Luna Senior Living

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Allegation investigated: Staff did not seek timely medical attention for a resident

Licensing Program Analyst (LPA) Seo Jeon conducted an unannounced visit to the facility to investigate the above allegation. LPA met with Danawaty Andhika, Caregiver, and informed them of the purpose of the LPA’s visit. The Department’s investigation involved interviews with staff and residents and review of records. On September 25, 2026, Community Care Licensing (The Department) received a complaint report with the following allegation. It was alleged that staff did not seek timely medical attention for a resident. Information received indicated that Resident #1 (R1) fell on September 21, 2026, but Staff #1 (S1) refused to call 911 and get medical attention for R1. LPA conducted an interview with R1. R1 stated that they fell in their room trying to touch an oxygen machine that belonged to a roommate. R1 did not state why they tried to touch the roommate’s oxygen machine. (Continued on LIC9099-C) Unsubstantiated R1 called for help, and S1 came into the room. R1 told S1 to call 911, but S1 refused to do so by stating that S1 could be in trouble for calling 911. R1 ultimately called 911 by themselves. LPA conducted an interview with S1, who denied refusing to call 911 when R1 fell in the room. S1 stated that S1 and a resident went to R1’s room when they heard R1 calling for help. S1 found R1 on the floor and asked if they were OK. S1 told R1 that R1 needed to go to a hospital, but R1 refused to go to a hospital. R1 stated that they were fine and did not need to see a doctor. After helping R1 get back on the bed, S1 asked R1 again to go to a hospital. R1 again refused to go to a hospital, stating that they were fine. S1 added that R1 was an independent resident managing their own medication and schedule their own appointments. LPA conducted an interview with Resident #2 (R2) who went to R1’s room with S1 during R1’s fall incident. R2 confirmed S1’s statement regarding R1’s fall incident. Due to conflicting information from the parties involved, the evidence found during the investigation did not meet the preponderance of evidence standard. Therefore, this allegation is unsubstantiated at this time. A finding that the complaint is UNSUBSTANTIATED means the allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred. An exit interview was conducted where a copy of this report was provided.the state’s words, verbatim · CDSS document, Sep 29, 2026 · control 18-AS-20260925074913

Allegation investigated: Staff do not assist resident with attending medical appointments Staff do not arrange transportation services for resident Staff do not ensure resident is treated with dignity and respect

Licensing Program Analyst (LPA) Seo Jeon conducted an unannounced visit to the facility to initiate an investigation into the above allegations. LPA met with Richard Souhuwat, Caregiver, and informed them of the purpose of the LPA’s visit. The Department's investigation involved interviews with staff and residents and review of records. On July 7, 2026, Community Care Licensing (The Department) received a complaint report with the following allegations. It was alleged that staff do not assist resident with attending medical appointments. Information received indicated that Resident #1 (R1) missed some doctor's appointments due to lack of help from staff members. LPA's records review revealed that R1 was admitted to the facility in May 2026. R1 requires staff assistance for activities of daily living (ADL) due to their physical and cognitive conditions. Continued on LIC9099-C.... Unsubstantiated LPA conducted interviews with four (4) residents. Two (2) residents interviewed stated that they make their own appointments. Two (2) residents interviewed required staff assistance with making appointments and have not experienced any problems. LPA conducted interviews with two (2) staff members, both of whom confirmed the residents' statements. LPA conducted an interview with R1, who stated that they use their own phone and make appointments by themselves. R1 repeatedly stated that R1 wanted their previous caregiver who was from a different facility that was in a different county. The evidence found during the investigation did not meet the preponderance of evidence standard. Therefore, this allegation is unsubstantiated. It was alleged that staff do not arrange transportation services for resident. Information received indicated that Resident #1 (R1) missed some appointments due to lack of transportation. LPA conducted interviews with four (4) residents. Three (3) residents interviewed stated that they arrange their own transportation. One (1) resident interviewed required staff assistance with arranging transportation and has not experienced any problems. LPA conducted interviews with two (2) staff members, both of whom confirmed the residents' statements. LPA conducted an interview with R1. R1 stated that they can call and arrange transportation. R1 again stated that they wanted their previous caregiver who worked for a different facility. The evidence found during the investigation did not meet the preponderance of evidence standard. Therefore, this allegation is unsubstantiated. It was alleged that staff do not ensure resident is treated with dignity and respect. Information received indicated that Resident #1 (R1) was told to go to bed at 08:00 PM by staff members. LPA conducted interviews with four (4) residents, all of whom stated that staff members have been helpful and respectful. All four (4) residents interviewed stated that they can go to bed at anytime they want. LPA conducted an interview with R1. R1 did not have any problem with the facility's bed time. R1 again wanted to have their previous caregiver. The evidence found during the investigation did not meet the preponderance of evidence standard. Therefore, this allegation is unsubstantiated. A finding that the complaint is UNSUBSTANTIATED means the allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred. An exit interview was conducted where a copy of this report was provided.the state’s words, verbatim · CDSS document, Jul 15, 2026 · control 18-AS-20260707095531

Allegation investigated: Staff did not assist resident with self-administered medication

Licensing Program Analyst (LPA) Seo Jeon conducted an unannounced visit to the facility to investigate the above allegation. LPA met with Richard Souhuwat, Caregiver, and informed them of the purpose of the LPA’s visit. The Department’s investigation involved interviews with staff and residents and review of records. On May 13, 2026, Community Care Licensing (The Department), received a complaint report with the following allegation. It was alleged that staff did not assist resident with self-administered medication. Information received indicated that staff are not dispensing medication to Resident #1 (R1). LPA’s records review revealed that R1 was admitted on April 30, 2026 and R1 was their own responsible person. R1 was on various prescription medications for R1’s physical and mental condition. Continued on LIC9099-C.... Unsubstantiated LPA obtained and reviewed R1’s medication records. LPA did not find any evidence of missing or mis-managed medication for R1. LPA conducted interviews with four (4) residents, all of whom denied staff missing medication dispense. LPA conducted interviews with two (2) staff members, both of whom denied missing medication dispense to any residents in care. LPA conducted an interview with R1 who stated that R1 did not recognize the medications staff had dispensed. R1 acknowledged that staff have dispensed medications. Based on interviews conducted and records review, the Department’s investigation did not provide enough information to corroborate the allegation that staff did not assist resident with self-administered medication. This allegation is unsubstantiated. A finding that the complaint is UNSUBSTANTIATED means the allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred. An exit interview was conducted where a copy of this report was provided.the state’s words, verbatim · CDSS document, May 18, 2026 · control 18-AS-20260513161756

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Seo Jeon made an announced visit to the facility for the purpose of conducting a pre-licensing inspection. LPA met with Sahak Hovsepian, applicant, who accompanied LPA for the inspection. The Applicant has submitted an application for six (6) non-ambulatory where one (1) can be bedridden in room #4. On 4-29-2-24, the Riverside County Fire Department approved a fire clearance for which the applicant has applied for. The home is a single story structure consisting of (4) bedrooms, (3) bathrooms, kitchen, dining room, garage and backyard. The bedrooms were observed to have bed, lighting, night stand, chest of drawers and area for sitting. The bathrooms had nonskid mats, and grab bars. There is plenty of extra linen (sheets, blankets, towels) that were observed to be in good repair. The smoke and carbon monoxide detectors are a dual system that were tested and found to be operable. The hot water temperature was tested and was found to be within regulatory limits measuring at 109.5 degrees Fahrenheit. The facility is equipped with flashlights and night lights. The facility has an emergency disaster plan, dementia plan and infection control training plan on file. The facility has a sufficient supply of dishes, cooking and eating utensils, that were observed to be in good repair. The facility food supply was observed to be sufficient as there was 2-day supply of perishable and a 7-day supply of nonperishable food items. The facility has an emergency food and water supply. There is a fully stocked first aid kit. The passageways, and ramps/inclines are clear and free from obstruction. The home has 1 fully charged fire extinguisher. The facility does not have any known guns or ammunition stored on grounds. The sharps/knives are stored in a locked cabinet next to the refrigerator. The medications will be kept in individual boxes that will be stored in a locked cabinet located in the kitchen. Continued on LIC809-C..... Upon entry to the home on the right side wall the required postings (facility sketch, theft and loss policy, personal rights, PUB475 CCL/dept complaint poster and he Long term Care Ombudsman poster were observed to be posted. The facility was observed to have activities to encourage socialization such board games as well as a covered seating area with plenty of outdoor space for walking and physical activities. LPA observed that the physical plant is clean, in good repair, and to be hazard-free during today’s visit. LPA determined the facility meets the operational requirements for licensure. The Pre-licensing inspection is complete, and this facility has no deficiencies. The facility has satisfied all requirements in accordance with Title 22, California Code of Regulations. An exit interview was conducted, and this report was discussed and provided to applicant, Sahak Hovsepian.the state’s words, verbatim · CDSS document, Sep 30, 2024

Type of visit: Office

Component II completion: Successful Facility Type: Residential Care Facility for the Elderly (RCFE) Application Type: Change in Ownership (CHOW) Capacity: 6 Census (if any clients in care): 3 COMP II Participants: Sahak Hovespian, Applicant/Administrator Interview Method: Waived On July 26, 2024 at 2PM, Applicant/Administrator participated in COMP II for the below pending facilities: Luna Senior Services Facility #331881617. Identification of the Applicant/administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, Applicant/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. During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of 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, Sep 4, 2024