Nana's Dream House Facility

Type of visit: Case Management - Annual Continuation

Licensing Program Analyst (LPA) Trevor Byrne arrived at the facility unannounced to conduct a continuation of the required annual visit at 10:16 AM. LPA met with the facility Administrator Naira Badalyan. Entrance interview was conducted and the reason for the visit was explained. RECORD REVIEW: Record review began at 10:22 AM. Staff and resident records were reviewed for documents including, but not limited to: health screening, TB test, staff training records, fingerprint clearance, resident physician's report, needs and service appraisal, consent forms, and personal rights. Five (5) resident files were reviewed. Two (2) resident admission agreements were observed to be missing the rate for basic services. Three (3) resident files for residents who were identified as having hearing loss were missing the required Telecommunications Device Notification form (LIC 9158). Two (2) incident reports were observed in resident files. LPA reviewed the facility’s file and did not observe incident reports for these incidents. LPA observed that the incident reports were sent within the required timeframe but were submitted to the incorrect fax number. This is considered a technical violation and no deficiency is being generated under this report. LPA provided the appropriate fax number to the Administrator who agreed to submit all future incident reports to the appropriate fax number. Five (5) staff files were reviewed. All staff files reviewed contained the required documentation and trainings. MEDICATION REVIEW: Medication review began at 12:05 PM. Medications are stored centrally and securely in the Administrator’s office. Medications for three (3) residents were observed. All medications reviewed were properly stored and were properly documented on their respective centrally stored medication and destruction record sheets. No deficiencies were observed during medication review. CONTINUED ON LIC 809C. INTERVIEWS: LPA interviewed one (1) staff and one (1) resident. The resident interviewed stated that staff treat them well and are attentive to their needs. The staff member interview was conducted with the assistance of the Administrator as a translator. The staff member interviewed was knowledgeable on their role and responsibilities, the resident’s rights, the different forms of abuse, and the appropriate reporting procedures for suspected abuse. Pursuant to Title 22 of the CA Code of Regulations, the following deficiencies were cited (refer to LIC 809-D): Exit interview conducted and copy of the report was issued and appeal rights provided.the state’s words, verbatim · CDSS document, Jul 27, 2026

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87507(g)(3)(A) · Plan of correction due date: Aug 10, 2026

87507 Admission Agreements (g) Admission agreements shall specify the following: (3) Payment provisions, including the following: (A) Rate for all basic services... This requirement is not met as evidenced by: Based on record review the Licensee did not comply with the section cited above as 2 resident admission agreements were observed to be missing the rate for basic services which poses a potential personal rights risk to clients in care.the state’s words, verbatim · CDSS document, Jul 27, 2026

Plan of correction: Administrator agreed to update the admission agreements for the identified residents and to obtain signatures from the residents responsible parties. Administrator agreed to submit the updated admission agreements to CCLD no later than POC due date.

From the deficiency page — Deficiency type: Type B · Section cited: CCR87507(b) · Plan of correction due date: Aug 10, 2026

87507 Admission Agreements (b) The licensee shall complete... a Telecommunications Device Notification form (LIC 9158, 11/04) for each resident whose...r medical assessment indicates ...hearing-impaired... This requirement is not met as evidenced by: Based on record review the Licensee did not comply with the section cited above as 3 resident files who were identified as having hearing loss were missing the telecommunications Device Notification form which poses a potential personal rights risk to clients in care.the state’s words, verbatim · CDSS document, Jul 27, 2026

Plan of correction: Administrator agreed to complete LIC 9158 forms for the identified residents and to obtain signatures from the residents responsible parties and to submit the completed forms to CCLD no later than POC due date.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Trevor Byrne arrived at the facility unannounced to conduct the required annual visit at 01:46 PM. LPA met the facility Administrator Naira Badalyan. Entrance interview was conducted and the reason for the visit was explained. Beginning at 01:52 PM, the LPA, along with the Administrator toured the physical plant areas inside and outside to ensure there are no health and safety hazards and that facility is in compliance with Title 22 Regulations. The following was observed: OUTDOOR SPACE: The facility has one (1) emergency exit gate located on the side of the facility. LPA observed clear passageways for emergency exit use. The facility had adequate shaded seating for resident use. Cameras were observed on the outdoors of the facility. All window screens appeared to be in good repair. LPA observed a sunroom attached to the outdoors of the facility which contained adequate shaded seating for resident use. COMMON AREAS: This included the living room, hallway, dining area, and Administrator’s office. LPA observed the living room to be clean and properly furnished at the time of the visit. The living room was observed to contain a television and activities for resident use. Additionally, the living room contained an appropriately screened fireplace. The hallway was observed to be clean and free from any obstructions. The hallway contained two (2) closets which contained extra linens. The dining area was observed to be clean and contained adequate seating for residents’ use. The Administrator’s office was observed to be inaccessible to clients in care. The Administrator’s office contained locked storage for resident medications and facility files. All furniture in the facility was observed to be clean and in good repair. Smoke detectors and carbon monoxide detectors, along with the facility’s fire door, at 02:09 PM and were functional at the time of the visit. CONTINUED ON LIC 809C. KITCHEN/GARAGE: LPA observed the kitchen area to be clean and kitchen appliances appeared to be in operable condition. The facility had a sufficient supply of two (2) days perishable and seven (7) days non-perishable food. LPA observed a secured lock box which contained knives and other sharp objects. LPA observed the fire extinguisher which was fully charged and was purchased on 07/09/2026. The garage is located adjacent to the kitchen and was observed to be inaccessible to clients in care. The garage was observed to contain the facility’s washer and dryer, cabinets which contained extra care supplies, an extra refrigerator/freezer, and a chemical storage closet which contained cleaning and laundry chemicals. BEDROOMS: There are three (3) bedrooms in the facility; all are designated as dual occupancy rooms and all are designated for resident use. LPA and the Administrator toured all three (3) resident rooms. All resident rooms were observed to be furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. Bedroom #3 contained a direct exit to the outdoors of the facility and is the bedridden approved room. BATHROOMS: There are two (2) bathrooms at the facility. One (1) is designated as a resident bathroom and one (1) is designated as a staff bathroom. Both bathrooms were observed to be clean and in good repair and all were equipped with nonskid surfaces. Grab bars were observed in the resident shower and near the resident toilet. All grab bars were properly secured. The water temperature was measured to be 108.5 degrees Fahrenheit, which is in compliance with regulation. INFECTION CONTROL/EMERGENCY DISASTER PLANNING: During today’s visit, the LPA reviewed the facility's infection control practices and the facility's emergency disaster plan. The facility’s policies and procedures as they pertain to infection control are adequate. The facility’s emergency disaster plan is up to date and is adequate. The last emergency disaster drill was conducted on 06/29/2026. Both the infection control plan and the emergency disaster plan are reviewed/updated annually by the facility’s Administrator. During today’s visit LPA obtained a copy of the facility’s updated emergency disaster plan, LIC 500, resident roster, and liability insurance. Due to time constraints LPA will return at a later date to conduct staff and resident file reviews, staff and resident interviews, and a medication review. Exit interview conducted. And a copy of the report was provided.the state’s words, verbatim · CDSS document, Jul 22, 2026

The state marks this report as 4 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Trevor Byrne arrived at the facility unannounced to conduct the required annual visit at 09:48 AM. LPA met with facility staff who contacted the facility Administrator Naira Badalyan via telephone call. The Administrator arrived to the facility at 09:50 AM Entrance interview conducted and the reason for the visit was explained. Beginning at 09:50 AM, the LPA, along with the Administrator toured the physical plant areas inside and outside to ensure there are no health and safety hazards and that facility is in compliance with Title 22 Regulations. The following was observed: BEDROOMS: There are three (3) bedrooms in the facility; all are designated as dual occupancy rooms and all are designated for resident use. LPA and the Administrator toured all three (3) resident rooms. All resident rooms were observed to be furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. Bedroom #3 contained a direct exit to the outdoors of the facility and is the bedridden approved room. Auditory alarms were observed on facility exits and were functional at the time of the inspection. BATHROOMS: There are two (2) bathrooms at the facility. One (1) is designated as a resident bathroom and one (1) is designated as a staff bathroom. Both bathrooms were observed to be clean and in good repair and all were equipped with nonskid surfaces. Grab bars were observed in the resident shower and near the resident toilet. All grab bars were properly secured. The water temperature was measured to be between 108.5 and 115.5 degrees Fahrenheit, which is in compliance with regulation. Continued on LIC 809C. KITCHEN: LPA observed the kitchen area to be clean and kitchen appliances appeared to be in operable condition. The facility has a sufficient supply of two (2) days perishable and seven (7) days non-perishable food. LPA observed a secured lock box to contain knives and other sharp objects. LPA observed the fire extinguisher to be fully charged and purchased on 07/14/2025. GARAGE: The garage is located adjacent to the kitchen and was observed to be locked and inaccessible to clients in care. The garage was observed to contain the facility’s washer and dryer, cabinets containing extra care supplies, and a locked chemical storage closet that contained cleaning and laundry chemicals. COMMON AREAS: This includes the living room, hallway, dining area, Administrator’s office, and sunroom. LPA observed the living room to be clean and properly furnished at the time of the visit. The living room was observed to contain a television and activities for resident use. Additionally, the living room contained a fireplace that was properly screened and contained no tools. The hallway was observed to be clean and free from any obstructions. The hallway was observed to contain two (2) closets that contained extra linens. The dining area was observed to be clean and contained adequate seating for residents’ use. The Administrator’s office was observed to be locked and inaccessible to clients in care. The Administrator’s office contained locked storage for resident medications and facility files. The sunroom was observed to contain adequate shaded seating for resident use. All furniture in the facility was observed to be clean and in good repair. Smoke detectors and carbon monoxide detectors, along with the facility’s fire door, were tested at 10:19 AM and were functional at the time of the visit. OUTDOOR SPACE: The facility has one (1) emergency exit gate located on the side of the facility. LPA observed clear passageways for emergency exit use. The facility has adequate shaded seating for resident use. Cameras were observed on the outdoors of the facility. RECORD REVIEW: Record review began at 10:31 AM. Staff and resident records were reviewed for documents including, but not limited to: health screening, TB test, staff training records, fingerprint clearance, resident physician's report, needs and service appraisal, consent forms, and personal rights. Three (3) staff files were reviewed. All staff files reviewed contained the required documentation and trainings. Four (4) resident files were reviewed. All resident files reviewed contained all required documentation and signatures. Continued on LIC 809C. MEDICATION REVIEW: Medication review began at 11:46 AM. Medications are stored centrally and securely in the Administrator’s office. Medications for two (2) residents were observed. All medications reviewed were properly stored and were properly documented on their respective centrally stored medication and destruction record sheets. No deficiencies were observed during medication review. INFECTION CONTROL/EMERGENCY DISASTER PLANNING: During today’s visit, the LPA reviewed the facility's infection control practices and the facility's emergency disaster plan. The facility’s policies and procedures as they pertain to infection control are adequate. The facility’s emergency disaster plan is up to date and adequate. The last emergency disaster drill was conducted on 08/02/2025. Both the infection control plan and the emergency disaster plan are reviewed/updated annually by the facility’s Administrator. INTERVIEWS: LPA interviewed one (1) staff and one (1) resident. The resident interviewed stated that staff treat them well and are attentive to their needs. The staff member interview was conducted with the assistance of the Administrator as a translator. The staff member interviewed was knowledgeable on their role and responsibilities, the resident’s rights, the different forms of abuse, and the appropriate reporting procedures for suspected abuse. During today’s visit LPA obtained a copy of the facility’s updated LIC500, resident roster, and liability insurance. No deficiencies were cited at the time of the visit. Exit interview conducted. And a copy of the report was provided.the state’s words, verbatim · CDSS document, Aug 12, 2025

The state marks this report as 5 pages; the online copy we transcribed has 4. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Trevor Byrne arrived at the facility unannounced to conduct a required annual visit at 09:17 AM. LPA met with facility staff who contacted the facility administrator Naira Badalyan via telephone call. Facility administrator arrived to the facility at 09:32 AM Entrance interview conducted and the reason for the visit was explained. Beginning at 09:32 AM, the LPA, along with facility administrator toured the physical plant areas inside and outside to ensure there are no health and safety hazards and that facility is in compliance with Title 22 Regulations. The following was observed: KITCHEN: The LPA observed the kitchen area to be clean. Kitchen appliances were in operable condition. The facility has a sufficient supply of seven (7) days non-perishable and two (2) days perishable food. LPA observed a secured lock box to contain knives and other sharp objects. The LPA observed the fire extinguisher to be fully charged and purchased on 07/29/2024. BEDROOMS: There are three (3) bedrooms in the facility; all are designated for resident use, and all are designated as dual occupancy rooms. LPA and facility administrator toured all three (3) resident rooms. All resident rooms were observed to be furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. Bedroom number three (3) is approved for a bedridden resident. Auditory alarms were observed to be functional on bedroom three’s (3’s) exit door. BATHROOMS: There are two (2) bathrooms at the facility. One (1) is designated as a resident restroom and one (1) is primarily used as a staff restroom. Both bathrooms were observed to be clean and in good repair and all were equipped with nonskid surfaces. Grab bars were observed in all showers, and all were properly secured. The water temperature was measured between 117.5 and 120 degrees Fahrenheit, which is in compliance with regulation. Report Continued on LIC 809-C COMMON AREAS: This includes the living room and sunroom. LPA observed the living room to be clean and properly furnished at the time of the visit. Smoke detectors and carbon monoxide detectors were tested at 10:50 a.m. and were functional at the time of the visit. The sunroom contains adequate shaded seating and board games for resident use. OUTDOOR SPACE: The facility has one (1) emergency exit gate, LPA observed clear passageways for emergency exit use. The facility has adequate seating for resident use. Cameras were observed by the front entrance to the facility. RECORD REVIEW: Record review began at 09:53 a.m. Staff and resident records were reviewed for documents including, but not limited to: health screening, TB test, staff training records, fingerprint clearance, resident physician's report, needs and service appraisal, TB tests, consent forms, and personal rights. Four (4) staff files were reviewed. All staff files contained the required documents and trainings. Four (4) resident files were reviewed. All resident files reviewed contained all required documentation. No deficiencies were observed during record review. MEDICATION REVIEW: Medication review began at 10:37 a.m. Medications are stored centrally and securely in the administrator’s office. Medications for four (4) residents were observed. All medications reviewed were documented properly on their centrally stored medication and destruction record sheet. No deficiencies were observed during medication review. INFECTION CONTROL/EMERGENCY DISASTER PLANNING: During today’s visit, the LPA reviewed the facility's infection control practices and the facility's emergency disaster plan. The facility’s policies and procedures as it pertains to infection control are adequate. Last emergency disaster drill was conducted on 06/02/2024. The facility’s emergency disaster plan is up to date and adequate. Report Continued on LIC 809-C INTERVIEWS: LPA interviewed one (1) staff and two (2) residents. All residents interviewed stated that the food was of good quality and is provided in sufficient amounts. All residents stated that staff treat them very well and are attentive to their needs. The staff interview was conducted with the assistance of the administrator as a translator. The staff member interviewed was knowledgeable on their roles and responsibilities, resident rights, the different forms of abuse and the appropriate reporting procedures for suspected abuse. During today’s visit LPA obtained a copy of the facility’s updated LIC500, resident roster, and liability insurance. No deficiencies were cited at the time of the visit. Exit interview conducted. And a copy of the report was provided.the state’s words, verbatim · CDSS document, Aug 20, 2024

The state marks this report as 4 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.