Healthy Life Families

Allegation investigated: Due to neglect, resident sustained a stage 4 pressure injury Due to neglect, resident sustained multiple wounds

Licensing Program Analyst, LPA Michael Cava conducted a subsequent complaint visit to the facility to conclude the investigation regarding the above allegations. The 10-day visit was initiated by LPA Cava on 12/17/24, to conduct a health and safety inspection. A subsequent visit was made by LPA Cava on 07/18/25. In addition to the health and safety checks conducted during both those visits, LPA Cava conducted interviews with the administrator, staff and residents. A record review was also made. Today’s visit to close out this investigation consisted of interviews with the administrator (between 8:30am-9:00am), one (1) of one staff (between 9:00am-9:30am), and five (5) of five residents (between 9:30am-10:00am). LPA also conducted a physical plant inspection (between 10:00am-11:00am) to insure facility compliance with title 22. In regards to both allegations, it was reported that on or around 12/06/24, Resident 1 (R1) was admitted Unsubstantiated to the hospital with multiple wounds, including a stage 4 pressure injury (PI) due to facility neglect. It’s not reported if R1 was receiving home health or hospice care to treat these wounds. The following is a timeline of events taken by LPA Cava during the course of this investigation. 12/17/24: LPA Cava interviewed the administrator and Staff 1 (S1), who both deny neglect. Both stated R1 was admitted on 11/15/24. Both stated R1 was receiving Hospice Care at admission. Both confirmed there were (PIs) present, but (PIs) were being treated by Hospice. Both confirm communication with Hospice daily regarding R1’s (PI). Both state on or around 12/06/24, R1’s (PIs) did progress, and followed hospice advise to have R1 transferred to the hospital. 12/17/24: LPA Cava reviewed facility records pertaining to R1. Record review reveal R1’s admission on 11/15/24. R1’s Pre-Placement Appraisal and Appraisal reveal (PI’s), but no stages indicated. 12/17/24: LPA interviewed R1’s family, who could not confirm when and where R1’s wounds developed and progressed. 07/18/25: LPA Cava conducted a subsequent visit to the facility to conduct additional interviews with both administrator and S1. Both repeated and confirmed information provided during initial visit. Contact was made to interview R1’s hospice nurse. According to hospice nurse, hospice was ordered for R1 at admission to facility. Hospice nurse confirmed R1 had (PIs) at admission. Hospice nurse stated part of the hospice care plan was to provide wound care for R1’s (PIs). Hospice nurse acknowledge that hospice care will end service if R1 was sent to the hospital. Hospice nurse stated R1’s wounds were not getting better on 12/06/24 and had ordered for R1 to get transferred to the hospital for a higher level of care. LPA requested for copies of R1’s hospice records. 07/21/25: LPA Cava received R1’s hospice records. 09/07/25: LPA reviewed the hospice records. Per review, hospice was ordered on 11/15/24. Hospice record documents a stage 2 and unstageable (PIs). Hospice records also indicate wound care for these (PIs). On 11/22/24, hospice records indicate visit with R1. Hospice documentation reveal R1 refused examination and treatment. Today, subsequent visit made to close out investigation. Interviews with five (5) of five residents deny any neglect and lack of supervision. Interviews with administrator and S1 remain consistent with interviews conducted during previous visits. Based on information obtained, although there is indication of Pressure Injuries (PIs) to R1 at admission to facility, there is evidence that hospice care was ordered to treat these wounds. Evidence obtained could not prove that due to facility neglect, R1 sustained multiple injuries, including a stage 4 Pressure Injuries. Therefore, the above allegations are deemed Unsubstantiated at this time.the state’s words, verbatim · CDSS document, Sep 12, 2025 · control 31-AS-20241216111437

Type of visit: Case Management - Deficiencies

In conjunction to Complaint Control # 31-AS-20241216111437, Licensing Program Analyst (LPA) Michael Cava conducted a Case Management (CM) visit to issue the following citation. Complaint investigation pertaining to this complaint control number reveal that the licensee retained Resident 1 (R1) with an Unstageable Pressure Injury (PI). Although hospice care was initiated to treat this Unstageable Pressure Injury, pursuant to Title 22, Licensees can request an exception under Program Flexibility to continue to provide care and supervision to a resident. LPA Cava conducted a review of facility file, and did not locate an exception to retain R1. Moreover, interview with the administrator confirm an exception was not submitted to the licensing agency. Therefore, based on this confirmation, a citation will be issued on an 809D. Administrator advised and a copy of this report issued.the state’s words, verbatim · CDSS document, Sep 12, 2025

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87209(a)(2) · Plan of correction due date: Sep 19, 2025

Program Flexibility- The use of alternate concepts, programs, services, procedures, techniques, equipment, space, personnel qualifications or staffing ratios, or the conduct of experimental or demonstration projects shall not be prohibited by these regulations provided that: A written request for a waiver or exception and substantiating evidence supporting the request shall be submitted in advance to the licensing agency. This requirement was not met as evidenced by no exception request was received to retain R1, who had a prohibited health condition.the state’s words, verbatim · CDSS document, Sep 12, 2025

Plan of correction: As POC, administrator will review this section of the regulation and self certify that they've read and understand section 87209(a)(2) Proof of this training will be submitted to the licensing agency by 09/19/25.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Michael Cava conducted an Annual Required visit and inspection of the facility. LPA met with administrator, Arusyak Ohanyan, and explained the reason for the visit. With the assistance of the administrator, LPA took a tour of the physical plant. The facility is a two story building. The second floor is used as storage only. Passageway/door to the second floor is kept locked at all times. No residents live up on the second floor. Required postings were observed in the entry area. The smoke alarms and carbon monoxide detector are dual. The fire extinguisher is located in the kitchen. It was purchased on May 9, 2025. KITCHEN: The kitchen area is equipped with a refrigerator, stove/oven, microwave oven and sink. There were adequate supplies of perishable and nonperishable food. Knives and utensils were observed locked in a kitchen drawer. Cleaning supplies and laundry detergents are kept locked in the laundry area. BEDROOMS: There are four (4) bedrooms designated for client use. Bedroom #1 and #4 are cleared to be private, with bedroom #1 having a bedridden fire clearance (per STD 850). Bedrooms #2 and #3 are semi-private rooms. The four resident bedrooms were observed to be properly furnished with appropriate beddings and linens with sufficient lighting. BATHROOMS: The facility has three (3) bathrooms. Bedrooms #1 and #4 has it's own bathroom with shower. The bathroom in bedroom #1 has a bath tub, but is not used by the residents. The third bathroom is located in the hallway by bedroom #1. All bathrooms were observed to have the proper fixtures, grab bars, and non-skid mats. The hot water delivered in the bathrooms measured between 107-111 degrees. COMMON AREAS: These included the living room and dining room area. The living room has two couches, a table, and a television. The fireplace is properly screened with a glass door. No fireplace tools were present. The dining room has a table large enough to seat up to six (6) residents. The floors were mopped and clean. Furniture is in good repair. Passageways and hallways were clear of obstruction. LAUNDRY ROOM: The laundry area is located by the kitchen. It has a locked door to make it inaccessible to the residents. Laundry detergents and cleaning supplies are kept locked inside. MEDICATIONS: The medication closet is located by the dining room. It is kept locked at all times. Medications and medication records were checked for proper storage and documentation. STAFF WORKSTATION: There is a small staff work station in the kitchen with a desk in place. Staff and resident records are maintained in a locked cabinet there. GARAGE: Facility does not have a garage. Resident Files: LPA conducted a file review of resident records to insure compliance of licensing forms. Staff Files: LPA also conducted a file review of staff records to insure forms and training are up to date and compliance with licensing forms. SURROUNDING GROUNDS: All entry and exit doors including the front and back doors, and exit door in resident room #1 and #4 have a functional auditory alerts. Proper ramps were in place at the front door, and at resident room #1 and #4. The backyard of the facility has backyard furniture to accommodate the six (6) residents. The facility backyard has sufficient yard space for leisure and activities. There is no swimming pool or bodies of water. Pursuant to Title 22 Division 6 of the CA Code of Regulations, there were no deficiencies observed during the visit. Exit Interview Conducted and a copy of the Report Issued.the state’s words, verbatim · CDSS document, Sep 10, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Michael Cava conducted an Annual Required visit and inspection of the facility. LPA met with administrator, Arusyak Ohanyan, and explained the reason for the visit. With the assistance of the administrator, LPA took a tour of the physical plant. The facility is a one story building. Required postings were observed in the entry area. The smoke alarms and carbon monoxide detector are dual. The fire extinguisher is located in the kitchen. It was purchased on 08/24/24 KITCHEN: The kitchen area is equipped with a refrigerator, stove/oven, microwave oven and sink. There were adequate supplies of perishable and nonperishable food. Knives and utensils were observed locked in a kitchen drawer. Cleaning supplies were stored and locked away, inaccessible to the residents. BEDROOMS: There are four (4) bedrooms designated for client use. Bedroom #1 and #4 are cleared to be private, with bedroom #1 having a bedridden fire clearance (per STD 850). Bedrooms #2 and #3 are semi-private rooms. The applicant furnished the resident bedrooms with beds, night stand, chairs, dresser, bedding and linen. All four bedrooms have sufficient lighting and closet space. BATHROOMS: The facility has three (3) bathrooms. Bedrooms #1 and #4 has it's own bathroom with shower. The bathroom in bedroom #1 has a bath tub, but will not be used by the resident at this time. The third bathroom is located in the hallway by bedroom #1. All bathrooms were observed to have the proper fixtures, grab bars, and non-skid mats. The hot water delivered in the bathrooms measured between 107-111 degrees. COMMON AREAS: These included the living room and dining room area. The living room has two couches, a tabe, and television. The fireplace is properly screened with a glass door. No fireplace tools were present. The dining room has a table large enough to seat up to six (6) residents. The floors were mopped and clean. Furniture is in good repair. Passageways and hallways were clear of obstruction. LAUNDRY ROOM: The laundry area is located by the kitchen. It was observed with a locked door to make it inaccessible to the residents. Laundry detergents and cleaning supplies were locked inside. MEDICATIONS: The medication closet is located by the dining room. It was locked during the visit. Medications and medication records were checked for proper storage and documentation. STAFF WORKSTATION: Staff workstation is located in the kitchen. There is a desk in place for staff use. Staff and resident records are maintained in a locked cabinet there. Resident Files: LPA conducted a file review of resident records to insure compliance of licensing forms. Staff Files: LPA also conducted a file review of staff records to insure forms and training are up to date and compliance with licensing forms. SURROUNDING GROUNDS: All entry and exit doors including the front and back doors, and exit door in resident room #1 and #4 have a functional auditory alert when the doors open. Proper ramps were in place at the front door, and at resident room #1 and #4. The backyard of the facility has backyard furniture to accommodate the six (6) residents. The facility backyard has sufficient yard space for leisure and activities. There is no swimming pool or bodies of water. Driveway was clear of any obstruction. Pursuant to Title 22 Division 6 of the CA Code of Regulations, there were no deficiencies observed during the visit. Exit Interview Conducted and a copy of the Report Issued.the state’s words, verbatim · CDSS document, Dec 7, 2024