Lifelong Senior Living

Type of visit: Required - 1 Year

On 12/17/25 at 09:25 AM, Licensing Program Analyst (LPA) Gina Saucedo arrived to conduct an unannounced, annual inspection at the facility. Upon arrival, LPA met with caregiver Gregory Valentine and disclosed the purpose of the visit. The administrator, Andranik Kapikyan was called and arrived about an hour later. LPA asked for the census, resident, and staff rosters. A physical tour was conducted at 9:55 AM and observed the following: The Kitchen area was toured, and LPA observed there to be sufficient seven (7) day supply of non-perishable foods and perishable food for all residents. The kitchen area was clean at the time of the tour. There is one (1) fire extinguisher located in the living room fully charged and dated 12/2024. There is extra, food in the kitchen pantries. The knives are located in one (1) of the kitchen counters on your left-side locked and inaccessible to the residents. The medications are locked and inaccessible to the residents in a storage room on your right-hand side at the entrance of the facility. Outside/Backyard: The outside/backyard has furniture for the residents with proper seating. The facility does have a signal system. There are cameras in common areas. The facility does not have a pool/body of water. LIC 809C-continued Bedrooms/Bathrooms: There are four (4) bedrooms designated for resident's use. All bedrooms, in use by the residents were observed to be properly furnished with appropriate beddings and linens, with sufficient lighting. There are two (2) bathrooms designated for resident's use. One (1) bathroom is located in the hallway and the other bathroom is a private bathroom in a resident's room. Hot water temperature was measured between 113 and 113.5 degrees Fahrenheit. The dining/living room area has enough seating for the residents and the staff. There is no fireplace. The house temperature is at 72-degree Fahrenheit. The smoke detector/carbon monoxide is in the hallway and is operable. The washer/dryer are located outside and can be accessed from the kitchen area. There is one (1) washer/dryer. Administrative: In the dining room/living room are on your left-hand side there is a billboard with the Ombudsman sign, Admission Agreement, Rights of Resident Council, Infection Control and the surety bond with an expiration date of 02/15/26. Staff/Resident Files: Two (2) staff files were reviewed and six (6) resident files. Garage: The garage is a converted ADU. The ADU has it's own separate entry. It is inaccessible to the residents in care. There is an address for the ADU which is 16001 Ludlow Street, Granada Hills, CA 91344. The 02/21/2023, the LIC 850 specifically stated that the garage would be an ADU and not included in the fire clearance. The certificate of occupancy was finalized on 10/17/2023 and the Building and Safety permit was finalized on 09/18/2023. An exit interview was conducted, no citation(s) were issued, and a copy of this report was issued to the Administrator.the state’s words, verbatim · CDSS document, Dec 17, 2025

Allegation investigated: Staff did not treat resident with diginity and respect Staff did not allow resident to leave the facility Staff did not allow resident to have access to a telephone Staff did not provide food service to resident

Licensing Program Analyst (LPA) Michael Cava conducted a subsequent complaint visit to the facilty to investigate the above allegations. LPA met with staff, Louis Ndende, and advised him of the complaint. The administrator, Adranik Kapikyan, was notified over the telephone. Today's investigation consisted of interviews with administrator, staff and residents. A physical plant inspection also made to insure the health and safety for the residents in care. Staff did not treat resident with dignity and respect/Staff did not allow resident to leave the facility: In regards to the above allegations, it was reported that staff do not allow for Resident 1 (R1) to leave the facility, or assist R1 in arranging transportation /appointments for medical needs. Most recently, when R1went out to the front of the facility, R1 was yelled at by staff. It's also alleged that the licensee has forged R1's signature on agency placement forms to keep R1 from moving out. Interviews with the administrator and staff deny the allegation. Both administrator and staff state R1 is allowed to leave and return to Unsubstantiated the facility without any violation of R1's rights. R1 is legally blind, and requires supervision when going out, which is provided. Transportation for medical appointments and needs is also provided, with staff accompanying R1 for supervision. Transportation via share ride, ACCESS, or taxi, paid by the licensee. Administrator and staff both adds R1 has house visits by their doctor scheduled. Regarding R1 wanting to move out, administrator acknowledges that right, but R1's responsible party prefers for R1 to continue to reside in the facility. Interview with R1 could not confirm the report of staff yelling at R1 or allowing for R1 to leave. R1 could not provide or identify any witnesses to corroborate the allegations. Interviews with five (5) of five residents also could not confirm allegations. Some residents that were interviewed confirmed licensee assistance for transportation to their doctor appointments. These residents also state staff treat them with dignity and respect. Based on the information obtained, there wasn't enough evidence to prove that staff do not treat residents with dignity or respect, and not allowing for residents to leave the facility. Therefore, the allegation is deemed Unsubstantiated at this time. Staff did not allow resident to have access to a telephone: In regards to the allegation, it was reported that staff do not allow R1 access to the facility telephone. Interviews with the administrator and staff deny the allegation, stating R1 has access to the land line, and utilizes the land line at all times. Interviews with Five (5) of five residents deny the allegation, confirming they have access to the facility phone. During the investigation, LPA observed R1 with the facility telephone on hand, making a phone call. Based on the information obtained, there is insufficient evidence to corroborate the allegation of staff not allowing residents access to the facility telephone. Therefore, the allegation is deemed Unsubstantiated at this time. Staff did not provide food service to resident: In regards to the allegation, it was reported that facility staff have refused to provide R1 meals since R1 is vegetarian. Interviews with the administrator and staff deny the allegation. Both administrator and staff state they try to accommodate all their resident's dietary needs. In the case for R1, although R1 does not require a special diet (vegetarian), alternative meals, fresh vegetables, non-meat food items such as peanut butter and jelly, tofu, is offered and served at no charge. LPA conducted an inspection of the facility food supply and observed fruits, vegetables and non-meat food items on stock to accommodate R1. Interviews with five (5) of five residents could not confirm staff not providing them any food service, or have any complaints regarding food service. Review of R1's physician report does not indicate that R1 requires a special diet. Based on the information obtained, there is insufficient evidence to corroborate the allegation of staff not providing food service to residents. Therefore, the allegation is deemed Unsubstantiated at this time.the state’s words, verbatim · CDSS document, Jul 9, 2025 · control 31-AS-20250606140409

Allegation investigated: Staff does not allow resident access to phone. Resident was verbally abused while in care. Staff does not assist resident in a timely manner. Staff are not meeting resident's dietary needs.

In conjunction to a Required Annual Inspection and complaint control #31-AS-20241218081847, Licensing Program Analyst (LPA) Michael Cava conducted a complaint visit to the facility to follow up on the above allegation. On 10/17/24 and 11/07/24, two calls were made from a co-complainants addressing the allegation of staff not allowing residents access to the telephone. Initial investigation to this allegation was made on 08/29/24, along with three other allegations. At that time, based on the information received, complaint pertaining to all four allegations were Unsubstantiated. Today's investigation consisted of interviews with staff and residents. A physical inspection was also made to insure the facility has a working telephone. Interviews with two (2) of two staff deny the allegation of staff not allowing residents access to the telephone. Interviews with six (6) of six residents do not corroborate with the allegation. Inspection of the physical plant confirm there is a working telephone on the facility grounds. Based on the information obtained, the allegation of residents not having access remain Unsubstantiated. Moreover, the other three (3) allegations will also remain Unsubstantiated at this time. Unsubstantiatedthe state’s words, verbatim · CDSS document, Jan 29, 2025 · control 31-AS-20240822103213

Allegation investigated: Staff did not ensure meals provided to the residents consist of an appropriate variety of foods Staff involuntarily transferred resident to a separate facility room

In conjunction with complaint control # 31-AS-20240822103213 and a Required Annual inspection, Licensing Program Analyst (LPA) Michael Cava conducted a subsequent complaint visit to the facility to conclude the investigation regarding the above allegations. LPA met with staff Lewis Ndende and Nsikeloelo Masuloa, and advised them of the complaint. The initial visit was made by LPAs Cava and Nadia Shahbazian on 12/20/24. LPA Cava’s investigation consisted of interviews with staff and residents. LPA also conducted a physical plant inspection and record review. Staff did not ensure meals provided to the residents consist of an appropriate variety of foods: In regards to the allegation, no indication was made about foods not consisting of an appropriate variety, but it was reported that food prepared caused a resident to become ill. Interviews with staff deny the allegation. Staff adds they haven’t experienced or witness the residents feel ill from meals that were served. No reports made to the health department regarding any food poisoning. Interviews with six (6) of six residents do Unsubstantiated not corroborate with the allegation. In addition to interviews, LPA made a physical plant inspection of the kitchen and food supply and observed a variety of perishable and non-perishable food on stock. Based on the information obtained, there was insufficient evidence to prove that staff do not ensure meals provided to residents consist of an appropriate variety. Therefore, the allegation is deemed Unsubstantiated at this time. Staff involuntarily transferred resident to a separate facility room: In regards to the allegation, it was reported that Resident 1 (R1) was involuntarily moved from their private room to a non-private room. R1’s responsible person was not notified of this, and because R1 is non-verbal, R1 could not have given consent for the move on their own. The complaint report also indicated that the private room is now occupied by a female resident. There is no clear explanation on why there was a room change. Moreover, it could not be confirmed if the Admission Agreement (AA)specified a private room would be provided to R1. Interviews with administrator and staff deny the allegation. At admission, R1 and the responsible person was notified of the shared room that R1 will be residing in. There were no room changes made. Room assigned was what was agreed upon. LPA conducted a review of R1’s AA and observed that private room service was declined, opting for the basic rate. Based on the information obtained, there was insufficient evidence to corroborate the allegation of R1 being involuntarily moved to a separate facility room. Therefore, the allegation is deemed Unsubstantiated at this time.the state’s words, verbatim · CDSS document, Jan 29, 2025 · control 31-AS-20241218081847

Type of visit: Required - 1 Year

In conjunction with complaint control numbers 31-AS-20241218081847 and 31-AS-20240822103213, Licensing Program Analyst (LPA) Michael Cava conducted an Annual Required visit and inspection of the facility. LPA met with staff, Lewis Ndende and Nsikeloelo Mauloa and advised them of the visit. With the assistance of staff, LPA took a tour of the physical plant. The facility is a one story building. The smoke alarms and carbon monoxide are dual and interconnected. There is one fire extinguishers, located in the living room. It was charged on 12/02/24. Kitchen: The kitchen appliances and fixtures were functional. LPA found a sufficient amount of perishable and non-perishable food at the facility; properly stored. No sharps or cleaning supplies were observed out in the open during the day's inspection. Bedrooms: There are four (4) bedrooms designated for residents' use. All bedrooms, in use by the residents were observed to be properly furnished with appropriate beddings and linens, with sufficient lighting. Bathrooms: There are two (2) bathrooms designated for residents' use. Bedroom #4 has it's own bathroom. Both bathrooms were properly supplied and had functional fixtures. Hot water temperature was measured between 109 and 114 degrees Fahrenheit. No cleaning supplies were observed in either bathrooms during the day of the inspection. Common Areas: These included the living room and dining area. The living room was furnished with two couches, coffee table, entertainment center and television. The dining room table is large enough to seat up to six (6) residents. Living room and dining room furniture where in good repair. Floors were mopped and clean. Exits and passageways were clear of obstruction. Surrounding Grounds: Entry/exits to the front and back yards were free of obstruction. There is a patio area that is furnished. The backyard space is large to hold outdoor activities. There are locked storage spaces used to keep cleaning supplies, located in the backyard/patio area. Gate at the backyard had no exterior lock and is clear to exit/evacuate in case of an emergency. Laundry area: The laundry area is outside, located at the side of the home. Toxins and detergents not present at this time. Staff Workstation/Office: There is a small office building at the front side of the home where files are kept. Resident Files: Resident files are kept locked in staff office. Staff Files: Staff files are also kept locked in the same office where resident files are kept. Medications: Medications are stored in a locked closet by the front entry (medication closet). Medications were reviewed for proper storage and documentation. Garage: The garage is a converted ADU. The ADU has it's own separate entry. It is inaccessible to the residents in care, and it does not intervene with the day to day operation of the facility. Pursuant to Title 22 Division 6 of the CA Code of Regulations, the physical plant is compliant with title 22. LPA will need to return on a Case Management-Annual Continuation to complete the Resident and Staff record review. Exit Interview Conducted and a Copy of the Report Issued.the state’s words, verbatim · CDSS document, Jan 29, 2025

Allegation investigated: Staff did not prevent residents engaging in a physical altercation(s). Staff handled resident in a rough manner. Staff went through resident personal belongings without permission.

Licensing Program Analsyt (LPA) Michael Cava conducted a complaint visit to the facility to investigate the above allegations. LPA met with staff, Lewis Ndende, and advised him of the allegations. Today's investigation consisited of a physical plant inspection, interviews with residents and staff, and record review. Staff did not prevent residents engaging in a physical altercation: In regards to the allegation, it was reported that on or around May 2024, Resident 2 (R2) became upset, and started hitting Resident 1 (R1) for no apparent reason. According to R1, there was staff, that intervened and broke up the incident, redirecting R2. It was also reported that on or around September 2024, as R1 was walking out of the bathroom, they were pushed by Resident 3 (R3). R1 did not sustain any injuries for either incidents. Interviews with staff deny the allegation of preventing residents from engaging in a physical altercation. Staff stated although you cannot really prevent an incident of this nature, they are trained to intervene and redirect. Interviews with five (5) of five residents could not corroborate with the allegation, Unsubstantiated stating they were unaware of either incidents, or have not witnessed either of the incidents. Based on the information obtained, although there was an altercation between R1 and R2, staff was present to intervene and redirect R2, possibly preventing injuries to either residents. Moreover, R1 confirmed there was staff intervention. Therefore, the allegation is deemed Unsubstantiated at this time. Staff handled resident in a rough manner: In regards to the allegation, it was reported that on or around August and September 2024, R2 was heard yelling at staff that they were "being to rough", while assisting R2 in the shower. There were no witnesses identified to confirm the allegation. Interviews with staff deny the allegation. Interviews with five (5) residents could not corroborate that this allegation has occurred. Based on the information obtained, there was insufficient evidence to prove staff handled R2 in a rough manner. Therefore, the allegation is deemed Unsubstantiated at this time. Staff went through resident personal belongings without permission: In regards to the allegation, it was reported that staff went through R1's toiletry bag while R1 was in the restroom. There was nothing reported missing. R1 just stated they normally zip their bag close, but when checked, zipper was open. Interviews with staff deny the allegation. Interviews with the five (5) other residents could not corroborate with the allegation, stating they haven't encountered an incident similar to this with staff. These residents had no complaints about safekeeping their personal belongings. Based on the information obtained, there was insufficient evidence to prove that staff went through R1's personal belongings without permission. Therefore, the allegation is deemed Unsubstantiated at this tiime.the state’s words, verbatim · CDSS document, Nov 5, 2024 · control 31-AS-20241030162404

Allegation investigated: Staff does not allow resident access to phone. Resident was verbally abused while in care. Staff does not assist resident in a timely manner. Staff are not meeting resident's dietary needs.

Licensing Program Analyst (LPA) Michael Cava conducted a complaint visit to the facility to investigate the above allegations. LPA met with staff, Lewis Ndende, and advised him of the complaint. Administrator, Adranik Kapikyan is currently out, but was reached over the telephone. Staff does not allow resident access to phone: In regards to the allegation, it was reported that Staff 1 (S1) does not allow Resident 1 (R1) to use the house phone to make calls. The facility has one telephones available for resident use. Phone is located in the livingroom. Interview with two (2) of two staff deny the allegation. Interviews made with six (6) of six residents does not corroborate with the allegation. During the visit, LPA tested the facility phone, and was able to observe the phone to be functional. Based on the information obtained, there was insufficient evidence to prove the allegation of resident not being allowed access to the the telephone. Therefore, the allegation is deemed Unsubstantiated at this time. Unsubstantiated Resident was verbally abused while in care: In regards to the allegation, it was reported that there was a physical incident between R1 and S1 which resulted in S1 contacting law enforcement and the fire department. R1 also reported that S1 was verbally "aggressive" towards them. Details were unknown as there was no time, date or witnesses identified. Interviews made with two of two staff deny the allegation. According to staff and the administrator, R1 has a history of making false accusations. Moreover, interviews with staff and one resident stated that it was R1 being aggressive to staff, which resulted in a call to law enforcement. No reports were left by law enforcement. Review of R1's records indicate that R1 has a diagnosis that can contribute to them making these claims. Interviews made with six (6) of six residents also do not corroborate with the allegation. Resident interviews also reveal that they have never witnessed staff being aggressive towards their peers. Based on the information obtained, there was insufficient evidence to prove R1 was verbally abused while in care. Therefore, the allegation is deemed Unsubstantiated at this time. Staff does not assist resident in a timely manner: In regards to the allegation, it was reported that when R1 makes a request for assistance or asks for something, S1 takes a long time to respond, and at times go missing. Interviews with two (2) of two staff deny the allegation, revealing that they haven't gotten any complaints or concerns of them not replying for assistance within a timely manner. Moreover, staff stated most residents are independent and prefer to get things done on their own. Interviews with six (6) of six residents do not corroborate with the allegation, stating they do not have any concerns with staff not being able to meet their needs, or not replying to their calls for assistance in a timely manner. Based on the information obtained, there was insufficient evidence to prove that staff do not assist residents in a timely manner. Therefore, the allegation is deemed Unsubstantiated at this time. Staff are not meeting resident's dietary needs: In regards to the allegation, it was reported that R1 is vegan and the facility sometimes runs out of the food they prefer. Review of R1's medical assessment does not indicate that R1 requires a special diet. Moreover, review of R1's admission agreement doesn't indicate any options, or extra pay for this type of meal provided or special service. Interviews with six (6) of six residents reveal no concerns regarding the facility food service. According to two (2) of two staff, they do try to accommodate, but there are times that R1 does not like meals that are served. Alternatives are then offered, which R1 would still decline at times. Interview with the administrator reveals that, even though vegan diet wasn't even included in R1's optional service, administrator still accommodates R1's preference in meals. Based on the information obtained, there was insufficient evidence to prove that staff are not meeting the resident's dietary needs. Therefore, the allegation is deemed Unsubstantiated at this time.the state’s words, verbatim · CDSS document, Aug 29, 2024 · control 31-AS-20240822103213

Allegation investigated: Wrongful eviction. Staff do not ensure that residents have access to a telephone. Facility has fire hazards. Staff do not ensure residents have access to the grounds outside Licensee did not ensure residents personal property was safely secured

Licensing Program Analysts (LPAs) Raymond Comer and Michael Cava conducted a complaint visit to the facility to investigate the above allegations. LPAs met with the administrator, Adranik Kapikyan, and advised him of the complaint. Today's investigation consisted of interviews with the administrator, two (2) staff, and six (6) residents. LPAs also conducted a physical plant inspection. Wrongful Eviction: In regards to the allegation, it was reported that Resident 1 (R1) was evicted for no proper reason. It was also reported that another resident (see control #31-AS-20240301105312) was unlawfully evicted on or around 03/01/24. According to the administrator and staff, R1 was never evicted. R1 stayed at the facility for approximately a week, and decided to move out on their own on 03/15/24 because they couldn't afford rent. Administrator stated R1 called a taxi service for pick up and left vountarily. Interviews with staff also confirm that R1 left on their own. Interviews with the six (6) residents could not confirm R1 was wrongfully Unsubstantiated evicted. Based on the information obtained, there wasn't enough evidence to prove R1 was wrongfully evicted. Therefore, the allegation is deemed Unsubstantiated at this time. Staff do not ensure that residents have access to a telephone/Staff do not ensure residents have access to the grounds outside: In regards to the allegations, it was reported that the house phone was removed, leaving the residents with no access to the telephone, and the residents are not allowed to leave the home, or have access to the outside grounds. Interviews with six (6) of six residents deny the allegation, stating they do have access to the phone to make and receive calls. In addition, these six residents also stated that they can leave the facility when they want without interference from staff, and they are allowed to sit at the outside patio area when they please. LPAs tested the telephone lines and observed it to be able to take incoming calls. LPA checked all the exits, and observed that all exits were free of obstruction. Based on the information obtained, there was insufficient evidence to prove that the residents don't have access to a telephone, or have access to the grounds outside. Therefore, the allegation is deemed Unsubstantiated at this time. Facility has fire hazards: In regards to the allegation, it was alleged that there are fire hazards in the home. During the course of the investigation, LPA conducted a physical plant inspection of the home to insure exits and passageways are clear of obstruction. The fire extinguisher is brand new, and located in the living room. The smoke detectors are interconnected. There are fire doors installed in four bedrooms and one bathroom. LPAs also interviewed staff and residents, who deny any fire hazards. Based on the information obtained, there wasn't enough evidence to prove that facility has fire hazards. Therefore, the allegation is deemed Unsubstantiated at this time. Licensee did not ensure residents personal property was safely secured: In regards to the allegation, it was reported that R1's personal belongings were reported missing during their stay at the facility. According to the administrator, R1 never reported anything missing during their stay. R1 completed an inventory list at admission, and everything on that list was accounted for when R1 left the facility. Interviews with six (6) of six residents expressed no complaints of their belongings being not properly secured. Based on the information obtained, there was insufficient evidence to prove licensee did not ensure R1's property was safely secured. Therefore, the allegation is deemed Unsubstantiated at this time.the state’s words, verbatim · CDSS document, Mar 19, 2024 · control 31-AS-20240315154808

Allegation investigated: Facility illegally evicted resident. Facility placed a camera in a resident's room without notifying the resident. Facility placed a camera inside of a bathroom.

Licensing Program Analyst (LPA) Michael Cava conducted a complaint visit to the facility to investigate the above allegations. LPA met with the administrator, Andranik Kapikyan, and advised him of the complaint. Today's investigation consisted of interviews with the administrator, record review and a physical plant inspection. Facility illegally evicted a resident: In regards to the allegation, it was reported that after R1's medical appointment on or around 03/01/24, R1 was asked not to return. Interview with the administrator deny the allegation. According to the administrator, on 03/02/24, R1 was exhibiting an aggressive behavior, which was causing a distrubance at the facility. Department of Mental Health and Law Enforcement were called for assistance. R1 was placed on a 5150 hold. R1 is still placed on 5150 hold at this time. Administrator stated they are awaiting discharge, but also stated an eviction was previously issued prior to the incident on 03/02/24 for faillure to comply with the Unsubstantiated house rules and the admission agreement. Based on the information obtained, the allegation of facility illegally evicting the resident is deemed Unsubstantiated at this time. Facility placed a camera in a resident's room without notifying the resident/Facility placed a camera inside of a bathroom: In regards to the allegation, a physical plant inspection was made, and there were only cameras in the common areas. There were no cameras installed in resident rooms or the bathrooms. Interviews with the administrator and staff deny cameras ever being installed in the resident rooms or bathrooms. Interviews with three (3) of four (4) residents also deny that there is a camera in their room, or in the bathroom. Based on the information obtained, the allegation is deemed Unsubstantiated at this time.the state’s words, verbatim · CDSS document, Mar 5, 2024 · control 31-AS-20240301105312

Allegation investigated: Staff handled resident in a rough manner Staff did not assist resident in a timely manner Staff did not provide adequate food service Staff did not provide a comfortable environment for residents Staff did not accommodate resident based on resident’s health conditions Staff did not meet resident's diapering needs Staff mismanaged resident medication

Licensing Program Analyst (LPA) Michael Cava conducted a complaint visit to the facility to investigate the above allegations. LPA met with the administrator, Adranik Kapikyan, and advised him of the complaint. Today's investigation consisted of interviews with the administrator, residents and staff, record review and a physical plant inspection. Staff handled resident in a rough manner: In regards to the allegation, it was reported that in the morning of, on or around 02/28/24, staff took a resident's cell phone away, and threw that resident back on the bed. There were no residents or witnesses identified to the allegation. Interviews with the administrator and staff deny the allegation. Interviews with three (3) of the four (4) residents could not confirm that the allegation had occurred. Based on the information obtained, there was insufficient evidence to corroborate the allegation of staff handling a resident in a rough manner. Therefore, the allegation is deemed Unsubstantiated at this time. Unsubstantiated Staff did not assist resident in a timely manner/Staff did not meet resident's diapering needs: In regards to the allegation, it was reported that on or around 02/28/24, at approximately 6:00am, a resident had a fall. This resident was left unassisted on the floor for a period of time, in their urine and feces. There were no residents or witnesses identified to these allegations. Interviews with the administrator and staff deny the allegation. Interviews with three (3) of the four (4) residents could not confirm that the allegations occurred. During interviews with these residents, it was revealed that each resident is able to go to the bathroom or take care of their toileting needs on their own. In addition to these interviews, LPA reviewed each resident files, and it revealed that all the residents can manage their own toileting needs. Based on the information obtained, there was insufficient evidence to corroborate the allegation of staff not assisting a resident in a timely manner, or staff not meeting a resident's diapering need. Therefore the allegations are deemed Unsubstantiated at this time. Staff did not provide adequate food service: In regards to the allegation, it was reported that the facility does not provide a balanced meal, serving mostly burned toast and baloney. Interviews with the administrator and staff deny the allegation. Interviews with three (3) of the four (4) residents also deny the allegation. Residents did not express any concerns of the food service, stating they are satisfied with what's being served. In addition to interviews, LPA conducted an inspection of the food supply and observed a variety and sufficient supply of perishable and non-perishable food. During the day's visit, LPA observed lunch, which is chicken stew, consisting of carrots, potato and rice. Based on the information obtained, the allegation of staff did not provide adequate food service is deemed Unsubstantiated at this time. Staff did not provide a comfortable environment for residents: In regards to the allegation it was reported that Staff 1 (S1) disturbs residents in the morning by intentionally talking loud and turning up the radio and television to wake them up by 5am. Interviews with the administrator and staff deny the allegation. During LPA's interview with S1, S1 was observed to be soft spoken. Interviews with three (3) of the four (4) residents also deny the allegation, and expressed no complaints towards S1. Based on the information obtained, the allegation of staff not providing a comfortable environment is deemed Unsubstantiated at this time. Staff did not accommodate resident based on resident’s health conditions/Staff mismanaged resident medication: In regards to the allegations, it was reported that the licensee admitted a resident who requires a higher level of care, and 24 hour supervision. It was also reported that resident medications are mismanaged. The reporting party did not identify this resident, or the conditions requiring the higher level of care. Nor did the reporting party identify residents whose medications were mismanaged. Interviews with the administrator and staff deny the allegation. There are no residents at the facility with a restricted or prohibited condition. Interviews with three (3) of the four (4) residents expressed no complaints or concerns with staff ever mismanaging their medications. During LPA's physical plant inspection, LPA observed the residents at the home to be appropriate and aware of their surroundings. Only one resident was observed to require the use of a wheelchair, but this resident was able to manage their own needs. In addition, LPA conducted a record review of resident records and did not observe any of the resident records indicating the need for 24 hour supervision, or a higher level of care. Medications were also reviewed, and no discrepancies were observed. Based on the information obtained, there was insufficient evidence to corroborate the allegations of staff not being able to accommodate a resident's health needs, or staff mismanaging a resident's medication. Therefore, the allegations are deemed Unsubstantiated at this time.the state’s words, verbatim · CDSS document, Mar 5, 2024 · control 31-AS-20240228085822

Type of visit: Prelicensing

At 10:40 a.m. on 12/06/2023, Licensing Program Analysts (LPAs) Nicholas Reed and Michael Cava conducted an announced prelicensing inspection. LPAs met with the applicant and administrator and disclosed the reason for the visit. LPAs, applicant, and administrator toured the facility inside and out at 10:50 a.m.. No immediate health and safety hazards were observed during this visit. It is a single story building with four (04) bedrooms, two (02) bathrooms, kitchen. garage, common areas, and outdoor areas. It has an approved fire clearance for non-ambulatory residents in Bedroom #1 and Bedroom #3, a bedridden resident in Bedroom #2, and an ambulatory resident in Bedroom #4. Hospice waivers for 6 residents. The facility uses surveillance cameras in common areas and exterior areas. At the main entrance, LPAs observed postings for personal rights, non-discrimination notice, administrator certificate, Ombudsman contact, complaint contact poster, and rights of resident councils. LPAs advised that the complaint poster must be 20” x 26”, and the facility should also post a blank copy of the admission agreement, visitation policy, emergency disaster plan, and a weekly menu. LPAs also observed facility sketches with evacuation procedures clearly labelled throughout the facility. All emergency exit paths were free from obstructions. The rear exit gate was unlocked with a self-closing latch. The rear exit gate shall remained unlocked as per the facility’s fire clearance. Front gates were locked and approved by the city Fire Inspector. At 10:55 a.m., the carbon monoxide detector at the front was tested and operational. At 11:00 a.m. today, the smoke detector in Bedroom #1 was tested and operational. During the test, three (03) out of three (03) fire doors closed. At approximately 11:05 a.m. LPA observed fully charged fire extinguishers at the front and in the kitchen. They were last inspected on 11/16/2022. The applicant set a reinspection date for 12/07/2023. At 11:10 a.m. today, six (06) out of six (06) auditory alarms were heard on and functioning. At 11:15 a.m. LPAs tested the house phone to be operational. The facility has 4 bedrooms. All bedrooms contained a chair, lamp, nightstand, storage, and a bed with adequate bedding. All furnishings were clean and in good condition. The ramp and handrails leading from Bedroom #2 were in good condition The facility has 2 bathrooms. 1 bathroom is private to Bedroom #4, and 1 is shared. All bathrooms contained liquid soap, trash can with lids, grab bars near the toilet and shower, and a non-skid mat in the shower. The shared bathroom used a revolving hand drying device. The shared bathroom used paper towels. At approximately 11:20 a.m. LPAs measured the water temperature to be 108.8 degrees Fahrenheit. Walls, floors, windows, screens, and blinds were clean and in good repair. At 11:25 a.m. LPA measured the room temperature to be 72 degrees Fahrenheit. Board games, books, and activities were observed in the living room. Additional linens and beddings were stored in an outdoor storage area. LPAs observed an adequate supply of non-perishable foods in the kitchen. The stove hood was clean. Appliances were in good condition. Sharps were locked below the counter. Cleaning solutions were locked below the sink. LPAs observed a storage area behind the kitchen for files, medications, and supplies. A washing machine and dryer were located in the rear of the facility. Both were in working order. Detergents were locked in a storage cabinet. LPA observed a patio area in the rear of the facility which was shaded by an awning. The patio contained furniture in good condition. LPAs, applicant, and administrator reviewed Component III at 12:00 p.m. today. During today's inspection, the facility needs additional postings mentioned above, a reinspection for fire extinguishers, and a complete first aid kit. Pre-Licensing is incomplete with deficiencies to be resolved by 12/08/2023. Applicant to notify LPAs of corrections and send photographs of corrections prior to licensure. Exit interview conducted. Copy of report provided.the state’s words, verbatim · CDSS document, Dec 6, 2023

Type of visit: Office

Component II completion: Successful Facility Type: RCFE Application Type: INITIAL Capacity: 6 Census (if any clients in care): 0 COMP II Participants: Liana Gafikyan - CEO/ Andranik Kapikyan Administrator Interview Method: Telephone interview On October 17, 2023, Applicant/Administrator participated in COMP II. Identification of the applicant and administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, applicant and administrator confirmed that they have read and understand community care facility licensing laws included in the Health and Safety Codes and the California Code of Regulations Title 22. Signed LIC 809 with copy of photo ID have been obtained. During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of the 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, Oct 17, 2023