Hilda Assisted Living

Type of visit: Required - 1 Year

Licensing Program Analysts (LPA) Michael Cava conducted an Annual Required visit and inspection of the facility. LPA met with the administrator, Nazar "Nick" Yegeyan and explained the reason for the visit. At approximately 10:45am, 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 are dual and interconnected. The fire extinguisher is located by the kitchen. It was purchased 01/07/26. Kitchen: The kitchen appliances, consisting of a refrigerator, stove/oven, microwave and fixtures were functional. LPA found a sufficient amount of perishable and non-perishable food properly stored. Licensee also maintains two buckets of emergency food supply, which serves up to 92 servings, and good for twenty-five years. Knives were stored locked in a kitchen drawer. Kitchen floor is observed to be mopped and clean. Bedrooms: There were four (4) bedrooms designated for residents' use. Two rooms are private, and two bedrooms are shared. All four bedrooms were observed properly furnished with appropriate beddings and linens with sufficient lighting and closet space. Bathrooms: There are two (2) bathrooms designated for residents' use. Both bathrooms were properly supplied with functional fixtures, grab bars and non-skid mats. Hot water temperature was measured between 111 to 112 degrees Fahrenheit. Cleaning supplies were observed kept locked underneath the kitchen sink. Common Areas: These included the living room and dining area. The common areas were properly furnished with sufficient seating, coaches, chair and television. The dining room table was large enough to seat up to six (6) residents. The auditory alarms on all exit doors were on and functional at the time of the visit. The common area floors is mopped and clean. Furniture is maintained and in good repair. Surrounding Grounds: Entry/exits were free of obstruction. There is outdoor furniture appropriate for outdoor use. No swimming pool or any other bodies of water. Garage: No garage Laundry: The laundry area is located in the hallway by resident room #4. No cleaning supplies or detergents out in the open during the visit. Resident Files: Resident files were kept in a cabinet by the dining room. LPA conducted a file review of resident records to insure compliance of licensing forms. Staff Files: Staff files are also kept in a cabinet by the dining room. LPA conducted a file review of staff records to insure forms and training are up to date and compliance with licensing forms. Medications: Medications are kept locked in a kitchen cabinet. Medication and Medication Records were reviewed for proper storage and documentation. 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 this Report Issued.the state’s words, verbatim · CDSS document, Mar 12, 2026

Allegation investigated: Staff did not reposition the resident, which led to resident sustaining multiple stage 3 pressure injuries Staff did not provide adequate food service and ensure for the resident to have drinking water, which resulted in excessive weight loss and malnourishment

Licensing Program Analyst (LPA) Michael Cava conducted a subsequent visit to the facility to conclude the investigation regarding the above allegations. LPA met with the administrator, Nazar "Nick" Yegeyan, and advised him of the complaint. The 10 day visit was made by LPA Cava on 07/23/24. Investigation was then referred to and accepted by Investigation Branch (IB), and assigned to IB Investigator Edward Hector. IB’s investigation consisted of interviews with Administrator, Staff 1 (S1) and Resident 1 (R1). IB also obtained medical records. On or around June 2024, it was alleged that R1 was sent to the hospital for UTI, where multiple stage 3 pressure injuries were discovered. Treating physician recommended to transfer R1 to a Skilled Nursing Facility (SNF), but R1's responsible person chose to have R1 return to the facility against physician’s advice. On or around July 21, 2024, During a visit to R1 at the facility, additional pressure injuries were observed. Also noted was a foul odor, with blood and pus coming out of the gauze. In addition R1 suffered excessive weight loss and acute organ dysfunction due to a lack of water and high protein food intake. Substantiated IB’s investigation consisted of interviews and record review, and the following revealed: On June 20, 2024. R1 admitted to hospital and was observed with two stage 3 wounds on lower left leg, an unstageable wound on left upper foot, stage 3 wound on right heel and stage 3 wound on her left knee. On June 22, 2024, R1 was discharged back to the facility against physician’s advice. On July 22, 2024, medical records from hospital reveal that R1 was admitted for weakness on July 22, 2024. Moreover, there was evidence of Stage II sacral wounds during physical exam. On July 23, 2024, R1 was discharged back to the facility. On or around July 23 or 24, 2024, records from home health reveal that wound care was provided for five wounds. Three stage 3 wounds to R1's right thigh and left leg. One Stage 2 on R1's left knee, and one Unstageable on R1’s sacrum. There were nurse visits on July 23 and 24, 2024. On November 25, 2024, IB interviewed staff from home health to confirm information from records received. Information from home health via interview and records confirm that R1 had initially six wounds that were Stage 3 as of July 4, 2024. Records also confirmed wound care provided every other day, but then increased to wound care every day. Moreover, there was indication of organ dysfunction, as a possible result from weight loss and malnourishment. Based on investigation and information obtained by IB, there was enough evidence to corroborate the allegations of R1 sustaining multiple stage 3 pressure injuries and R1 experiencing weight loss and malnourishment. Therefore, the allegations are Substantiated. Citations issued on the 9099D. Administrator advised and a copy of this report issued. Per California Code of Regulations (CCR), Title 22, an immediate civil penalty of $500 issued today for a violation resulting in R1's pressure injuries. The Licensee is informed that additional civil penalties may be assessed pursuant to Health and Safety Code 1569.49(f) per Departmental analysis.the state’s words, verbatim · CDSS document, May 9, 2025 · control 31-AS-20240722130514

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87615(a)(1) · Plan of correction due date: May 9, 2025

Prohibited Health Condition: Persons who require health services for or have a health condition including, but not limited to, Stage 3 and 4 pressure injuries, shall not be admitted or retained in a residential care facility for the elderly. This requirement was not met as evidenced by medical records received and interviews with home health staff conducted by IB confirming R1 sustaining multiple stage 3 wounds.the state’s words, verbatim · CDSS document, May 9, 2025

Plan of correction: As POC, the administrator will hire a consultant for additional training to address this section of regulation. As proof the POC has been met, copy of training log, training topic and attendance shall be submitted to the Licensing agency by May 23, 2025

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87466 · Plan of correction due date: May 9, 2025

Observation of the Resident When changes such as unusual weight gains or losses or deterioration of mental ability or a physical health condition are observed, the licensee shall ensure that such changes are documented and brought to the attention of the resident's physician and the resident's responsible person, if any. This requirement was not met as evidenced by medical records received by IB revealing R1 suffered weight loss and malnourishment.the state’s words, verbatim · CDSS document, May 9, 2025

Plan of correction: As POC, the administrator will hire a consultant for additional training to address this section of regulation. As proof the POC has been met, copy of training log, training topic and attendance shall be submitted to the Licensing agency by May 23, 2025

Type of visit: Required - 1 Year

Licensing Program Analysts (LPA) Michael Cava conducted an Annual Required visit and inspection of the facility. LPA met with the administrator, Nazar "Nick" Yegeyan and explained the reason for the visit. At approximately 11:45am, 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 are dual and interconnected. The fire extinguisher is located by the kitchen. It was purchased 04/08/25. Kitchen: The kitchen appliances and fixtures were functional. LPA found a sufficient amount of perishable and non-perishable food at the facility; properly stored. Licensee also maintains two buckets of emergency food supply, which serves up to 92 servings, and good for twenty-five years kept in the facility. Knives were stored locked in a kitchen drawer. Bedrooms: There were four (4) bedrooms designated for residents' use. Two rooms are private, and two bedrooms are shared. All four bedrooms were observed properly furnished with appropriate beddings and linens with sufficient lighting. Bathrooms: There are two (2) bathrooms designated for residents' use. Both bathrooms were properly supplied and had functional fixtures. Hot water temperature was measured at 113 degrees Fahrenheit. Cleaning supplies are kept locked underneath the kitchen sink. Common Areas: These included the living room and dining area. The common areas were properly furnished. The dining room table was large enough to seat up to six (6) residents. The auditory alarms on all exit doors were on and functional at the time of the visit. The floors were clean and mopped. Furniture is in good repair. Surrounding Grounds: Entry/exits were free of obstruction. There is outdoor furniture appropriate for outdoor use. No swimming pool or any other bodies of water. Garage: No garage Laundry: The laundry area is located in the hallway by resident room #4. No cleaning supplies or detergents out in the open during the visit. Resident Files: Resident files were kept in a cabinet by the dining room. LPA conducted a file review of resident records to insure compliance of licensing forms. Staff Files: Staff files are also kept in a cabinet by the dining room. LPA conducted a file review of staff records to insure forms and training are up to date and compliance with licensing forms. Medications: Medications are kept locked in a kitchen cabinet. Medication and Medication Records were review for proper storage and documentation. 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 this Report Issued.the state’s words, verbatim · CDSS document, Apr 18, 2025

Type of visit: Required - 1 Year

Licensing Program Analysts (LPAs) Michael Cava conducted an Annual Required visit and inspection of the facility. LPA met with the administrator, Nazar Yegeyan and explained the reason for the visit. At 10:20am, with the assistance of the administrator, LPA took a tour of the physical plant. Required postings were observed in the entry area. The smoke alarms and carbon monoxide are dual and interconnected. The fire extinguisher is located by the kitchen. It was purchased July 11, 2023. Kitchen: The kitchen appliances and fixtures were functional. LPA found a sufficient amount of perishable and non-perishable food at the facility; properly stored. Licensee also maintains two buckets of emergency food supply, serves up to 92 servings, and good for twenty-five years kept in the facility. Knives were stored locked in a kitchen drawer. Properly labeled medications were locked in one of the kitchen cabinets. Bedrooms: There were four (4) bedrooms designated for residents' use. Two rooms are private, and two bedrooms are shared. All four bedrooms were observed properly furnished with appropriate beddings and linens with sufficient lighting. Bathrooms: There are two (2) bathrooms designated for residents' use. Both bathrooms were properly supplied and had functional fixtures. Hot water temperature was measured at 110.7 degrees Fahrenheit. There were no cleaning supplies observed accessible to the residents during the day's inspection. Cleaning supplies are kept locked underneath the kitchen sink. Common Areas: These included the living room and dining area. The common areas were properly furnished. The auditory alarms on all exit doors were on and functional at the time of the visit. The floors were clean and mopped. The indoor furniture were in good repair. Passageways were clear of obstruction. Surrounding Grounds: Entry/exits were free of obstruction. There was backyard furniture appropriate for outdoor use. The outdoor area was free of hazards. The laundry area is located in the hallway by resident room #4. No detergents present. Resident Files: Resident files were kept in a cabinet by the dining room. LPAs conducted a file review of resident records to insure compliance of licensing forms. Staff Files: Staff files are also kept in a cabinet by the dining room. LPAs also conducted a file review of staff records to insure forms and training are up to date and compliance with licensing forms. Medications: Medication and Medication Records were review for proper documentation. 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 this Report Issued.the state’s words, verbatim · CDSS document, Mar 12, 2024