident’s medication records are kept confidential and locked. At 11:35 AM LPA reviewed centrally store medication sheet and compared it to medication in hand for four (4) out of four (4) residents. At the time of the visit revealed no discrepancies were note. INTERVIEWS: LPA interviewed two (2) staff members and one (1) resident. They don’t have any concern at the time of the visit. No citations observed during today’s visit. Exit interview conducted. A copy of the report is providedthe state’s words, verbatim · CDSS document, May 24, 2024

Type of visit: Required - 1 Year

Licensing Program Analysts (LPAs) Valeria Conway and Kelly Dulek arrived at the facility unannounced to conduct a required annual visit at 11:43AM. LPAs initially met with facility staff. Administrator was contacted via telephone and arrived at the facility at 12:20PM. Entrance interview conducted. Beginning at 12:25PM, the LPAs, along with Administrator toured the physical plant areas inside and outside to ensure there are no health and safety hazards and that facility is in compliance with Title 22 Regulations. The following was observed: Fire extinguisher is fully charged and last serviced on 03/27/2023. Hardwired smoke detectors were tested at 04:34PM, separate carbon monoxide detector was tested at 04:35PM and all were functional at the time of the visit. Fire pulls were tested during January 2023 fire inspection. No fire clearance concerns were observed during today's visit. BEDROOMS: There are six (6) total bedrooms in the facility; five (5) bedrooms are designated for resident use and one (1) staff room. The staff room is kept locked. All resident rooms were observed to be furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. KITCHEN: The LPAs observed the kitchen. Kitchen appliances appeared to be in operable condition. The facility has a sufficient supply of seven (7) days non-perishable and two (2) days perishable food. Knives were locked in a kitchen drawer. At 12:35PM, LPAs observed cockroaches around the refrigerator, inside kitchen cabinets, and on the kitchen floor. COMMON AREAS: This includes the living room and dining room areas. LPA observed common area to be properly furnished at the time of the visit. A fireplace was noted in the living room to be covered and Report Continued on LIC 809-C inaccessible to residents in care. At 12:00PM, LPAs observed a cockroach on the entry way table and a dead cockroach on the windowsill. Laundry area was observed in the hallway, with locked chemical storage. BATHROOMS: There are two (2) bathrooms for resident use. Restrooms were observed to be equipped with nonskid surfaces and contain nonskid mats. Grab bars were observed in the bathrooms. The water temperature was measured and was in compliance with regulation. LPAs observed a dead insect taped to the restroom wall in the back common restroom. GARAGE: Detached garage was observed locked and extra food, supplies, and emergency food and water, and chemical storage. LPAs observed expired macaroni and cheese in the outdoor food storage area. OUTDOOR SPACE: The backyard has a covered patio area with patio furniture including a table and chairs for resident use. All passageways were observed to be clear. There was a fountain observed on the back patio, which was inoperable, but did contain standing water from the recent rain. LPAs advised Administrator to remove standing water and ensure no further water is deposited in the fountain. At 12:58PM, LPAs observed both outdoor gates to not be self-closing or self-latching. RECORD REVIEW: Resident records were reviewed for documents including, but not limited to: physician's report, needs and service appraisal, and personal rights. Two (2) of five (5) resident files observed contained an Admission Agreement for the closed facility previously located at this address. All remaining files observed were in compliance with regulation. Staff files were not reviewed during today's visit. INFECTION CONTROL/EMERGENCY DISASTER PLANNING: During today’s visit, the LPAs reviewed the facility's emergency disaster plan. Last emergency drill was conducted on 01/11/2023. Emergency disaster plan was observed to be complete and updated annually, as required. Infection control plan was not reviewed during today's visit. MEDICATION REVIEW: Not reviewed during today's visit. Report Continued on LIC 809-C INTERVIEWS: Interviews were not conducted during today's visit. The following deficiencies were observed (See LIC 809-D) and cited from the California Code of Regulations, Title 22 and/or California Health and Safety Code. Administrator was informed that failure to correct the deficiencies may result in civil penalties. Exit interview conducted. A copy of the report and appeal rights were provided.the state’s words, verbatim · CDSS document, Jan 23, 2024

The state marks this report as 8 pages; the online copy we transcribed has 6. You can request the full file from the county licensing office.