Illustration — no photo of this home on file yet
Green Field Haven
Small home·Licensed for 6·North Highlands, California
- Care approvals on fileWheelchair · HospiceState licensing record · September 27, 2026
- Estimated starting rate$4,050 a monthCovelight estimate · likely $3,300–$5,000
- Home sizeLicensed for 6Small care home · a licensed care home (RCFE)
- Room at the last state visit5 of 6 beds occupiedApril 8, 2026 · not a current opening
- Ways to payAsk the homeMedi-Cal ALW participation not on file
- Last state visitAugust 20, 2026CDSS inspection record
Green Field Haven is a small care home in North Highlands — a licensed residential care facility for the elderly (RCFE), the licence category behind “assisted living” and “board and care.” It is licensed for 6 residents since 2007. Dementia care and bedridden care are not on file.
Built from CDSS public records · September 27, 2026. Every fact below names its source and date.
Quick answers and the state record
A citation does not make a home unsafe, and an empty file does not make a home good.
Quick answers about Green Field Haven
Is Green Field Haven licensed?
The state lists this license as “Licensed,” per CDSS records as of September 27, 2026.
How many residents is Green Field Haven licensed for?
6 residents — a small home, per CDSS records as of September 27, 2026.
Has Green Field Haven been cited?
0 Type A and 0 Type B citations since 2007, per CDSS records as of September 27, 2026. Those records count 15 state visits over the same years.
Is Green Field Haven still open?
This license was on the CDSS roster as of September 28, 2026.
What does Green Field Haven cost?
$4,050 a month to start is a Covelight estimate, likely $3,300–$5,000. This home’s own rate is not on file. Ask: “What is the all-in monthly rate, and what would push it higher?”
Covelight’s estimate starts from the rates 16 small homes and similar homes within 5 miles publish, then adjusts for this home’s size, state care approvals, Medi-Cal waiver participation, years licensed and the area’s prices. In testing, the likely range held the real rate for 6 in 10 homes. This home’s own rate is not on file.
Among 51 other homes of a similar licensed size across Sacramento County that publish a starting rate, the middle half runs $3,500 to $5,000 a month, and the middle figure is $4,000 (n = 51 other homes publishing a starting rate).
Each of those is a home’s own published figure, gathered on its own date in September 2026 — not an average of ours, and not a survey. Similar size means small and mid-size homes counted together, and large communities counted on their own, because they are different markets.
A home outside the band is not overcharging or underpricing: a starting rate covers different things in different homes, which is the first thing to ask about.
The price is made in the phone call. Nothing here is a quote, an offer or a discount.
A starting rate is the room and the base care. California homes commonly bill care levels, medication management, supplies, transport and a second person in the room as extras. Many also charge a one-time fee at move-in. Ask for that list in writing before anything is signed.
Only prices a home put out itself count here: its own website, a listing it supplied, or a price a listing site says the home confirmed. Prices a site shows without saying where they came from are left out.
Does Green Field Haven take Medi-Cal?
On Medi-Cal’s Assisted Living Waiver: this home is not on the DHCS participation list dated September 23, 2026. Ask the program about current options. The waiver pays for care services, not room and board.
Who holds the license?
The license is held by Kononov, Larisa S., per CDSS records as of September 27, 2026.
Is there a hospital nearby?
Kaiser Foundation Hospital - Sacramento is 3.5 miles away in a straight line, per the CDPH licensed-hospital list dated September 16, 2026. See licensed care homes near it.
Can Green Field Haven keep a resident on hospice?
Hospice care is approved on this license, covering up to 4 residents, per CDSS records as of September 27, 2026.
Green Field Haven license and inspection record
- Name on the license: “GREEN FIELD HAVEN”, per the CDSS roster as of May 25, 2025.
- License #347003494. The state lists this license as “Licensed,” per CDSS records as of September 27, 2026.
- Licensed for 6 residents — a small home, per CDSS records as of September 27, 2026.
- Licensed to Kononov, Larisa S., per CDSS records as of September 27, 2026.
- First licensed in 2007, per CDSS records as of September 27, 2026.
- 15 state inspection visits since 2007, per CDSS records as of September 27, 2026.
- 0 Type A and 0 Type B citations on file since 2007, per CDSS records as of September 27, 2026. The same records count 15 state visits in that period.
- 4 complaints and 0 substantiated allegations on file since 2007, per CDSS records as of September 27, 2026. One complaint can carry several allegations.
- The most recent state visit on file is August 20, 2026, per CDSS records as of September 27, 2026.
California writes these definitions for every licensed home, not for this one. CDSS citation definitions (PDF) ↗
Can they support the care needed?
California licenses a home for specific kinds of care. The state’s record lists what this home is approved for; the home’s own answers fill in what changes as needs change.
- Wheelchair / non-ambulatoryApproved · covers up to 6 residents
- Dementia / memory careNot on file · ask the home
- Hospice careApproved · covers up to 4 residents
- BedriddenNot on file · ask the home
State licensing record · September 27, 2026. An approval may cover specific rooms or residents; it does not establish an opening.
Read the state’s own wording
LICENSED FOR 6 NON-AMBULATORY RESIDENTS OVER 60 YEARS OF AGE. ALL RESIDENTS SHALL RESIDE IN SOUTH END OF HOUSE ONLY. BEDROOMS # 1 &5 FOR STAFF ONLY. HOSPICE WAIVER FOR FOUR (4) ON FILE.
935 - ELDERLY
CDSS record, verbatim · September 27, 2026
As needs change
- Staying through hospice
Hospice waiver on file · covers up to 4 — care may continue at the end of life
Ask: “If hospice is needed, can care continue here until the end?”
State licensing record · September 27, 2026
4 more questions to ask the home
- Two-person transfers or a lift
Not on file
Ask: “If two people or a lift are needed to transfer, can the person stay?”
- Someone awake overnight
Not on file
Ask: “Who is awake overnight, and how do residents ask for help?”
- Medicines
Not on file
Ask: “Who manages the medicines, and what happens when a dose is missed?”
- If memory loss develops
Dementia-care designation not on file
Ask: “If memory loss develops, what would change — and when would a move be needed?”
What it costs here
Covelight estimate
$4,050a month to start
Likely $3,300–$5,000
From 16 nearby homes that publish rates · this home’s rate is not on file
Likely monthly total
$4,050a month
Likely $3,300–$5,200
With a shared room and basic help.
An estimate for planning, not a quote. The price is made in the phone call.
See the full cost breakdownRoom, care and fees · how people pay · how this estimate works
Memory care is not priced here: a dementia-care designation is not on file for this home. Ask the home.
Starting monthly rate$4,050likely $3,300–$5,000
Covelight’s estimate starts from the rates 16 small homes and similar homes within 5 miles publish, then adjusts for this home’s size, state care approvals, Medi-Cal waiver participation, years licensed and the area’s prices. In testing, the likely range held the real rate for 6 in 10 homes. This home’s own rate is not on file.
Basic help with daily careUsually includedup to $600
Basic help is usually part of the starting rate. Homes that price care by level start around $600 a month (45 California homes publish a care-level range, seen in September 2026).
One-time move-in fee$2,000one time · likely $0–$4,000
Homes that list a one-time entry or community fee charge a median of $2,000 (134 California listings; middle half $1,000–$4,000). Many homes list none — ask.
- Likely monthly totalLikely $3,300–$5,200
- $4,050
- First monthWith a one-time move-in fee · likely $3,900–$8,350
- $6,050
How people payPrivate pay, Medi-Cal waiver, SSI/SSP, veterans, insurance
- Private payMost residents pay from savings, a home sale or family help. Ask for the rate and what it includes in writing.
- Medi-Cal Assisted Living WaiverThis home is not on the DHCS participation list dated September 23, 2026. Ask the program about current options. The waiver pays for care services, not room and board.
- SSI/SSPCalifornia’s 2026 standard is $1,626.07 a month; $1,444.07 of it goes to the home and $182 stays with the resident. Whether this home accepts it is not on file — ask.
- VeteransVA Aid & Attendance can add to a veteran’s or surviving spouse’s pension. Ask whether residents here have used it.
- Long-term care insuranceMost policies pay for licensed care homes. Ask what paperwork the home provides for claims.
- MedicareDoes not pay for room and board in a care home. It can still cover hospice or home-health visits inside one.
Avoid surprises on the billWhat changes the price, and what to ask
- The care level
Some homes charge one all-inclusive rate. Others add levels or points as needs grow. Ask how the level is set, who decides, and what the next level costs.
- What is billed separately
Medication management, incontinence supplies, transportation and a second person in the room are often extra. Ask for the list in writing.
- Move-in costs
A one-time community fee or deposit is common. Ask what it covers and whether any of it comes back if the stay is short.
- Increases
California requires at least 90 days’ written notice, with reasons, before a rate rises (Health & Safety Code §1569.655). A change in the resident’s care level is the section’s own exception and can be billed sooner.
- What is the full monthly cost for the room and care we need, and what does it include?
- What would the next care level cost, and who decides when it changes?
- What is billed separately, and is there a one-time fee or deposit at move-in?
- Is any private-pay period required before another payment program can begin?
How this estimate worksWithin 25% for 7 in 10 homes in testing
Covelight’s estimate starts from the rates 16 small homes and similar homes within 5 miles publish, then adjusts for this home’s size, state care approvals, Medi-Cal waiver participation, years licensed and the area’s prices. In testing, the likely range held the real rate for 6 in 10 homes. This home’s own rate is not on file.
16 homes like this within 5 miles publish starting rates mostly between $3,450–$5,500.
- Only prices a home put out itself count: its own website, a listing it supplied, or a price Seniorly says the home confirmed. Prices a listing site shows without saying where they came from are left out.
- Nearby homes are the nearest of the same size that publish a rate, widening from 3 to 40 miles until at least 8 do. The estimate starts from what they charge, then adjusts for this home’s size, state care approvals, Medi-Cal waiver participation, years licensed and the area’s prices.
- Room, care-level, second-person and move-in lines come from what California homes publish on listing sites. Memory care uses Covelight’s researched premium over assisted living.
- Totals add each line’s figure and combine the lines’ ranges as separate charges, because a home is rarely at the top, or the bottom, of every line at once.
- We tested this estimate on 1,546 California homes that publish their own starting rate. It was within 10% of the real rate for 3 in 10 homes and within 25% for 7 in 10; the likely range held the real rate for 6 in 10 (September 12, 2026).
- It cannot see this home’s specials, how it assesses care, or which rooms are open.
Show the 16 nearby homes behind this estimate
- Kentfield Estates Ranch RCFESacramento · 0.5 mi · Small home$4,000Listed on Seniorly · seen September 9, 2026
- Meraki of SacramentoSacramento · 1.1 mi · Mid-size home$3,500Listed on Seniorly · seen September 9, 2026
- Norris Senior HomeSacramento · 1.5 mi · Small home$5,000Listed on Seniorly · assisted living private room · seen September 9, 2026
- Marylou's Home CareSacramento · 1.5 mi · Small home$3,500Listed on Seniorly · assisted living shared bedroom · seen September 9, 2026
- Maria's Home CareNorth Highlands · 1.5 mi · Small home$6,500Listed on Seniorly · assisted living · seen September 9, 2026
- Eastern ManorSacramento · 2.8 mi · Mid-size home$3,800Listed on Seniorly · assisted living shared bedroom · seen September 9, 2026
- Sunny Beach VillaSacramento · 2.9 mi · Small home$3,200Listed on A Place for Mom · seen September 9, 2026
- Marconi VillaSacramento · 3.1 mi · Small home$5,500Listed on Seniorly · assisted living private room · seen September 9, 2026
- Abundant Love and Care for the ElderlyCarmichael · 3.3 mi · Small home$3,300Listed on A Place for Mom · seen September 9, 2026
- Madison Square Senior Living IICarmichael · 3.4 mi · Small home$4,000Listed on Seniorly · seen September 9, 2026
- Cozy Home CareCarmichael · 3.5 mi · Small home$5,000Listed on Seniorly · assisted living · seen September 9, 2026
- Courtyard TerraceSacramento · 3.7 mi · Mid-size home$4,345Listed on Seniorly · seen September 9, 2026
- Mount Hood Serenity CareSacramento · 3.9 mi · Small home$3,800Listed on Seniorly · seen September 9, 2026
- Splendor Oaks Senior Living 1Carmichael · 4.3 mi · Small home$3,500Listed on Seniorly · assisted living shared bedroom · seen September 9, 2026
- Hollister Care HomeCarmichael · 4.5 mi · Small home$4,500Listed on Seniorly · seen September 9, 2026
- Glorious Homes #1Citrus Heights · 5.0 mi · Small home$5,500Listed on Seniorly · assisted living shared bedroom · seen September 9, 2026
Where it is
- 3620 Winona Way, North Highlands, CA 95660Address from the public record · September 27, 2026. Confirm the entrance with the home before visiting.
Opening the neighborhood map…
The state record
California inspects every licensed home and publishes what it found. Here are the dated documents and the state’s own words, beside what is typical for homes this size.
Since 2021, the state has filed 14 documents for this home, and its records count 15 visits since 2007. The most recent is a facility evaluation report, dated August 20, 2026.
- On file since
- 2021
- State visits
- 15
- Most recent visit
- August 20, 2026
- Occupied · April 8, 2026 visit
- 5 of 6 bedsa count on that day, not an opening
We hold 4 complaint reports the state published for this home, dated October 1, 2024 to April 8, 2026. 4 of the 4 carry the state's recorded outcome word: “Unfounded” (2), “Unsubstantiated” (2). 4 include the transcribed allegation the state investigated, word for word. Summary composed by computer from the 4 complaint reports below — every count derives from them, and the documents themselves are the state's records, verbatim. We never grade, score, or color a record.
Beside homes the same size
- Type A citations0typical 0
- Type B citations0typical 0
- Substantiated allegations0typical 0
- Total complaints4typical 0
“Typical” is the statewide median across the 6,808 licensed small board-and-care homes (6 or fewer beds) in the state record — larger, longer-licensed homes accumulate more visits and reports, so compare like with like. One complaint can contain several allegations. Counts cover this licence since 2007.
Year by year
The last 36 months — 11 of 14 documents
Aug 20, 2026Facility evaluation reportReport on file
Type of visit: Case Management - Incident
Licensing Program Analyst (LPA) Cassie Yang arrived at the facility to conduct a case management visit regarding an absence without leave (AWOL) incident report that was submitted to the department on August 18, 2026. LPA met with caregiver and explained the purpose of the visit. Additionally, LPA contacted Administrator via telephone and explained to Administrator the purpose of the visit. The incident report stated on August 17, 2026, R1 was in the backyard with R2 when R1 decided to leave to visit R1's brother. R2 did not inform staff until approximately an hour later. Administrator took immediate action and contacted R1's responsible party and local law enforcement which R1 was then located by law enforcement and returned to the facility. Based on file review of R1's LIC 602 Physician Report, R1 is not allowed to leave facility unassisted. LPA and Administrator discussed that a plan will be in place to ensure no residents wander outside of the facility. Administrator stated there is no concerns regarding staff supervision as it was R1's first time wandering outside of the gate as R1 is still adjusting to the new facility. As a result of today's visit, deficiency was cited. Please see LIC 809-D. Exit interview, a copy of the report and appeal rights provided.the state’s words, verbatim · CDSS document, Aug 20, 2026
From the deficiency page — Deficiency type: Type A · Section cited: HSC 1569.312(d) · Plan of correction due date: Aug 21, 2026
1569.312 Basic services requirements Every facility required to be licensed under this chapter shall provide at least the following basic services: (d) Being aware of the resident's general whereabouts, although the resident may travel independently in the community. This requirement is not met as evidenced by: based on file review, licensee did not comply as R1 left the facility unassisted which poses an immediate health and safety risk fro residents in care.the state’s words, verbatim · CDSS document, Aug 20, 2026
Plan of correction: Licensee is to submit a plan of how facility will ensure R1 will not wander outside of the facility unassisted. Plan of correction is due to LPA by Friday August 21, 2026.
Apr 8, 2026Complaint investigation reportUnsubstantiated
Allegation investigated: Staff did not keep the facility free from infestation 2. Staff mishandled a resident's medication 3. Staff did not meet a resident's oxygen needs 4. Staff did not timely address a resident's change in medical condition
Licensing Program Analyst (LPA) Hiratsuka, conducted this unannounced visit to deliver the findings for the allegations above. 1. LPA interviewed staff and residents. Licensee stated when the weather was hot there was an issue with roaches coming into the facility. Licensee stated she put out traps and that stopped the roaches from coming into the facility. LPA was informed there was an issue with the toilet in one of the bathrooms and a few roaches were found until the toilet was fixed and that was only one time. The person stated the toilet was fixed quickly. LPA did not observe any roaches, rodents, or bugs in the facility during today's visit and on 03/11/2026. LPA cannot confirm or deny the facility was infested based on the above and observations. Unsubstantiated 2. The medication in question regards blood pressure and blood pressure medications. License stated the resident moved in with very little medication. Witness stated the blood pressure reading indicated the blood pressure medications were not given correctly. Staff stated they don't remember being told the blood pressure was too low. Staff stated they give the medication as prescribed. LPA is not able confirm or deny based on each side having their own version of events. 3 and 4. Licensee stated the resident moved in with oxygen equipment but no doctor's orders. Licensee stated the resident also refused to use the oxygen. Physician's report states resident is unable to self administer oxygen but there is no order in the paperwork stating the resident requires oxygen. LPA interviewed the resident and the resident stated they never needed oxygen. Witness stated the resident's oxygen levels were very low and the resident showed signs of distress. Licensee has since contacted the doctor and received confirmation the oxygen is not needed. LPA cannot confirm or deny the allegation based on the above. As a result of this investigation, LPA finds the allegation to be (US)Unsubstantiated - A finding that the complaint is Unsubstantiated means that although the allegation may have happened or is valid, there is no preponderance of evidence to prove that the alleged violation occurred. Exit interview and a copy of report was provided.the state’s words, verbatim · CDSS document, Apr 8, 2026 · control 59-AS-20251231114722
Apr 8, 2026Facility evaluation reportReport on file
Type of visit: Case Management - Annual Continuation
Licensing Program Analyst (LPA) Hiratsuka, conducted this annual continuation visit. This is in response to the first annual inspection not completed on March 11, 2026. On March 11, 2026, LPAs Yang and Hiratsuka observed a lot of items that Licensee stated she was in the process of gathering and getting ready to discard. During today's visit LPA Hiratsuka did not observe any of the items that were seen on March 11, 2026. Licensee stated she got rid of the items and more than what LPAs observed. Today, LPA reviewed staff and resident records. Resident records were complete. Staff records were missing: -Annual staff training records are for 2024. There was no training for 2025 for 2026. Deficiencies cited from the California Code of Regulations, Title 22, Division 6 of California Regulation and California Health and Safety Code. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Appeal rights were provided.the state’s words, verbatim · CDSS document, Apr 8, 2026
From the deficiency page — Deficiency type: Type B · Section cited: CCR 87411(c) · Plan of correction due date: May 8, 2026
Personnel Requirements - General. All RCFE staff who assist residents with personal activities of daily living shall receive initial and annual training as specified in Health and Safety Code sections 1569.625 and 1569.69 This requirement is not met as evidenced by: Based on LPA's record review, staff did not have training for 2025 and 2026. This does not pose an immediate risk to residents.the state’s words, verbatim · CDSS document, Apr 8, 2026
Plan of correction: By 05/08/2026, Licensee shall submit a written plan of correction how she shall ensure staff have continuing annual training per the regulations.
Mar 11, 2026Facility evaluation reportReport on file
Type of visit: Required - 1 Year
On March 11, 2026, Licensing Program Analysts (LPAs) Cassie Yang and Kerry Hiratsuka arrived unannounced at the facility to conduct a required annual inspection utilizing inspection. LPAs met with Administrator and explained the purpose of the visit. There are five clients in care, facility is approved for six non-ambulatory residents. Hospice waiver for four. LPA Yang provided Administrator an updated copy of facility license. Today's inspection, LPAs and Administrator conducted a tour of the interior of the facility to ensure the health and safety of residents in care. LPAs LPAs observed facility to have the required compliance poster posted in the common area. LPAs observed fire extinguishers present throughout the facility, fire extinguishers were recently serviced on December 9, 2025. LPAs observed paint supplies and medications in a vacant room. The following was asked to be removed and properly stored away. LPAs observed a chain lock on the front door, LPAs were informed facility does not utilize the lock. LPAs observed chain lock to be removed during LPAs' visit. Administrator was advised that excess walkers and wheelchairs should be disposed and/or stored in an area other than the common area. At this time, LPAs obtained a copy of Licensee Mortgage Interest Statement. LPAs are requesting a copy a liability insurance, LIC 308 and LIC 500. LPAs were unable to complete today's inspection. A case management visit annual continuation visit will be conducted in the future. All observations today remain under review. Exit interview conducted and a copy of report was provided.the state’s words, verbatim · CDSS document, Mar 11, 2026
Oct 14, 2025Complaint investigation reportUnsubstantiated
Allegation investigated: Resident developed several UTI's while in care due to staff neglect.
Licensing Program Analyst (LPA) Cassie Yang arrived at the facility to deliver the finding of the allegation above. LPA met with Caregiver and explained the purpose of the visit. For the allegation of, Resident developed several UTI's while in care due to staff neglect, based on an interview conducted with the Administrator, it was revealed that only one resident (R1) in care has had a recent urinary tract infection. The interview revealed that R1 was admitted to the facility with a catheter and has home health coming to the facility twice a week. The facility assists with catheter draining but is unable and not trained to clean the urinary tube. An interview conducted with the caregiver revealed that the caregiver assists with draining R1’s catheter bag as needed. R1 often tugs and pulls on the catheter, and once disconnected, then home health is contacted for the tube to be reinserted. Based on the information provided, the allegation is unsubstantiated. As a result of this investigation, LPA finds the allegation to be (US)Unsubstantiated - A finding that the complaint is Unsubstantiated means that although the allegation may have happened or is valid, there is no preponderance of evidence to prove that the alleged violation occurred. Exit interview and a copy of report was provided. Unsubstantiatedthe state’s words, verbatim · CDSS document, Oct 14, 2025 · control 59-AS-20250919154608
Apr 1, 2025Facility evaluation reportReport on file
Type of visit: Case Management - Deficiencies
On April 1, 2025, Licensing Program Analyst (LPA) Cassie Yang arrived unannounced at the facility to conduct a case management visit regarding the deficiencies observed during annual inspection. LPA met with Licensee and explained the purpose of the visit. Based on file review, it revealed Tenant 1 (T1) has been residing at the facility since November 2024. File review revealed T1’s criminal clearance is “in process”. LPA explained to Licensee that all background checks need to be cleared prior to the individual working, volunteering and/or residing at the facility. Licensee is to contact Care Provider Management Bureau (CPMB) at: CPMB Phone Number: 1-888-422-5669 CPMB Email: guardian@dss.ca.gov Deficiencies cited . Please see LIC 809-D. Exit interview conducted and a copy of the report and appeal rights was provided.the state’s words, verbatim · CDSS document, Apr 1, 2025
From the deficiency page — Deficiency type: Type B · Section cited: CCR 87355(e)(2) · Plan of correction due date: Apr 11, 2025
87355 Criminal Record Clearance (e) 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: (2) Obtain a California clearance or a criminal record exemption as required by the Department or Based on observation and file review, Licensee did not comply as T1 has an "in process" status on clearance which poses a potential risk for residents in care.the state’s words, verbatim · CDSS document, Apr 1, 2025
Plan of correction: T1 requires care and supervision and will not leave the facility. Licensee is to contact CPMB for updates on T1's clearance. Updates are to be provided to LPA as needed.
Mar 28, 2025Facility evaluation reportReport on file
Type of visit: Case Management - Annual Continuation
Licensing Program Analyst (LPA) Cassie Yang arrived unannounced at the facility to continue the annual inspection conducted on February 25, 2025. LPA met with Licensee and explained the purpose of the visit. Today's visit, LPA conducted a file review of five residents and three personnel files. LPA observed the resident files to be complete with the required documents. File review of personnel files, LPA observed documentation of S1 and S2's annual 20 hours training. Additionally, LPA observed active First Aid and CPR certificates for Administrator, S1 and S2. LPA advised Administrator to keep all training and certificates together in personnel files. No deficiencies cited. Exit interview conducted and a copy was provided.the state’s words, verbatim · CDSS document, Mar 28, 2025
Feb 25, 2025Facility evaluation reportReport on file
Type of visit: Required - 1 Year
On February 25, 2025, Licensing Program Analyst (LPA) Cassie Yang arrived unannounced at the facility to conduct a required 1-year annual inspection utilizing the inspection tool. LPA met with caregiver who then contacted Administrator who arrived to the facility shortly afterwards. LPA observed posted license to be outdated. LPA printed a new facility license to post. LPA observed the posted Administrator Certificate to be expired but file review reveals Administrator Certificate is active on CCLD website. LPA will reach out to Admin Cert unit for a copy to provide to Administrator. LPA observed the resident roster to be present. LPA observed six residents to be residing in the "South" part of the facility. In the "North" part of the facility, LPA observed three tenants name listed. LPA and Administrator conducted a tour of the North and South of the facility. Areas toured included but not limited to: North bedrooms, bathroom, and common areas. South bedrooms, laundry room, bathroom, kitchen and the common areas. Administrator and LPA discussed facility's current hospice waiver of two. Administrator stated she was informed her license was approved for four. LPA will provide Administrator a copy of CCR 87632 Hospice Care Waiver. Additionally, LPA and Administrator discussed the pending fingerprint clearance for T1. LPA informed Administrator, LPA will return a later date to complete this annual inspection. At this time, LPA obtained a copy of staff schedule and facility liability insurance. Exit interview and a copy of report was provided.the state’s words, verbatim · CDSS document, Feb 25, 2025
Oct 1, 2024Complaint investigation reportUnfounded
Allegation investigated: Staff are not meeting resident's hygiene needs. Staff are not allowing resident to use the phone
Amend: To make Public- On October 1, 2024, Licensing Program Analyst (LPA) DeAnna Williams-Lyons arrived unannounced to deliver findings for complaint #59-AS-20240802154406. LPA met with Larisa Kononov, Licensee, and informed her the reason for the visit. The Department received a complaint alleging staff are not meeting resident’s hygiene needs and staff are not allowing resident to use the phone. LPA interviewed all staff (3) and 2 witnesses and a resident. LPA reviewed medical documents of the resident and facility files. According to all staff, Resident #1 (R1) is incontinent. LPA verified R1’s condition with the physician’s report. The Licensee states R1 receives 2 to 3 showers a day due to R1’s medical condition. R1 told LPA, R1 doesn’t want to visit with their family. R1 stated the facility is talking good care of him and gets showers and shaves daily. R1 also said when their family comes to visit, R1 doesn’t make eye contact or speak with their family. ALLEGATION UFOUNDED. To continue see 9099-C... Unfounded 9099-C... Regarding the allegation that staff will not allow resident to use the phone, in an interview, R1 indicated was making calls in the middle of the night so their family took R1's cell phone and R1 agreed. ALLEGATION UNFOUNDED. This agency has investigated the complaint alleging staff are not meeting resident’s hygiene needs and staff are not allowing resident to use the phone, based on LPA's observations and interviews the complaint was UNFOUNDED, meaning that the allegations were false, could not have happened and/or is without a reasonable basis. Per California Code of Regulations, Title 22, no citations were issued. An exit interview was conducted and a copy was given to Larisa.the state’s words, verbatim · CDSS document, Oct 1, 2024 · control 59-AS-20240802154406
Oct 1, 2024Complaint investigation reportUnfounded
Allegation investigated: Staff are overmedicating resident in care. Licensee does not ensure that resident(s) are provided with activities while in care. Staff limit visitations with resident in care.
Amend: to make public-On October 1, 2024, Licensing Program Analyst (LPA) DeAnna Williams-Lyons arrived unannounced to deliver findings for complaint # 59-AS-0815091717. LPA met with Larisa Kovonov, Administrator and informed her the reason for the visit. The department received a complaint alleging facility staff are over medicating resident while in care, Licensee does not ensure that resident(s) are provided with activities while in care and Staff limits visitations with resident in care. During the investigation process interviews and a records review was initiated. LPA reviewed R1s medical documentation and physician report and needs and services plan. R1’s son is the Power of Attorney. LPA investigated the allegation, “Staff are over medicating resident while in care.” LPA reviewed R1s PRN Medication Records and medical provider’s medication list. Documents obtained show that all current medications were administered and logged correctly for R1, per their doctor’s orders. Interview indicated staff were not over medicating R1 and R1 expressed no concerns with medication administration. Allegation Unfounded. Unfounded 9099-C... LPA observed residents participating in activities during today's visit and on. LPA also interviewed residents and all but one stated there were activities. LPA learned the one resident that stated there are none does not choose to participate in activities. LPA observed two separate activity calendars. ALLEGATION UNFOUNDED. LPA investigated the allegation staff limits visitations with resident in care. R1 told LPA, R1 doesn’t want to visit with their family. R1 also said when their family comes to visit, R1 doesn’t make eye contact or speak with their family. R1 stated the facility is talking good care of him and gets showers and shaves daily. ALLEGATION UNFOUNDED. This agency has investigated the complaint alleging facility staff are over medicating resident while in care, Licensee does not ensure that resident(s) are provided with activities while in care and staff limits visitations with resident in care. Based on LPA's observations and interviews the complaint was UNFOUNDED, meaning that the allegations were false, could not have happened and/or is without a reasonable basis. Per California Code of Regulations, Title 22, no citations were issued. An exit interview was conducted and a copy given to Larisa.the state’s words, verbatim · CDSS document, Oct 1, 2024 · control 59-AS-20240815091717
Mar 7, 2024Facility evaluation reportReport on file
Type of visit: Required - 1 Year
On 03/07/24 Licensing Program Analyst (LPA) Cheyenne Ratajczak arrived at the facility unannounced to conduct a Required-1 Year Inspection utilizing the inspection tool. LPA met with Administrator Larisa Kononov and explained the purpose of the visit. LPA and Administrator conducted a tour of the interior and exterior of the facility. Areas toured included but not limited to the kitchen, dining room, residents bedrooms, bathrooms, common areas and backyard. LPA observed the facility to have sufficient food supplies for seven (7) day non-perishable and two (2) day perishable. LPA observed toxins, knives and centrally stored medications to be locked and inaccessible to residents in care. All required Licensing posters are present in common areas in the facility. Hot water temperature was measured at 117.2 degrees Fahrenheit at the bathroom sink, which is within the required range of 105 to 120 degrees. The temperature in the facility was 71 degrees. Fire extinguishers was last inspected on 12/06/23. LPA conducted a file review of three (3) resident files and two (2) personnel files. LPA observed two (2) personnel files to be incomplete with no annual training. LPA requested a copy of the current liability insurance to be sent to LPA Ratajczak by 03/21/24. LPA completed the full care tool and deficiencies was observed. Please see LIC 809-D. Exit interview conducted and a copy of the report and appeal rights was provided.the state’s words, verbatim · CDSS document, Mar 7, 2024
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