Lindley Residential Care

Type of visit: Required - 1 Year

On 6/3/2026 Licensing Program Analyst (LPA) Perchui Milena Khurshudyan arrived at this facility to conduct a required Annual Inspection. Upon arrival LPA was greeted by Staff, who granted access to the facility. LPA introduced herself by showing her badge and explained the reason for the visit. LPA Khurshudyan reviewed the required postings on a wall throughout the facility. The inspection tool was used to complete today's visit. At 10:00am LPA with the help of the Staff, began a physical plant tour of the facility and the following was observed: This is a single-story building with three (3) bedrooms, three (3) bathrooms, kitchen, common areas, and outdoor areas. It has an approved fire clearance for six (6) Ambulatory Residents, No Dementia Care, and Hospice waiver for four (4) residents. There are three (3) licensed RCFEs in the property. Kitchen: LPA observed a seven-day supply of non-perishable food and a two-day supply of perishable food, all properly stored and labeled. Knives and other sharp items are secured in a locked box placed on the kitchen cabinet, that remains under staff supervision. An emergency supply of food and water was stored inside the pantry located in the hallway next to the laundry closet. LPA observed one fully charged fire extinguisher in the kitchen area, with a service date of 1/7/2026. A weekly menu was also posted and available for review. Common Areas: The common areas include the living and dining rooms. LPA observed these areas to be clean, well-organized, and free of clutter. Furniture appeared relatively new and in good repair, with seating capacity appropriate for the number of residents. Walls, floors, windows, screens, and blinds were clean and in good condition. Continue on LIC809-C At 11:20 AM, LPA measured the room temperature at 72 degrees Fahrenheit. A hallway linen closet contained an adequate supply of fresh linens ready for use. No obstructions or tripping hazards were observed throughout the facility. A television and a variety of activities, including games, board games, and art supplies, were available for client use. Bedrooms: The facility has three bedrooms; all rooms are for residents’ use only. LPA observed bedrooms to be properly furnished with beds, linens, nightstands, chairs, dressers, closets, and adequate lighting. All rooms were clean, organized, and in good condition. Bathrooms: The facility has three (3) bathrooms. Each bathroom was stocked with hand soap, paper towels, toilet paper, and trash bins with lids. At approximately 11:45 a.m., hot water temperatures were measured at 108.2 degrees Fahrenheit. Required signage was posted, and non-skid mats were placed in all shower areas. Smoke and Carbon Monoxide Detectors: At 2:05 p.m., the Licensee tested all smoke and carbon monoxide detectors. LPA observed them to be in proper working order. Garage: The garage is currently being used as storage. The door/sliding door accessing the garage is always locked and under supervision. Laundry Room: A functioning washer and dryer are located next to the pantry. Disinfectants, laundry detergents, and hygiene supplies were stored securely in a locked cabinet and were inaccessible to clients. Backyard: LPA observed a spacious, fenced backyard with appropriate outdoor furniture and a shaded area for clients to sit and enjoy the outdoors. LPA discussed the importance of maintaining adequate care and supervision to meet client needs. Exit doors were unobstructed and unlocked. The facility does not have a swimming pool or any other body of water. Continue on LIC809-C Staff/Client File review: Facility records are stored inside locked cabinets located in the living room. From 11:45 a.m. to 1:50 p.m., LPA reviewed six (6) staff files and two (2) out of two (2) residents files. All records were complete, current, and well-organized. Medications: At approximately 12:55 p.m., LPA reviewed the Centrally Stored Medication and Destruction Records and found documentation to be generally complete, however, two medications had extra pills with no documentation. The facility does not maintain Medication Administration Records (MARs). Centrally stored medications were observed secured inside a locked commercial cabinet, inaccessible to clients. The first-aid kit was fully stocked and included an up-to-date manual. All PRN medications had current physician orders. Potentially dangerous items were stored securely and kept inaccessible to clients. The facility operates with two shifts, with one staff member assigned per shift. The administrator is on call and visits the facility every day. An emergency exit plan/sketch is posted on the wall along with other posting requirements. Both residents were present during the visit; LPA conducted interviews with the residents and 3 staff during the visit. LPA collected LIC500, LIC9020, copy of Certificate of Liability Insurance, and copy of Administrator Certificate. Property Liability insurance Exp date is 1/3/2027. The Administrator's certificate - Exp date is 1/28/27. LPA informed the Administrator/ Licensee to update LIC610E Emergency Disaster Form and submit the updated form to the department. A deficiency issued during today's visit, see LIC809-D Exit interview conducted. Copy of this report provided.the state’s words, verbatim · CDSS document, Jun 3, 2026

Allegation investigated: Facility smells malodorous

Licensing Program Analyst (LPA) Abeye Duguma conducted an unannounced initial complaint visit to the facility, met with Loura Bobakova, and explained the reason for the visit. Loura was designated by the Administrator to sign and accept the report. ---Facility smells malodorous It was alleged facility smells malodorous due to the several garbage cans which are located on the facility premises and outside of the facility. To investigate the allegation, on March 12, 2026, LPA conducted a physical plant tour, interviewed two (02) staff from 10:00a.m. – 11:30a.m., four (04) residents and four (04) neighbors from 11:30a.m. – 1:00p.m. During the physical plant tour, LPA observed all trash bins with lids and did not experience malodor in the facility. During interviews, all staff stated they make sure trash bins are kept on the property and lids remain closed at all times. (CONT on LIC9099-C) Unsubstantiated All residents stated they are unaware of any malodor in the facility. \ Based on observations and interviews, there is not enough information to verify the allegation. Therefore, the allegation is UNSUBSTANTIATED at this time. No health and safety hazards noted during the visit. Exit interview conducted and a copy of the report was issued.the state’s words, verbatim · CDSS document, Mar 12, 2026 · control 31-AS-20260306113804

Type of visit: Required - 1 Year

On 02/10/25 at 10:40 AM, Licensing Program Analyst (LPA) Gina Saucedo, arrived to conduct an unannounced, annual inspection at the facility. Upon arrival, LPA Saucedo met with Lead, Caregiver Larisa Bobakova and disclosed the purpose of the visit. Administrator was called via phone and advised of the visit. LPA asked for the census, resident, and staff files. A physical tour was conducted at 11:10 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. The fire extinguisher is located against the wall on your right-hand side towards the backyard. It is fully charged. The expiration date is 07/2025. There is a telephone line on the counter in the kitchen. There is extra, food in the kitchen pantries. The medications are locked and inaccessible to the residents in one (1) of the top, black cabinets on your right-hand side at the entrance of the facility. The knives are at the top of the kitchen counter on your right-side in a locked black box and inaccessible to the residents. The first aid kit is on the kitchen counter area on the right-side of the sink. Outside/Backyard: The outside/backyard has furniture for the residents with proper seating. The facility does have a signal system. The facility does not have a pool/body of water or a garage. LIC 809C-continued Bedrooms: There are three (3) bedrooms and two (2) 1/2 bathrooms. There a bathroom that is only half bathroom it only has a sink and a toilet, no shower area in the hallway. There is a full bathroom in the hallway. There are two (2) bedrooms for residents and one (1) for staff. The staff bedroom has a private bathroom. There are two (2) bedrooms that are shared. All bedrooms and bathrooms were toured and were properly furnished and have appropriate bedding, linens, toiletry, and lightning. The bathrooms have proper toiletry and grab bars. The bathroom temperatures of the water are within regulations reading at 115 degree Fahrenheit. The dining/living room area has enough seating for the residents and the staff. There is a pantry/room in the hallway that has extra linen and food storage. It is locked and inaccessible to the residents. The house temperature is at 70-degree Fahrenheit. The smoke detector/carbon monoxide is in the hallway and is operable. The washer/dryer along with the chemicals is in the hallway in a locked room, inaccessible to the residents. Administrative: There is no annual fee that is due right now. Towards the back of the facility on your right-hand side there is a facility sketch, House Rules, Disaster Plan, Resident Rights, Rights of Resident Council, Wifi connection instructions, Designation of facility, Infection Control and the surety bond. An exit interview was conducted, no citation(s) were issued, and a copy of this report was issued.the state’s words, verbatim · CDSS document, Feb 10, 2025

Allegation investigated: Licensee did not post ombudsman program information as required by law

On 11/12/24, at 10:54am, Licensing Program Analysts (LPA) Gina Saucedo arrived at the facility to conduct an unannounced, initial complaint visit and was greeted by Lead Caregiver Larisa Bobakova. LPA disclosed the purpose of the visit. LPA explained the purpose of this visit was to gather information, conduct staff and resident interviews and deliver findings for this complaint. The investigation consisted of the following: LPA asked for the census, requested the staff and resident roster. At 11:15am, LPA toured the physical plant. During the tour, residents and staff were interviewed. 9099C-continued Unsubstantiated Regarding the allegation: Licensee did not post ombudsman program information as required by law. It is being alleged that the LTCOP (long term care ombudsman program) poster was given to the above facility, and it was not posted. At the time of the LPA’s visit, the LTCOP (long term care ombudsman program) poster was posted on the right side of the entrance of the facility against the wall. LPA took pictures of the LTCOP (long term care ombudsman program) poster. LPA interviewed two (2) staff and confirmed that it was given to them in September, they signed a paper saying it was received and they posted it. LPA interviewed one (1) resident that confirmed the poster has always been posted where it currently is. Therefore, based on the LPA's record reviews, staff and resident interviews the above allegation(s) above is UNSUBSTANTIATED at this time. An exit interview was conducted, no citation(s) were issued for the above allegation(s), and a copy of this report was given to the Lead Caregiver.the state’s words, verbatim · CDSS document, Nov 12, 2024 · control 31-AS-20241104153927

Allegation investigated: Staff denied food to residents in care

On 09/18/24, at 12:55pm, Licensing Program Analyst (LPAs) Gina Saucedo and Angelica Segovia arrived at the facility to conduct an unannounced, initial complaint visit and was greeted by Caregiver, Larisa Bobakova and LPAs disclosed the purpose of the visit. The administator, Armenuhi Avetisyan arrived fifteen (15) minuted later. LPA explained the purpose of this visit was to gather information, conduct staff and resident interviews and deliver findings for this complaint. The investigation consisted of the following: LPA Saucedo asked for the census, requested the staff and resident roster. At 1:05pm, LPA toured the physical plant. During the tour, LPA's interviewed staff and resient roster. 9099C-continued Unsubstantiated Regarding the allegation: Staff denied food to residents in care. It is being alleged that the resident asked for food/snacks and it was denied by staff and therefore they lost a lot of weight. Three (3) residents confirmed that food is not denied to them and they receive snacks anytime they request it. Two (2) witnesses also confirmed that food is not denied to any of the residents and they are given snacks when they request it. One (1) of the witnesses (W1) is resident #1 (R1)'s daughter who confirmed that R1 is given food and snacks when appropriate. W1 also confirmed that R1 lost weight prior to coming to the above facility and has continued to lose weight due to their medical diagnosis and medication which has nothing to do with staff denying food and snacks to R1. W1 also confirmed that they visit R1 weekly and have never heard staff denying any resident's food or/and snacks. Two (2) staff also confirmed that food is not denied to any of the residents and snacks are given to them when they ask for it. LPA's were able to obtain R1's medication and medical diagnosis that confirms the weight loss. Therefore, based on the LPA's record reviews, staff and resident interviews the above allegation(s) above is UNSUBSTANTIATED at this time. An exit interview was conducted, no citation(s) were issued for the above allegation(s), and a copy of this report was given to the Administrator.the state’s words, verbatim · CDSS document, Sep 18, 2024 · control 31-AS-20240916093637

Type of visit: Required - 1 Year

On 03/04/24 at 1:01 PM, Licensing Program Analyst (LPA) Gina Saucedo, arrived to conduct an unannounced, annual inspection at the facility. Upon arrival, LPA Saucedo met with caregiver Larisa Bobakova and disclosed the purpose of the visit. LPA asked for the census, resident, and staff rosters. A physical tour was conducted at 1:50 PM 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. The fire extinguisher is located against the wall on your right-hand side towards the backyard. It is fully charged. The expiration date is 07/2024. There is a telephone line on the counter in the kitchen. There is extra, food in the kitchen pantries. The medications are locked and inaccessible to the residents in one of the top, black cabinets on your right-hand side at the entrance of the facility. The knives are at the top of the kitchen counter on your right-side in a locked black box and inaccessible to the residents. The first aid kit is on the kitchen counter area on the right-side of the sink. Outside/Backyard: The outside/backyard has furniture for the residents with proper seating. The facility does have a signal system. The facility does not have a pool/body of water. LIC 809C-continued Bedrooms: There are three (3) bedrooms and three(3) bathrooms. There are two (2) bedrooms for residents and one (1) for staff. The staff bedroom has a private bathroom. There are two (2) bedrooms that are shared. All bedrooms and bathrooms were toured and were properly furnished and have appropriate bedding, linens, toiletry, and lightning. The bathrooms have proper toiletry and grab bars. The bathroom temperatures of the water are within regulations reading at 117-118 degree Fahrenheit. The dining/living room area has enough seating for the residents and the staff. There is a pantry/room in the hallway that has extra linen and food storage. It is locked and inaccessible to the residents. The house temperature is at 69-degree Fahrenheit. The smoke detector/carbon monoxide is in the hallway and is operable. The washer/dryer along with the chemicals is in the hallway in a locked room, inaccessible to the residents. Administrative: There is no annual fee that is due right now. Towards the back of the facility on your right-hand side there is a facility sketch, House Rules, Disaster Plan, Resident Rights, Rights of Resident Council, Licensee Expiration dated 01/2025, Wifi connection instructions, Designation of facility, Infection Control and the surety bond with an expiration date of 01/2025. An exit interview was conducted, no citations were issued, and a copy of this report was issued.the state’s words, verbatim · CDSS document, Mar 4, 2024