Heart of Home Senior Living

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Quoc Huynh arrived at the facility unannounced to conduct a required annual visit at 9:42AM. The LPA met with Licensee Kajo Movsesian who arrived shortly thereafter. Entrance interview conducted. Beginning at 10:06AM, the LPA and the Licensee toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. The following was observed: KITCHEN: Knives are stored inaccessible in a locked cabinet. Cleaning supplies and laundry products were stored inaccessible under the sink. Kitchen appliances were clean and in operable condition. The facility has a sufficient supply of perishable and non-perishable food, as well as emergency food and water. Food in the refrigerator was observed to be of good quality. The Kitchen also had extra facility supplies and linens. COMMON AREAS: At the time of the visit, living room and dining room furniture was observed to be in good condition. The facility maintained a comfortable temperature throughout the visit. LPA Huynh noted required signage and postings in the facility’s entryway. LPA observed nightlights throughout the facility’s hallways. Additionally, a laundry closet is located in the hallway and was observed to be operable and in good condition. Report Continued on LIC 809-C BEDROOMS/RESTROOMS: There are four (4) total bedrooms: two (2) private and two (2) shared. Bedrooms were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. There were two (2) total restrooms in the facility: one (1) shared restroom located in the hallway and one (1) private resident restroom. Restrooms were clean and sanitary and in operating condition with grab bars and non-slip surfaces. All restrooms were sufficiently stocked with soap, paper products, and displayed hand washing signs. Hot water was tested and measured between 109.8 degrees F and 113.5 degrees F. OUTDOOR AREA: The backyard has an area equipped with furniture for resident and visitor use. There is one (1) self-latching side gate for emergency use. No bodies of water noted, and exits are free of obstructions. LPA observed an Additional Dwelling Unit (ADU) fenced off in the backyard with residents who are unrelated to the facility. The was a secured shed that contained general storage. RECORDS: Record review began at 10:23AM. Resident records were reviewed for, but not limited to care plans, physician's report, admissions agreement, and consent forms. All records were in order. Personnel records were reviewed for, but not limited to health assessments, criminal record clearances, first aid/CPR training, and the appropriate training. All files were in order. INFECTION CONTROL/EMERGENCY DISASTER PLAN: During today's visit, LPA reviewed the facility's infection control plan and emergency disaster plan. Both documents were observed to be complete and reviewed annually as required. Emergency disaster drills are conducted quarterly, with the last documented drill on 04/06/2026. Two (2) fire extinguishers were observed throughout the facility and were last serviced on 04/08/2026. Smoke and carbon monoxide detectors were tested at 10:52AM and were operational at the time of the visit. Report Continued on LIC 809-C MEDICATIONS: Medication review began at 11AM. Medications are centrally stored and kept inaccessible in the kitchen. Medications were observed for two (2) residents. Medications were labeled and checked for expiration dates. Medications were properly documented on the centrally stored medications and destruction record. No errors observed during the medication review. No deficiency cited. Exit interview conducted. A copy of today's report was reviewed and provided.the state’s words, verbatim · CDSS document, Jun 18, 2026

Allegation investigated: Resident was left in a soiled diaper Resident is unable to communicate with staff due to language barrier

Licensing Program Analyst (LPA) Quoc Huynh conducted an unannounced initial complaint visit for the above allegations. LPA arrived at 9:40AM and met with the Licensee Kajo Movsesian and explained the reason for the visit. Entrance interview conducted. Beginning at 9:57AM, the LPA and Licensee conducted a brief tour to ensure the health and safety of the residents, and no immediate concerns were observed. Between 10:05AM and 11:24AM, the LPA interviewed four (4) residents, two (2) staff, and the Licensee. At 12:05PM, the LPA reviewed and obtained pertinent documents. The following was then determined: Report Continued on LIC 9099-C *Report amended due to missing signature Unsubstantiated Allegations: “Resident was left in a soiled diaper” and “Resident is unable to communicate with staff due to language barrier.” It was reported that on 09/17/2025, emergency services responded to a 911 call from the facility with complaints of chest pain from Resident #1 (R1). R1 was observed to be in a soiled diaper that leaked through their shirt and mattress. It was also alleged that residents are unable to communicate with facility staff and staff were unable to provide emergency services information for the residents in care due to a language barrier. Interview with three (3) out of four (4) residents revealed they have not experienced being left in a soiled diaper for long periods of time. R1 reported that there were two (2) previous occasions that they believed they were not changed but was not certain about their answer. Resident #2 (R2) reported that they were unsure if they utilized an adult diaper. Resident #3 (R3) and Resident #4 (R4) reported having no issues with their diaper changes and that staff are attentive to their incontinence needs. Record review showed that two (2) out of five (5) residents require some assistance with toileting/incontinence needs while three (3) residents required full assistance. Staff #1 (S1) and Staff #2 (S2) reported that they conduct physical checks on residents often with diaper checks every two (2) to three (3) hours, and more if needed. S1 stated diapers are changed often, and in addition to routine checks, if staff smell a foul odor they will change the resident immediately. S2 stated some residents can utilize the bathroom or communicate to the staff if they are soiled. S2 also educated the more independent residents on how to change their own diapers, however, staff will continue to assist with changes as needed. Residents reported that they had no issues with communication with staff. R3 stated S1 can sometimes have difficulty with communicating due to limited English. R3 and R4 stated that they communicate with S1 by repeating themselves and using hand gestures or signals for better understanding, to which S1 then successfully understands and can fulfill their requests. R1 described the staff as “ok” and R1 had no problems with staff communication. Residents had no overall complaints about the staff and their abilities for meeting resident needs. Interview with S1 was accomplished through the utilization of a translator app, however S1 was able to respond to the LPA’s questions with basic English. Report Continued on LIC 9099-C S1, S2, and the Licensee stated that S1 is the only staff who knows limited English, however, will have scheduled shifts with staff who are more fluent. In an emergency when 911 is dispatched, staff immediately notified the Licensee in which the Licensee will arrive at the facility within five (5) minutes or communicate with emergency services via telephone call. Although the Licensee is known to communicate with emergency services, S1 and S2 were knowledgeable in emergency procedures and were aware of where to access the residents’ information. Additionally, the Licensee stated that during an emergency, staff are instructed to not touch or move the residents which included pausing diaper changes, until emergency services evaluated the situation. Although the allegations may have happened or are valid, there is not sufficient evidence to prove the alleged violations did or did not occur, therefore the allegations are deemed UNSUBSTANTIATED at this time. No deficiency related to the allegations were cited. Exit interview conducted. A copy of the report was reviewed and provided.the state’s words, verbatim · CDSS document, Sep 25, 2025 · control 29-AS-20250918123856

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Quoc Huynh arrived on September 18, 2025 at 09:30AM for an unannounced inspection to follow up on a substantiated allegation of a complaint investigation. The LPA met with Licensee Kajo Movsesian who arrived at 9:51AM. Beginning at 9:52AM, the LPA and Licensee conducted a brief safety tour, and no immediate concerns were observed. On March 2, 2022, the Department concluded a complaint investigation regarding the following allegation: Failure to provide adequate care and supervision. The Licensee was cited for California Code of Regulations (CCR) 87615(a)(1) Prohibited Health Conditions; CCR 87631(a)(1) Healing Wounds; CCR 87468.2(a)(4) Additional Personal Rights of Residents in Privately Operated Facilities; and CCR 87465(g) Incidental Medical and Dental Care. At the time of the complaint visit on March 2, 2022, an immediate civil penalty of $500 was issued and the licensee was informed that an additional civil penalty might be assessed based on Health and Safety Code §1569.49(f). Report Continued on LIC 808-C The Department has concluded an analysis and has determined that a civil penalty is warranted for serious bodily injury. The Welfare and Institutions Code Section 15610.67 defines serious bodily injury as “an injury involving extreme physical pain, substantial risk of death, or protracted loss or impairment of a function of a bodily member, organ, or of mental faculty, or requiring medical intervention, including but not limited to, hospitalization, surgery, or physical rehabilitation.” This is evidenced by the facility not providing care and supervision to a resident (R1) that resulted in serious bodily injury. The facility did not assess R1’s skin condition and seek prompt medical care, leading to pressure injuries and pain that required hospitalization and surgical intervention. Today, September 18, 2025, the Department will be issuing a civil penalty per Health and Safety Code § 1569.49(f) for a violation that the Department constitutes as serious bodily injury in the amount of $10,000. However, since an immediate civil penalty of $500 was previously issued on March 2, 2022, the amount of the civil penalty issued today will be $9,500. Exit interview conducted. A copy of the report issued. Appeal rights provided. The Licensee Kajo Movsesian’s signature on this report acknowledges receipt of the appeal rights, found on page two of LIC 421D.the state’s words, verbatim · CDSS document, Sep 18, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Quoc Huynh arrived at the facility unannounced to conduct a required annual visit at 9:10AM. The LPA was greeted by staff, informed them of the reason for the visit, and staff notified the Administrator. Administrator Kajo Movsesian arrived at 9:19AM. Entrance interview conducted. Beginning at 9:21AM, the LPA and the Administrator toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. The following was observed: COMMON AREAS: At the time of the visit, living room and dining room furniture was observed to be in good condition. The facility maintained a comfortable temperature throughout the visit. LPA Huynh noted required signage and postings in the facility’s entryway. Smoke and carbon monoxide detectors were tested at 11:00AM and were operational at the time of the visit. One fire extinguisher was observed throughout the facility and was last serviced on 05/06/2025. LPA observed nightlights throughout the facility’s hallways. Additionally, a laundry closet is located in the hallway and was observed to be operable and in good condition. Report Continued on LIC 809-C BEDROOMS/RESTROOMS: There are four (4) total bedrooms: two (2) private and two (2) shared. Bedrooms were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. Extra linens are stored in the kitchen cabinets. There were two (2) total restrooms in the facility: one (1) shared restroom located in the hallway and one (1) private resident restroom. Restrooms were clean and sanitary and in operating condition with grab bars and non-slip surfaces. All restrooms were sufficiently stocked with soap, paper products, and displayed hand washing signs. Hot water was tested and measured between 112.6 degrees F and 113.9 degrees F. OUTDOOR AREA: The backyard has an area equipped with furniture for resident and visitor use. There is one self-latching side gate for emergency use. No bodies of water noted, and exits are free of obstructions. LPA observed an Additional Dwelling Unit (ADU) fenced off in the backyard with residents who are unrelated to the facility. KITCHEN: The LPA observed the facility kitchen at 9:45AM. Knives are stored inaccessible in a locked cabinet. Cleaning supplies and laundry products were stored inaccessible and locked under the sink. Kitchen appliances were clean and in operable condition. The facility has a sufficient supply of perishable and non-perishable food, as well as emergency food and water. Food in the refrigerator was observed to be of good quality. The Administrator stated the facility does a grocery run once a week. RECORDS: Record review began at 9:55AM. Resident records were reviewed for, but not limited to care plans, physician's report, admissions agreement, and consent forms. All records were in order. Personnel records were reviewed for, but not limited to health assessments, criminal record clearances, first aid/CPR training, and the appropriate training. All files were in order. Report Continued on LIC 809-C INFECTION CONTROL/EMERGENCY DISASTER PLAN: During today's visit, LPA reviewed the facility's infection control plan and emergency disaster plan. Both documents were observed to be complete and reviewed annually as required. Emergency disaster drills are conducted quarterly, with the last documented drill on 04/29/2025. MEDICATIONS: Medication review began at 11:04AM. Medications are centrally stored and kept inaccessible in the kitchen. Medications were observed for two (2) residents. Medications were labeled and checked for expiration dates. Medications were properly documented on the centrally stored medications and destruction record. No errors observed during the medication review. One (1) staff and three (3) residents were interviewed. No complaints were reported. No deficiency cited. Exit interview conducted. A copy of today's report was reviewed and provided.the state’s words, verbatim · CDSS document, May 27, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Sandra Urena arrived at the facility unannounced to conduct a required annual visit. the LPA met with staff and explained the reason for the visit. The Administrator was called by staff, and Administrator Kajo Movsesian arrived at the facility shortly thereafter. The LPA, and the Administrator toured the physical plant areas inside and outside to ensure there are no health and safety hazards and that the facility is in compliance with Title 22 Regulations. COMMON AREAS: The LPA observed common areas to be relatively clean and properly furnished. The LPA observed the fire extinguishers to be fully charged and last serviced on 02/15/2024. At 12:30 p.m., fire alarms/carbon monoxide detectors were tested and functioned properly. All exits have functioning auditory devices and were operational at the time of the visit. There is a washer and dryer located in one of the hallways. KITCHEN: The LPA observed the kitchen/dining area. Knives are stored in a locked kitchen cabinet. Kitchen appliances are in operable condition. The facility has a sufficient supply of perishable and non-perishable food. Medications are located in a locked kitchen cabinet. Cleaning solutions, toxins, chemicals and hazardous items were inaccessible and locked away inside a kitchen cabinet. BEDROOMS: The facility is a single-story residential home with four (4) bedrooms and two (2) bathrooms for resident's use. The LPA observed residents’ bedrooms, which were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. Inside temperature was maintained at a comfortable level. Continues on LIC 809C... RESTROOMS: Restrooms are relatively clean and sanitary and in operating condition with grab bars and non-skid mats. Hot water measured at 115.3-degree Fahrenheit. The sinks had sufficient liquid soap, and paper towels. OUTDOOR AREA: The backyard has a covered outdoor area equipped with furniture for client use. There is a side gate for client use and is single-latched. No bodies of water were noted. RECORDS: Records review began at 12:45 p.m., Residents’ records were reviewed for, but not limited to care plans, medical records, admissions agreement, consent forms. All records were in order. Personnel records were reviewed for, but not limited to health assessments, criminal record clearances, first aid/CPR training, and the appropriate training. All files were in order. MEDICATIONS: Medications review began at 1:30 p.m.; medications are centrally stored and locked in a cabinet in the kitchen area; medications are labeled and checked for expiration dates. Medications are properly documented on the centrally stored medications and destruction record. No errors observed during the medication review. INFECTION CONTROL: The facility has an adequate supply of Personal Protection Equipment (PPE) and the facility is able to obtain additional supplies as needed. The facility’s cleaning protocol is sufficient. If needed, the facility has the capacity to designate a single isolation room if the facility has a confirmed case of COVID-19. The LPA reviewed the following documents: - LIC500 Personnel Report - LIC9020 Client Roster No deficiencies cited at this time. Exit interview conducted. A copy of the report was issued.the state’s words, verbatim · CDSS document, Jun 10, 2024

Type of visit: Case Management - Legal/Non-compliance

Licensing Program Analyst (LPA) Emily Peraldi conducted an unannounced case management - legal/non-compliance visit. At 9:28 a.m., the LPA met with staff and explained the reason for the visit. At 9:40 a.m., the Administrator Kajo Movsesian arrived at the facility. The purpose of today’s visit was to monitor the licensee’s compliance with Title 22 Regulations. The facility is on a two-year Compliance Plan. The LPA focused today’s visit on resident records and personnel records. RECORD REVIEWS: Between 9:50 a.m. and 11:26 a.m., the LPA conducted a file review for all six (6) residents and staff regularly scheduled and observed the following: Staff have current first aid and training documentation showing required training completed. Resident records were reviewed for, but not limited to, care plans, medical records, admissions agreement, consent forms. It was noted that a disaster drill was conducted on 01/08/2024 and fire drill was conducted on 01/12/2024. All files were in order. The Administrator’s certificate expired on 12/19/2023 and is in the process of renewing. At 12:00 p.m., the LPA along with the Administrator, conducted a brief physical plant tour. At 12:01 p.m., the LPA observed two (2) fire extinguishers to be last serviced on 11/03/2022. During the time of the visit, the Administrator had the two (2) fire extinguishers serviced. The hot water temperature was measured in all bathrooms and was found in compliance between 105.3 and 106.8-degrees Fahrenheit. Pursuant to Title 22 of the California Code of Regulations Division 6, Chapter 8 and California Health and Safety Code the following deficiency was cited (refer to LIC 809-D) Exit interview conducted. A copy of the report and appeal rights were provided.the state’s words, verbatim · CDSS document, Feb 15, 2024

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87203 · Plan of correction due date: Feb 16, 2024

87203 Fire Safety All facilities shall be maintained in conformity with the regulations adopted by the State Fire Marshal for the protection of life and property against fire and panic. This requirement is not met as evidenced by: Based on observation, the Licensee did not comply with the section cited above as two fire extinguishers were observed to be not serviced within a year which poses a potential health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Feb 15, 2024

Plan of correction: The Administrator had the two fire extinguishers serviced during the time of visit. POC has been met.