Golden Age

Type of visit: Required - 1 Year

On 07/31/2026, Licensing Program Analyst (LPA) Jaime Vado conducted an unannounced annual inspection visit. LPA met with licensee Alex Zitser and explained the purpose of today's visit. According to Alex, his son Marat, is the primary administrator and his Currently there are 5 residents in the facility and 3 staff at time of arrival. This is a split level facility approved all residents to be non-ambulatory and 2 hospice residents. There are no residents on hospice care during today's visit. The physical plant was toured inside and outside of the facility to ensure the safety of the residents. Cameras are present through out the facility in the common areas only, and outside observing the perimeter areas of the facility. LPA observed the facility kitchen which is clean and observed appliances are in good repair. Knives are stored and locked in the kitchen in a drawer adjacent to the facility stove. Medications are observed to be locked in a cabinet adjacent to the refrigerator. Perishable and non-perishable food items are observed as low. During the visit the son of the administrator arrived to pick up the shopping list. There are additional refrigerator and freezer in the garage area which also carry additional food supplies which is also observed as low. First aid kit is observed as complete with required items. LPA observed that there are multiple fire extinguishers in place inspected 08/26/2019 but it is charged within the normal operating range. LPA observed 3 extinguishers. Smoke detectors, carbon monoxide detectors are observed in place through out the facility, facility is equipped with full fire sprinklers through out, and central heating/cooling system. Facility is also equipped with fire alarm pull station near the front door. Continued on next page... Page 2 PPE and additional food supplies are observed as in place. Laundry area is also observed as fully operational in the garage area. Emergency exit routes are observed inside and outside to be free and clear of obstructions. Last emergency/disaster drill is not documented nor conducted for at least a year which poses an immediate health and safety risk for residents in care. Water temperature was measured at 110F in a common resident bathroom in the hallway connecting to resident rooms on the lower level. LPA observed rooms numerous resident rooms and all appeared clean, free of odors, and contained all the required furniture per regulatory recommendations. Resident linen supplies are observed as in place in linen closet on the upper level. During today's visit LPA reviewed 3 resident files and 3 staff files. Per licensee Alexander Zitser, the primary administrator is Marat Zitser as the primary administrator along with his wife, Polina. LPA advised that he submit a request to have this changed by the department. Marat's administrator certificate is observed as expiring 02/18/2027. Last disaster drill conducted in May 2025. The following updated forms are requested to be submitted to CCLD by 08/07/2026: • Copy of updated Administrator Certificate • Copy of facility's liability insurance • LIC308 Designation of responsible staff persons • LIC500 Staff Schedule No citations issued today. Report is reviewed with the licensee Alex Zitser and a copy is provided on this day.the state’s words, verbatim · CDSS document, Jul 31, 2026

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87463(h)(1) · Plan of correction due date: Aug 7, 2026

87463(h)(1) Reappraisals - Documentation of the annual routine visit, such as a visit summary, shall be added to the resident's record. This regulation has not been met as evidenced by: Based on resident records reviewed, R1, does not have documentation of an annual routine medical visit on file. Interview with administrator, it was indicated that R1 has had a medical visit since 2023, but there just is not any record kept on file at time of inspection.the state’s words, verbatim · CDSS document, Jul 31, 2026

Plan of correction: Facility shall develop a written plan showing how it will meet this regulation at all times in having on file record of annual medical visit. Written plan shall be submitted by the due date shown.

From the deficiency page — Deficiency type: Type B · Section cited: CCR87463(a) · Plan of correction due date: Aug 7, 2026

87463(a) Reappraisals - The pre-admission appraisal, as specified in Section 87457, Pre-Admission Appraisal, shall be updated in writing as frequently as necessary or once every 12 months, whichever occurs first, to note significant changes in condition, as defined in Section 87101, Definitions, and to keep the appraisal accurate. For the purposes of this section, the updated pre-admission appraisal shall be referred to as the reappraisal.This regulation has not been met as evidenced by: Based on resident records reviewed, 1 of 5 residents have LIC625 on file. LIC625 is considered as part of the reappraisal, and all apprasails are to be trasferred to the LIC625.the state’s words, verbatim · CDSS document, Jul 31, 2026

Plan of correction: Facility shall develop a written plan showing how it will meet this regulation at all times. Written plan shall be submitted by the due date shown.

Type of visit: Required - 1 Year

On 07/21/2025, Licensing Program Analyst (LPA) Jaime Vado conducted an unannounced annual inspection visit. LPA met with caregiver Lee Collano initially, then licensee Alex Zitser arrived with administrator Marat Zitser. LPA explained the purpose of today's visit. Currently there are 6 residents in the facility and 2 staff at time of arrival. This is a split level facility approved all residents to be non-amblatory and 2 hospice residents. The physical plant was toured inside and outside of the facility to ensure the safety of the residents. Cameras are present through out the facility in the common areas only, and outside observing the perimeter areas of the facility. LPA observed the facility kitchen which is clean and observed appliances are in good repair. Knives are stored and locked in the kitchen in a drawer adjacent to the facility stove. Medications are observed to be locked in a cabinet adjacent to the refrigerator. Perishable and non-perishable food items are observed as low. During the visit the son of the administrator arrived to pick up the shopping list. There are additional refrigerator and freezer in the garage area which also carry additional food supplies which is also observed as low. First aid kit is observed as complete with required items. LPA observed that there are multiple fire extinguishers in place inspected 04/25/2019 but it is charged within the normal operating range. LPA observed 3 extinguishers. Smoke detectors, carbon monoxide detectors are observed in place through out the facility, facility is equipped with full fire sprinklers through out, and central heating/cooling system. Facility is also equipped with fire alarm pull station near the front door. PPE and additional food supplies are observed as in place. Laundry area is also observed as fully operational in the garage area. Emergency exit routes are observed inside and outside to be free and clear of obstructions. Last emergency/disaster drill is not documented nor conducted for at least a year which poses an immediate health and safety risk for residents in care. Water temperature was measured at 115F in a common resident bathroom in the hallway connecting to resident rooms on the lower level. Continued on next page... Page 2 LPA observed rooms numerous resident rooms and all appeared clean, free of odors, and contained all the required furniture per regulatory recommendations. Resident linen supplies are observed as in place in linen closet on the upper level. Cleaning supplies such as comet and fabuloso, are observed in the upper floor bathroom below the sink, this poses an immediate health and safety risk to residents. During today's visit LPA reviewed 6 resident files and 4 staff files. Per licensee Alexander Zitser, his son Marat Zitser is the administrator of the facility. His administrator certificate is observed as expiring 02/18/2027. Last disaster drill conducted in May 2025 . The following updated forms are requested to be submitted to CCLD by 07/28/2025: • Copy of updated Administrator Certificate • Copy of facility's liability insurance • LIC308 Designation of responsible staff person • LIC610E Emergency Disaster Plan • LIC500 Staff Schedule • Copy of control of property or current lease Citations are issued on this day on the attached LIC809D pages. LIC9102TV are also issued on the attached pages. Report is reviewed with the licensee Alex Zitser and a copy is provided on this day.the state’s words, verbatim · CDSS document, Jul 21, 2025

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87309(a) · Plan of correction due date: Jul 22, 2025

87309 Storage Space - (a) Disinfectants, cleaning solutions, poisons, firearms and other items which could pose a danger if readily available to clients shall be stored where inaccessible to clients. This regulation has not been met as evidenced by: Based on facilty observations, LPA observed cleaning solutions stored below resident bathroom sink, on the upper level. This poses an immediate health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Jul 21, 2025

Plan of correction: Facility shall develop a written plan showing how it will meet this regulation at all times. Written plan shall be submitted by the due date shown. FACILITY REMOVED ITEMS DURING TODAY'S VIST THUS THE DEFICIENCY IS CLARED ON THIS DAY.

From the deficiency page — Deficiency type: Type A · Section cited: CCR87465(h)(2) · Plan of correction due date: Jul 22, 2025

87465 Incidental Medical and Dental Care (h)(2) - The following requirements shall apply to medications which are centrally stored: Centrally stored medicines shall be kept in a safe and locked place that is not accessible to persons other than employees responsible for the supervision of the centrally stored medication. This regulation has not been met as evidenced by: Based on facilty observations, LPA observed prescribed medications such as insulin and eye drops in an unlocked refrigerator of the facility in the main kitchen. This poses an immediate health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Jul 21, 2025

Plan of correction: Facility is developing a plan to ensure the medications are secured and locked within the refrigerator. The facility will secure with a lockable bag or similar that will be placed in the refrigerator. Plan and evidence of locked medications in refrigerator is to be received by due date.

Type of visit: Required - 1 Year

On 07/23/2024, Licensing Program Analyst (LPA) Jaime Vado and Kiran Jain conducted an unannounced annual inspection visit. LPA met with caregiver Lee Collano initially, then around 0915 the administrator/licensee Alex Zitser arrived, and LPA explained the purpose of today's visit. LPAs was allowed entry into the facility. This is a split level facility approved all residents to be non-amblatory and 2 hospice residents. The physical plant was toured inside and outside of the facility to ensure the safety of the residents. LPA observed the facility kitchen which is clean and observed appliances are in good repair. Knives are stored and locked in the kitchen in a drawer adjacent to the facility stove. Medications are observed to be locked in a cabinet adjacent to the refrigerator. Perishable and non-perishable food items are observed as in place. There are additional refrigerator and freezer in the garage area which also carry additional food supplies. First aid kit is observed as complete with required items. LPA observed that there are multiple fire extinguishers in place inspected 08/25/2019 but it is charged within the normal operating range, smoke detectors, carbon monoxide detectors are observed in place through out the facility, facility is equipped with full fire sprinklers through out, and central heating/cooling system. Facility is also equipped with fire alarm pull station near the front door. PPE and additional food supplies are observed as in place. Laundry area is also observed as fully operational in the garage area. Emergency exit routes are observed inside and outside to be free and clear of obstructions. Last emergency/disaster drill is not documented nor conducted for at least a year which poses an immediate health and safety risk for residents in care. Water temperature was measured at 133F in a common resident bathroom in the hallway connecting to resident rooms on the upper floor. This temperature poses an immediate health and safety risk to residents in care. Also observed in place in common areas are video cameras for resident safety. Continued on next page... Page 2 LPAs observed rooms numerous resident rooms and all appeared clean, free of odors, and contained all the required furniture per regulatory recommendations. Resident linen supplies are observed as in place in linen closet on the upper level. Cleaning supplies are observed in the upper floor bathroom below the sink, this poses an immediate health and safety risk to residents. Facility does not handle resident monies. During today's visit LPAs reviewed three resident files and 3 staff files. Per file reviews, staff files were not current with first aid cards or CPR cards. This poses an immediate health and safety risk to residents in care. The following updated forms are requested to be submitted to CCLD by 07/30/2024: • Copy of updated Administrator Certificates • Copy of facility's liability insurance • LIC308 Designation of responsible staff person • LIC610E Emergency Disaster Plan • LIC500 Staff Schedule • Copy of control of property or current lease Citations are issued on this day on the attached LIC809D pages. Report is reviewed with the licensee/administrator Alex Zitser and a copy is provided on this day.the state’s words, verbatim · CDSS document, Jul 23, 2024

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87303(e)(2) · Plan of correction due date: Jul 24, 2024

87303(e)(2) Maintenance and Operation (e)(2) Faucets used by residents for personal care such as shaving and grooming shall deliver hot water. Hot water temperature controls shall be maintained to automatically regulate the temperature of hot water used by residents to attain a temperature of not less than 105 degree F (41 degree C) and not more than 120 degree F (49 degree C). This regulation has not been met as evidenced by: Based on physical plant tour and water temperature taken in common hallway bathroom, the water temperature was measured at 133F which poses an immediate health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Jul 23, 2024

Plan of correction: Facility shall develop a written plan on how to address this regulation and keep a record showing that the water temperature delivered is within regulatory standards at all times.

From the deficiency page — Deficiency type: Type A · Section cited: HSC1569.695(c) · Plan of correction due date: Jul 24, 2024

§1569.695 Emergency Plans(c) A facility shall conduct a drill at least quarterly for each shift. The type of emergency covered in a drill shall vary from quarter to quarter, taking into account different emergency scenarios. An actual evacuation of residents is notrequired during a drill. While a facility may provide an opportunity for residents to participate in a drill, it shall not require any resident participation. Documentation of the drills shall include the date, the type of emergency covered by the drill, and the names of staff participating in the drill. This health and safety code has not been met as evidenced by: Based on documentation reviewed, LPA observed that there is no disaster drill log present. Per interviews with staff, a disaster drill has not been conducted in about a year. This poses an immediate health and safety risk to residents and staff in the facility.the state’s words, verbatim · CDSS document, Jul 23, 2024

Plan of correction: Facility shall create a written plan on how to meet this health and safety code section at all times and maintaining the record of such drills accurately and conduct drills quarterly.

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87309(a) · Plan of correction due date: Jul 24, 2024

87309 Storage Space - (a) Disinfectants, cleaning solutions, poisons, firearms and other items which could pose a danger if readily available to clients shall be stored where inaccessible to clients. This regulation has not been met as evidenced by: Based on facilty observations, LPAs observed cleaning solutions stored below resident bathroom sinks, on both the upper level and lower level. This poses an immediate health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Jul 23, 2024

Plan of correction: Facility shall develop a written plan showing how it will meet this regulation at all times. Written plan shall be submitted by the due date shown. FACILITY REMOVED ITEMS DURING TODAY'S VIST THUS THE DEFICIENCY IS CLARED ON THIS DAY.

From the deficiency page — Deficiency type: Type A · Section cited: HSC1569.618(c)(3) · Plan of correction due date: Jul 24, 2024

1569.618(c)(3) Administration and management of residential care facilities; substituted qualifications; employee scheduling - (c) The facility shall employ, and the administrator shall schedule, a sufficient number of staff members to do all of the following: (3) Ensure that at least one staff member who has cardiopulmonary resuscitation (CPR) training and first aid training is on duty and on the premises at all times. This paragraph shall not be construed to require staff to provide CPR. This health and safety code has not been met by: Based on staff file review observations, LPAs discovered that no staff on duty have first aid or cpr training on file. Per interview with administrator/licensee, he was unaware that the facility had to maintain first aid/cpr any longer.the state’s words, verbatim · CDSS document, Jul 23, 2024

Plan of correction: Facility shall develop a plan in writing to reflect the assurance that all staff will have at least first aid training and one staff with CPR training and obtain curren first aid/CPR certifications to meet this requirement. Such evidence shall be submitted to the department.