Lilos Tender Senior Care Inc. I

Type of visit: Required - 1 Year

Licensing Program Analysts (LPA) Angelica Boyles conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was welcomed by, identified herself, and discussed the purpose of the visit with staff Erick Mendoza. According to the facility's license, the facility has a maximum capacity of six (6) residents, all of whom may be non-ambulatory and one (1) may be bedridden in bedroom #4. The facility also has a granted waiver for hospice care for six (6) residents. This facility does not feature a secured perimeter or delayed egress doors. LPA, accompanied by staff, toured the interior and exterior of the facility, and inspected each room. Pathways were free of obstruction and slip hazards. Resident bedrooms contained the required furnishings. Doors, toilets, and showers were in working order. Extra linens and hygiene supplies were present. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and client activities. The facility’s ambient internal temperature was comfortable and compliant. There was at least 2 days of perishable food, and at least 7 days non-perishable food present, all safely stored. Cooking/dining equipment and utensils were present. There were no sharp objects, toxic chemicals/poisons, fireplaces, or open-faced heaters accessible to residents. Medications were labeled, as required, and stored in locked areas. Confidential records were stored in locked areas. (Continued on LIC 809-C) (Continued from LIC 809) No pools or bodies of water were observed on the premises. Per staff, no firearms or ammunition are kept at the facility. Smoke alarms, carbon monoxide detectors, emergency lighting, and facility telephone were all working. Fire extinguisher(s) were serviced within the last 12 months. First aid kit were complete and readily accessible. Required licensing postings were observed in visible areas of the facility. LPA interviewed staff and reviewed multiple staff and resident records/files. LPA interviews did not raise any licensing concerns. The files which LPA reviewed contained required documents. No deficiencies were observed or cited during today's annual inspection. An exit interview was conducted with staff Erick Mendoza to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided during the visit.the state’s words, verbatim · CDSS document, Apr 22, 2026

Allegation investigated: Licensee's staff filmed a resident without their permission.

Licensing Program Analyst (LPA) Dang Nguyen conducted an unannounced visit to commence a Complaint Investigation regarding the above allegations. LPA was welcomed by, identified himself to, and discussed the purpose of the visit with Caregiver Ashley Vidaurre Cruz. LPA then met with House Manager Stephanie Molina, who arrived shortly after. LPA also spoke via phone with Licensee Anna Petrosyan, via phone. The Complainant alleged that Licensee’s staff filmed a resident without their permission. CCLD’s investigation involved an unannounced facility tour/welfare check and interviews of all residents in care, multiple pertinent staff, and outside sources. The Department also reviewed relevant care records, work schedule, and staff log notes. [CONTINUED ON LIC 9099-C] Unsubstantiated [CONTINUED FROM LIC 9099] Specifically, the Complainant said on a date in early February 2026, Staff #1 (S1) used their personal smartphone camera to film Resident #1 (R1) while providing incontinence care to R1, while inside R1’s bedroom. [See LIC811 Confidential Names List for a description of person identifiers used in this report.] Records and interviews aligned to show: R1 was incontinent and routinely required assistance of two (2) caregivers to be cleaned in bed, and to have their Depends changed. During the alleged incident, R1 was assisted by both S1 and Staff #2 (S2) with incontinence care. S1 denied filming R1, either during that incident or on any other day. S2 said they were sure they did not see S1 film R1, either during that incident or any other day. S1 gave LPA permission to access and review the photographs which were stored on their personal smartphone. LPA reviewed both the currently stored photographs as well as the file containing recently deleted photographs. LPA found no photographs of videos of R1 stored on S1’s smartphone. LPA interviewed multiple other coworkers; none of these staff had ever seen S1 film R1 or any other residents without their permission. LPA interviewed all five (5) of R1’s housemates/peers; all these residents denied staff ever filming them without their permission. Based on records and interviews, a preponderance of evidence does not exist to show that Licensee’s staff filmed a resident without their permission. The allegation is therefore Unsubstantiated, and no deficiency was cited for it. An exit interview was conducted with House Manager Stephanie Molina. A copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided to Licensee during today’s visit.the state’s words, verbatim · CDSS document, Feb 11, 2026 · control 08-AS-20260206090140

Allegation investigated: -Licensee's staff touched a resident in a sexual manner. -Licensee infringed a resident’s right to receive their visitor.

Licensing Program Analyst (LPA) Dang Nguyen conducted an unannounced visit to commence a Complaint Investigation regarding the above allegations. LPA was welcomed by, identified himself to, and discussed the purpose of the visit with Caregiver Ashley Vidaurre Cruz. LPA then met with House Manager Stephanie Molina, who arrived shortly after. LPA also spoke via phone with Licensee Anna Petrosyan, via phone. The Complainant alleged that Licensee’s staff touched a resident in a sexual manner, and that Licensee infringed a resident’s right to receive their visitor. CCLD’s investigation involved an unannounced facility tour/welfare check and interviews of all residents in care, multiple pertinent staff, and outside sources. The Department also reviewed relevant care records, work schedule, and staff log notes. [CONTINUED ON LIC 9099-C] Unsubstantiated [CONTINUED FROM LIC 9099] Specifically, the Complainant said on a date in early February 2026, Staff #1 (S1) touched Resident #1’s (R1’s) private parts in a sexual manner during incontinence care. [See LIC811 Confidential Names List for a description of person identifiers used in this report.] The Complainant also said that on 02/09/2026, facility manager Staff #3 (S3) refused to allow R1 to receive their Visitor #1 (V1) at the facility. Records and interviews aligned to show: R1 was incontinent and routinely required assistance of two (2) caregivers to be cleaned in bed, and to have their Depends changed. During the alleged incident, R1 was assisted by both S1 and Staff #2 (S2) with incontinence care. Since R1 had soiled themselves, S1 used a wet wipe to thoroughly clean skin in R1’s peri areas. S1 denied touching R1 in a sexual manner. S2 said they were sure they did not see S1 touch R1 in a sexual manner. R1 themselves confirmed to LPA that S1 cleaned them that day due to their own incontinence episode, and that S1 did not touch R1’s peri areas beyond using wet wipes. R1 confirmed that S1 did not try to fondle R1’s genitals or try to digitally penetrate them. LPA interviewed all staff who were witness to the 02/09/2026 visitation incident. Staff interviews, corroborated by a resident interview, showed that on this date, V1 was argumentative with facility staff and loud. V1 was heard by a neighbor who lived across the street from the facility. Because V1 could not be redirected to calm down, and because this threatened to disturb other residents’ peaceful enjoyment of the premises, S3 asked V1 to leave. V1 initially refused to leave. After S3 phoned police, V1 left the premises. Interviews showed: Staff told V1 that they could try visiting the facility again on another day. At no point was V1 told they were banned from visiting the facility in the future. LPA interviewed all five (5) of R1’s housemates/peers: All these residents denied facility staff ever physically abusing them or touching them in a sexual manner. All these residents also denied facility staff ever impeding or interfering with their own ability to receive their visitors. Based on records and interviews, a preponderance of evidence does not exist to show that Licensee’s staff touched a resident in a sexual manner, or that Licensee infringed a resident’s right to receive their visitor. These allegations are therefore Unsubstantiated, and no deficiencies were cited for them. An exit interview was conducted with House Manager Stephanie Molina. A copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided to Licensee during today’s visit.the state’s words, verbatim · CDSS document, Feb 11, 2026 · control 08-AS-20260211154239

Type of visit: Required - 1 Year

Licensing Program Analysts (LPA) Amy Rodgers conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was welcomed by, identified herself, and discussed the purpose of the visit with house manger Stephanie Molina later joined the visit. According to the facility’s license, the facility has a maximum capacity of six (6) clients of which six (6) are non-ambulatory and one (1) may be bedridden . This facility does not feature a secured perimeter or delayed egress doors. LPA, accompanied by licensee’s staff, toured the interior and exterior of the facility, and inspected each room. Pathways were free of obstruction and slip hazards. Client bedrooms contained the required furnishings. Doors, toilets, and showers were in working order. Extra linens and hygiene supplies were present. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and client activities. The facility’s ambient internal temperature was compliant. There was at least 2 days of perishable food, and at least 7 days non-perishable food present, all safely stored. Cooking/dining equipment and utensils were present. There were no sharp objects, toxic chemicals/poisons, fireplaces, or open-faced heaters accessible to clients. Medications were labeled, as required, and stored in locked areas. Confidential records were stored in locked areas. (continued on 809-C) (continued 809) No pools or bodies of water were observed on the premises. Per the licensee, no firearms or ammunition are kept at the facility. Smoke alarms, carbon monoxide detectors, emergency lighting, and facility telephone were all working. Fire extinguisher(s) were serviced within the last 12 months. First aid kit were complete and readily accessible. Required licensing postings were observed in visible areas of the facility. LPA interviewed staff and reviewed multiple staff and client records/files. LPA interviews did not raise any licensing concerns. The files which LPA reviewed contained required documents. Licensee also presented proof of current/active business liability insurance No deficiencies were observed or cited during today's annual inspection. An exit interview was conducted with House manager Stephany Molina Staff to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided during the visit.the state’s words, verbatim · CDSS document, Apr 14, 2025

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Amy Domingo conducted an announced Pre-Licensing visit. LPA Domingo was joined by Applicant Nvard Bebekyan and granted entry into the facility. The purpose of the visit was to inspect the facility to ensure that the facility is in compliance with California Code of Regulations, Title 22, Division 6. The fire inspection was completed on 02/12/24, and the facility was approved for 5 non ambulatory residents and 1 bedridden resident. During today's visit, LPA, accompanied by applicant, toured the facility inside and outside and inspected every room. The facility was found to be in good repair with no pathway obstructions. Clients' bedrooms were observed to be clean and resident accommodations included furnishings, linens and personal hygiene items; resident bathrooms were equipped with grab bars, bath mats; staff and administrative records are located in a locked office; food service including dishes, utensils, food storage and a seven day supply of non perishables and a two day supply of fresh perishables are present; toxic substances are stored locked in the garage or the office; medication storage and administration logs are located in a locked cabinet in the kitchen; first aid kit and current first aid manual are located in the office; activities, supplies and sufficient space to conduct are present; fire extinguishers are affixed with a current tag; smoke and carbon monoxide detectors are present and operable; facility posting requirements are present in a common area and the facility administrators certification is current; no pools or other body of water is present on the facility; per the applicant there are no guns, weapons or ammunition located on the property. Discussed with the applicant were continuing operation requirements, record keeping and physical plant compliance. The applicant shall contact the Centralized Application Unit (CAU) for completion of this pending facility application. An exit interview was conducted with Nvard Bebekyan , and a copy of this report and Licensee Appeal Rights (LIC 9058) were were printed and given to Nvard Bebekyan at the facility.the state’s words, verbatim · CDSS document, Apr 18, 2024