Five Star Assisted Living

Type of visit: Required - 1 Year

On 02/19/26 Licensing Program Analyst (LPA) K.Kaur arrived unannounced for an annual inspection visit. LPA was allowed entry by staff Maryann Castillo. LPA introduced self, explained reason for visit. Administrator Jasmine Oganyan was contacted and arrived a short while later. LPA conducted tour with Staff. The facility was observed to be at a comfortable temperature, in good repair, with no passageway obstructions or fire hazards. Residents observed in common areas and in rooms. There was 1 resident on hospice. LPA observed a 7-day supply of non-perishable foods and a 2-day supply of perishable foods. Fire extinguisher in the Kitchen was last serviced on 01/21/2026 and was fully charged. All common areas were properly furnished and well-lit throughout. LPA toured laundry area which appeared clean. Medications and first aid are kept locked in a closet next to laundry. Chemicals and cleaning supplies are locked in hallway closet and laundry room. Smoke Alarm and Carbon Monoxide detector tested and operational. All client bedrooms toured and observed to be adequately furnished. LPA observed one bedroom that is shared room and four with single occupancy. The exterior tour was conducted. Pool was observed gated and locked. The backyard was observed to have sufficient seating under covered Patio. Medication was reviewed. LPA observed PRN records missing orders. Staff records were reviewed for good health and training, all clients’ records reviewed to have Admission Agreement, Physician’s Report and emergency contact information. Deficiency is being cited on the attached 809D in accordance with California Code of Regulations, Title 22, Division 6. LPA is requesting the following documents be submitted to the Fresno CCL office by 2/26/2026: Current copy of Administrator Certificate, Designation of Facility Responsibility (LIC308), Administrator Organization (LIC309), Affidavit regarding Client/Resident Cash Resources (LIC 400), Emergency and Disaster Plan (LIC610D), Personnel Report (LIC500), Register of Facility Clients/Residents for LIC9020. Exit interview conducted with Licensee. A copy of this report was discussed and provided to Licensee, whose signature on this form confirms receipt of this document.the state’s words, verbatim · CDSS document, Feb 19, 2026

The state marks this report as 4 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

On 01/21/24 Licensing Program Analysts (LPAs) M. Garza and M. Medina arrived unannounced for an annual inspection visit. LPAs were met by Direct Care Staff, John Agustin and Cheryl Nolasco. LPA introduced self, explained reason for visit and was permitted entry into the facility. LPAs completed a health and safety check on residents in care. LPAs toured the facility inside and out. Residents observed in common areas and in rooms. There was 1 resident on hospice and 2 bedridden at the time of the inspection. Pathways and doors were clear and free from obstruction. Facility was clean and without odor. Common areas were clean, adequately furnished, and adequately lit. Smoke detectors and carbon monoxide detectors were present and operational at time of visit. Fire extinguisher last serviced 1/7/2025. Last fire drill completed on 12/03/24. Water temperature measured 116.3 degrees F. Resident rooms observed to have the required furnishings and with adequate lighting. Linen supplies are kept in linen closets. Sharps, chemicals and medications were located in locked closets/rooms. LPAs observed sufficient seating under covered patio areas. The following issues were observed during todays visit: Front entrance observed with stairs and ramp without hand railing. Front door observed with pin and hole at bottom of door. Let us know sign is not properly sized. Living room couch observed with tears and in need of replacement. R1 observed non-ambulatory with wheelchair across living room. Non-perishable food source observed not to be sufficient for 6 residents in care. Over-the-counter medication observed in refrigerator and in kitchen cabinet unlocked and accessible. Hallway vent air circulation observed dirty and in need of replacement. Back door steps observed without hand railing. Patio fan drooping and in need of replacement. Tools observed in backyard unlocked and accessible. Exit gate on side of facility observed locked/stuck closed in need of repair. Backyard fence observed leaning and with broken boards in need of repair. Dog feces observed on walkway and in yard in need of cleaning. LPAs requested the following documents to be submitted to CCL by 1/31/25: current copy of Administrator’s Certificate, Administrator Organization (LIC 309), Designation of Administrative Responsibility (LIC 308), Emergency Disaster Plan (LIC 610-D), Personnel Report (LIC 500), Register of Facility Clients/Residents (LIC 9020) in order to update the facility file. Exit interview completed with Licensee, Jasmin. A copy of this report, deficiencies and TV's provided.the state’s words, verbatim · CDSS document, Jan 21, 2025

Type of visit: Case Management - Annual Continuation

On 1/21/25, Licensing Program Analysts (LPAs) M. Medina and M. Garza conducted an unannounced annual required inspection. LPAs stated the purpose of the visit and were allowed entry into the facility. Administrator contacted by direct care staff and arrived a short time later to meet with LPAs. LPAs conducted facility tour with direct care staff. LPA Medina reviewed a sample of staff and resident files and observed the files to have the required documentation and staff training. LPA Garza will document the physical plant tour and inspection tool results on a separate report. Exit interview conducted and facility report signed by Administrator. No deficiencies cited on this report. Due to technical problems. A copy of this report will be emailed to Administrator.the state’s words, verbatim · CDSS document, Jan 21, 2025

Type of visit: Required - 1 Year

On 01/22/24, Licensing Program Analyst (LPA) M. Yang arrived unannounced to conduct an Annual Inspection. LPA introduced stated the purpose of the visit and met with Administrator Jasmine Oganyan. LPA toured facility with Administrator. Five residents were present during inspection. The facility was observed to be at a comfortable temperature, clean, in good repair, and no passageway obstructions or fire hazards were observed inside. Fire extinguisher was observed with a served date: 02/16/23. An adequate supply of perishable and non-perishable food was observed. Knives were observed locked under kitchen sink. Refrigerator temperature observed maintained at 37 degree F and freezer temperature maintained at -1 degree F. Medications were observed kept locked in laundry closet. Cleaning chemicals were observed locked and inaccessible to residents under laundry sink. Residents' bedrooms were toured and observed to be adequately furnished with bed, dresser, and adequate lighting. All bathrooms are toured. All bathrooms were observed operating and functioning during inspection. Non-skid mat and grabbed bars were observed. Hot water temperature was tested between range 115 and 113.4 degrees in master bathroom. Hot water temperature was tested at 112.2 in bathroom. Extra linens were observed. Outside of facility toured. Side gate was observed self-closing and free of debris. Adequate outdoor seating available for residents. Due to time constrain, LPA will return at later date for an Annual continuation inspection. No deficiencies cited during today’s visit. Exit Interview conducted. A copy of this report was provided to Administrator, whose signature on this form confirms receipt of these report.the state’s words, verbatim · CDSS document, Jan 22, 2024