Healing Pines Senior Living

Allegation investigated: Staff do not ensure the facility is clean and sanitary.

On 7/23/26 Licensing Program Analyst (LPA) Perchui Milena Khurshudyan conducted an initial 10-day complaint visit to investigate the above allegation. Upon arrival, LPA met with the Staff/Caregiver Ronny Tjhung, introduced herself by showing the Department badge and gained access to the facility. LPA contacted the Administrator over the phone and explained the reason for the visit. During the course of investigation, LPA requested staff and residents’ rosters. At approximately 9:15am LPA accompanied Staff 1 (S1), conducted physical plant tour throughout the facility to ensure health and safety of the residents are protected. No health and safety hazards noted during the visit. At 9:40am LPA requested copies of Admission Agreement, Appraisal Needs and Services, Physician Report, copy of CSMDR/MAR, and reviewed other pertinent documents relevant to the investigation. LPA also conducted interviews with the Administrator, two (2) staff members, six (6) out of six (6) residents. Continue on LIC9099-C Unsubstantiated Allegation: Staff do not ensure the facility is clean and sanitary. To investigate the allegation, LPA interviewed the Administrator, staff, and residents. The administrator denied the allegation and stated that the facility is cleaned daily, and that hygiene items and cleaning supplies are maintained and readily available for residents. Administrator further denied ever refusing residents food or any prescribed medications. Staff members interviewed also denied refusing residents’ food, medications, and stated that the residents receive meals, medications, and hygiene supplies as needed. Staff walked with LPA throughout the facility and showed the locations where hygiene supplies, including soap, toilet paper, personal hygiene items, and cleaning supplies are stored and maintained for residents’ use. During the visit LPA inspected the house, including all residents’ bedrooms, common / living areas, kitchen, and bathrooms. LPA observed the facility to be generally clean, sanitary, organized, and in good repair with no objectionable odors or evidence of unsanitary conditions. LPA inspected two of two bathrooms and observed soap and toilet paper available in each restroom. The LPA also observed additional stock of hygiene supplies stored inside the supply closet located in the hallway. Furthermore, LPA interviewed six (6) out of six (6) residents residing in a facility. Five (5) out of six (6) residents denied concerns regarding the cleanliness and sanitary condition of the facility. Residents further stated they have never observed the bathrooms without soap or toilet paper and confirmed that hygiene items are available when needed. LPA inspected the kitchen and food storage areas and observed the adequate supply of food, including at least two days supply of perishable foods and seven days’ supply of non-perishable foods available for residents. Based on interviews conducted, observations, and evidence obtained during the investigation, there is insufficient evidence to support the allegation that staff did not ensure the facility is clean and sanitary. Therefore, the allegation is Unsubstantiated at this time. Exit interview conducted, and a copy of this report signed and delivered.the state’s words, verbatim · CDSS document, Jul 23, 2026 · control 31-AS-20260721085726

Allegation investigated: Resident was sexually abused while in care. Staff did not meet residents' showering needs. Staff is withholding residents' belongings. Staff speaks inappropriately to resident.

Licensing Program Analyst (LPA) Leslie Ngo-Castaneda conducted an unannounced initial visit regarding the above allegations. LPA met with staff member (S2), Liana Gafikyan, and explained the purpose of the visit. LPA toured the physical plant at 8:20 AM. At 8:35 AM, LPA interviewed the administrator (S1) by telephone, one (1) staff member, and six (6) out of six (6) residents. At 10:30 AM, LPA conducted a records review and requested copies of the following documents: Staff Roster (LIC 9020), Personnel Report (LIC 500), residents' physician's reports, admission agreements, inventories of personal belongings, staff training records, and other pertinent documents. Allegation: Resident was sexually abused while in care. Continue to LIC 9099-C Unsubstantiated It was alleged that Resident #1 (R1) was sexually abused while in care through the use of electricity. Staff interviews revealed that staff had never witnessed or observed any sexual abuse, neglect, physical abuse, or verbal abuse involving residents in care. During resident interviews, the residents denied the allegation and stated that the facility provides a safe environment and that they are treated with respect and dignity. During an interview with R1 in Bedroom #1 at 8:35 AM, R1 stated that they had never been sexually or physically abused while in care at the facility. Based on interviews conducted, there is insufficient evidence to support the allegation. Therefore, the allegation is deemed Unsubstantiated at this time. Allegation: Staff did not meet residents' showering needs. It was alleged that staff did not meet R1's showering needs. Staff interviews revealed that R1 receives showers two (2) to three (3) times per week, or more frequently if requested or needed. Resident interviews revealed that they shower two (2) to three (3) times per week, they are able to shower independently, and reported no concerns regarding the facility showering needs. During today's visit, LPA observed staff assisting R1 with dyeing their hair and providing a shower at 11:00 AM. LPA observed all residents to be well-groomed, appropriately dressed, and without any noticeable odor. Based on interviews and observations conducted, there is insufficient evidence to support the allegation. Therefore, the allegation is deemed Unsubstantiated at this time. Allegation: Staff is withholding residents' belongings. It was alleged that staff were withholding R1's belongings, including clothing and shoes. Staff interviews revealed that staff have not taken, withheld, or stolen R1's belongings or the belongings of any other resident. Staff further stated that no staff at the facility would steal or withhold residents' personal belongings. LPA observed R1's shoes on the floor beside their bed in bedroom #1. Clothing was observed in R1's closet and dresser, and additional clothing was being laundered during the visit. Resident interviews revealed that they had not experienced or observed any personal belongings being withheld, missing, or stolen. Continue to LIC 9099-C A review of R1's Personal Property and Valuables form did not include any entries for shoes or clothing. S2 stated and showed LPA that they recently purchased additional clothing for R1. Based on interviews, record reviews, and observations conducted, there is insufficient evidence to support the allegation. Therefore, the allegation is deemed Unsubstantiated at this time. Allegation: Staff speaks inappropriately to resident. It was alleged that staff spoke inappropriately to R1 by using derogatory names. Resident interviews consistently indicated that staff treat residents with respect and dignity. Staff denied being rude or disrespectful toward residents. During an interview with R1 in Bedroom #1 at 8:35 AM, R1 stated that they overheard staff making derogatory remarks but clarified that the remarks were not directed toward them. Based on the information obtained through interviews and the investigation, there is insufficient evidence to support the allegation that staff interacted with or spoke inappropriately to residents. Therefore, the allegation is deemed Unsubstantiated at this time. An exit interview was conducted, and a copy of this report was provided to staff.the state’s words, verbatim · CDSS document, Jul 22, 2026 · control 31-AS-20260714120758

Allegation investigated: Staff mishandled a resident's medication.

At approximately 8:20 AM, Licensing Program Analysts (LPA), Leslie Ngo-Castaneda arrived at the facility in response to the above-mentioned allegation. LPA met with the staff designee (S#2) and explained the reason for the visit. At 9:31 AM, LPA spoke with the administrator by phone regarding the reason for the visit. At approximately 8: 50 AM, LPA conducted a physical plant tour to ensure the health and safety of the residents are protected. At 8:40 AM, LPA requested copies of pertinent information, which include, but are not limited to, Physician’s report, Admission Agreement, LIC 500 (staff roster), LIC 9020 (resident roster), needs and service plan, and relevant documents to the investigation. LPA interviewed the Administrator over the phone, staff designee who are in the facility, and four (4) out of four (4) residents. Allegation: Staff mishandled a resident's medication. Continue to LIC 9099-C Unsubstantiated To investigate the allegation, License Program Analysts (LPA) Leslie Ngo-Castaneda reviewed all of the residents' Centrally Stored Medication and Destruction Records (CSMDR). Records reveal that medications were administered in a timely manner, that no medications were missing for the residents, and that everything is accounted for. LPA observe S2 knocking on bedroom #4 for R1 insulin before serving breakfast and was ignored at 8:25 AM and 9:00 AM. R1 eventually came out of their bedroom at 11:00 AM and requested for his insulin. LPA interviewed residents on 7.8.2026, and it was revealed that residents do not have concerns about being managed by facility staff. Interviews with staff revealed that all medications are provided to clients as prescribed. Therefore, based on interviews and a review of records, and due to a lack of supporting evidence, the allegation is unsubstantiated at this time. An exit interview was conducted, and a copy of the report was given to staff.the state’s words, verbatim · CDSS document, Jul 8, 2026 · control 31-AS-20260702083316

Type of visit: Prelicensing

On 3/26/2026 at 10:00am, Licensing Program Analyst (LPA) Perchui Milena Khurshudyan conducted a Pre-Licensing Inspection with the Administrator Ghukasyan Kristine. This is a Change of Ownership Application from facility #197610320 to #197610911 to operate an Residential Care Facility for Elderly (RCFE). A Change in Ownership (CHOW) Application to operate the RCFE was received by Community Care Licensing (CCL) on 9/19/2025. A fire clearance was approved on December 30th, 2025, for five (5) non-ambulatory residents, and one (1) Bedridden resident for bedroom # 3. Facility has Hospice waivers granted for six (6) residents. The smoke alarms and carbon monoxide detectors are hard wired and inter-connected; they were tested and are operational. The facility has two (2) fire extinguishers that were serviced on 3/14/2026 and will be located on the kitchen wall and in the hallway. A tour of the physical plant was initiated at approximately 10:45am and the following was observed: KITCHEN: The facility has a Kitchen area that is equipped with a refrigerator, gas stove, microwave oven and sink. There were adequate supplies of two (2) days of perishable and seven (7) days of nonperishable food, dining ware to accommodate a maximum capacity of six (6) residents. Knives and other sharps were observed locked inside the kitchen cabinets and chemicals observed stored inside locked cabinet under the sink. COMMON AREAS: These include living room and a dining room. LPA observed the area was generally clean and organized. The living room was equipped with furniture, a television, tables and chairs. There is fireplace in the living room which is blocked and not accessible to residents. The dining area has a dining table to accommodate six (6) residents. There were no visible immediate hazards. The facility has comfortable temperature which was measured at 10:55am to be 70 degrees F. Continue on LIC809-C BEDROOMS: The facility has four (4) bedrooms, and all bedrooms are designated for residents' use. All residents' bedrooms were observed to be nicely furnished with beds, nightstands, lamps, chairs, dresser, bedding and linen. The bedrooms have sufficient lighting and closet space. Additional fresh linen is available inside the linen cabinet located in the hallway. Bedrooms #1 and #2 are for non-ambulatory residents and bedrooms #3 is for bedridden only. BATHROOMS: The facility has two (2) bathrooms, both designated for residents’ and staff use. All bathrooms were observed to have the proper fixtures, grab bars, non-skid mats, trash cans with closed lids, paper towels/ hand dryer and washing hands signs. The hot water delivered in the bathrooms measured at 11:10am to be at 110.1 degrees. Bathroom #1 is located in the hallway next to bedroom #2 and bathroom #2 is inside bedroom #3. GARAGE: LPA observed that there is a garage located on the premises and was informed by the licensee that they recently received approval to convert the structure into an Accessory Dwelling Unit (ADU). The licensee stated that the required documentation and notification related to this approval will be submitted to the department for review. LAUNDRY ROOM: The washer and dryer is located in the hallway, inside a separate laundry area. Laundry chemicals are always locked and under supervision inside a separate cabinet. Client Files: From 11:05am to 12:00pm LPA conducted a file review of all client records to ensure compliance of licensing forms. Clients’ files are complete and kept locked inside the kitchen cabinet. Staff Files: Staff files are also kept inside a locked kitchen cabinet. From 12:00pm to 12:20pm LPA conducted staff file review, files were complete with all documents and training certificates. MEDICATIONS: Medications are kept locked inside the kitchen cabinet. At approximately 12:15pm to 12:45pm LPA observed each centrally stored prescription and PRN medication has been logged in the medications log with proper documentation from the clients’ doctor. All medications are properly labeled and checked for expiration dates. First Aid and the new manual available and locked inside the kitchen cabinet along with medications. LPA observed the First-aid has all proper items and is current. Continue on LIC809-C SURROUNDING GROUNDS: The driveway, passageways and entrance to the home were clear of obstruction. The backyard of the facility is properly fenced, has a patio and backyard furniture to accommodate six (6) residents. There is no pool or body of water in the premises. There are two (2) exit gates on both sides of the property, LPA checked gates were unlocked and easily accessible. LPA observed the facility is clean, safe, sanitary and odorless. All window screens were in good repair. Auditory signals were installed on exit doors and operational. All passageways were free of obstruction. In addition to the Pre-Licensing inspection, a Component III power point presentation was also held. Pursuant to Title 22, CA Code of Regulations, the facility's physical environment appears to be compliant and ready for licensure. CAB will be advised. An emergency exit plan/sketch along with other posting requirements were available in the hallway next to the entrance. No deficiency cited on today’s visit. Exit interview conducted and copy of this report signed and delivered to the Licensee/Administrator.the state’s words, verbatim · CDSS document, Mar 26, 2026

Type of visit: Office

Facility Type: RCFE Application Type: CHOW Capacity: 6 Census (if any clients in care): 3 Method: Telephone call with CAB COMP II Participants: Ghukasyan, Kristin On 2/9/2026, the applicant/administrator participated in COMP II at CAB via telephone call with analyst at CAB. Identification of the applicant and administrator was verified by confirming driver’s license number. During COMP II, applicant and administrator confirmed the understanding of Title 22. Component II was successfully completed. Applicant and administrator were advised to email/fax signed LIC 809 with copy of photo ID to CAB. During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of following areas: 1. Facility operation: License type, client/resident populations, and program 2. Admission Policies 3. Staffing requirements & Training 4. Restrictive/Prohibited Health Conditions 5. General provisions 6. Emergency Preparedness 7. Complaints & Reporting 8. Pre-licensing readinessthe state’s words, verbatim · CDSS document, Feb 9, 2026