No Ho Residential Care

Type of visit: Case Management - Deficiencies

Licensing Program Analyst (LPA) Christine Yee conducted an unannounced Case Management visit due to a deficiency that was observed during the Annual Inspection conducted on 3/12/26. The deficiency was not addressed during the Annual Inspection due to the need for clarification from the Fire Inspector for the fire clearance granted during the application process. LPA Yee was let into the home by Naira Aghajanyan, Staff. Rebeka Durgaryan, Administrator, was contacted and she arrived at 4:17pm to conduct the visit. The reason for today's visit was provided. Per review of the fire clearance (STD850) granted on 1/21/21 and the facility sketch that was submitted with the request for a fire clearance of the home during the application process, the back three bedrooms were approved for six (6) non-ambulatory residents of which one (1)may bedridden. The facility sketch identifies the bedrooms as Bedroom #1, Bedroom #2 and Bedroom #3. Per the facility sketch, Bedroom #1 and Bedroom #3 do not have direct exit doors to the outside. Bedroom #2, which is located at the very back of the home, has a direct exit door that leads on to a ADA approved ramp. Based on the setup of Bedroom #2, the room is designated and approved for one (1) bedridden resident. A fire rated door was installed at the end of the hallway that leads from the living room to the three(3) bedrooms located in the back to allow the retention of non-ambulatory residents in Bedroom #1 and Bedroom #3 as there is no door to allow direct exit to the outside. The fire rated door would allow the residents to exit from the door located in the den. Per review of the facility sketch, the room previously identified as an office and the front staff bedroom also do not continued on LIC809-C Page 2. have direct doors to the outside except the front door. During the Annual Inspection, LPA Yee observed a non-ambulatory resident housed in the room previously identified as an office and now identified as Bedroom #4. After the visit, clarification was obtained from the Fire Inspector on the use of Bedroom #4 and the front bedroom, identified as the staff room. A copy of the facility sketch was submitted to the fire inspector for review. Per information and clarification provided by the Fire Inspector, the 3 back bedrooms, identified as Bedroom #1, Bedroom #2 and Bedroom #3 are the only rooms approved for non-ambulatory residents. The former bedroom that was previously identified as an office and the front staff room may only be used for ambulatory residents. As a result of the clarification obtained, today's visit was conducted to issue citation and assess immediate civil penalties of $500 for a fire clearance violation. Deficiencies cited under California Code of Regulations, Title 22, Division 6, Chapter 8. Immediate civil penalties of $500 were assessed. Exit interview was conducted, APPEALS RIGHTS were discussed and a copy was provided.the state’s words, verbatim · CDSS document, Mar 26, 2026

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87204(b) · Plan of correction due date: Mar 27, 2026

Limitations - Capacity and Ambulatory Status-Resident rooms approved for 24-hour care of ambulatory residents only shall not accommodate nonambulatory residents. Residents whose condition becomes nonambulatory shall not remain in rooms restricted to ambulatory residents. This requirement was not met as evidenced by: Resident #1 was observed housed in the front bedroom previously identified on the facility sketch as the office and now identified as Bedroom #4.the state’s words, verbatim · CDSS document, Mar 26, 2026

Plan of correction: The Licensee will relocate the resident into the approved non-ambulatory rooms or provide a plan of action by 3/27/26 as to how the faclity will come into compliance regarding the placement of a non-ambulatory resident in a room approved for ambulatory residents use only.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Christine Yee conducted an unannounced required Annual Inspection using the complete CARE Inspection Tool and was let into the home by Naira Aghajanyan, Staff. Rebeka Durgaryan, Administrator was contacted by staff and she arrived 10 minutes later to conduct the visit. The reason for today's visit was provided. The home is a single storey family home consisting of a living room, dining room, a kitchen, a den, an office, 5 bedrooms and 3 full bathrooms of which one is designated for staff use.. Four bedrooms are designated for resident use and the bedroom by the front door is for staff use. The facility is fire cleared for 5 NON-AMBULATORY and 1 BEDRIDDEN resident. Bedroom #2, located in the back right hand corner, is designated for Bedridden use. All 12 domains of the CARE Inspection Tool was reviewed on today's visit, six (6) resident files and 6 staff files were reviewed and a tour of the physical plant was conducted, inside and outside. The following were observed: The living room, dining room, den and kitchen were all equipped with the appropriate furnishings and equipment. The water temperature tested in the kitchen read 137.4 degrees Fahrenheit. Bedroom #1 and bedroom #2 were observed with 2 hospital beds, 2 night stands, 2 chairs, 2 lamps, 2 small chest of drawers and a built in closet. Bedroom #2 has 1 shared dresser. Bedroom #3 and bedroom #4 were observed with 1 hospital bed, 1 night stand, 1 lamp, 1 dresser, a continued on LIC809C Page 2. lamp and a built in closet. The fifth bedroom is for staff use. The common bathroom located in the front was equipped with a walk in shower, a toilet and a 1 sink vanity. A shower chair was observed. A grab bar was not observed in the shower but was observed by the toilet. The front of the top drawer on the vanity was observed to be loose and needs to be repaired. The holes created by the grab bar on the wall that is by the toilet needs to be patched up. The water temperature was tested and read 138.9 degrees Fahrenheit The common bathroom located between bedroom #2 and bedroom #3 is equipped with a sink, a toilet and a walk in shower, is equipped with a grab bar, a shower chair and a slip resistant mat. Also located inside the bathroom is the washer and dryer. The water temperature was tested and read 135.2 degrees Fahrenheit. Located in the kitchen and in the den are two fire extinguishers that will expire on 4/7/25. A new fire extinguisher was purchased on 03/05/26 The hardwired smoke detectors located in all the bedrooms, den, resident hall, living room, office were tested and were operational. The combination smoke/carbon monoxide detectors are located in the living room, office, den and the resident hallway. The fire rated door located in the hallway that separates bedrooms #1, #2 and #3 is connected to the smoke detector system did not deploy and release the door when the smoke detectors were tested. There was sufficient perishable foods for a minimum of 2 days and non-perishable foods for a minimum of 7 days was observed on the premises. The first aid kit was reviewed and had the required tweezer, scissors, thermometer, gauze and band aids. A first aid manual was observed. The facility has current general liability insurance that meets Title 22 requirements Per tour of the outside areas, the outside areas need general maintenance, Pallets, mops, bucket, bricks, 3 empty oxygen tanks were stored in back, along the side of the home need to be discarded or stored away. The trash cans stored along the right side of the home were observed to be tightly sealed except for the continued on LIC809-C Page 3. the blue recycle bin did not have a lid and the green bin had half the lid missing. located in the back is a ramp for wheelchairs. The front yard was observed with chairs, tables and an umbrellas for shade. Deficiencies cited under California Code of Regulations, Title 22, Division 6, Chapter 8. Immediate civil penalties were assessed. Exit interview was conducted, APPEALS RIGHTS were discussed and a copy was provided.the state’s words, verbatim · CDSS document, Mar 12, 2026

The state marks this report as 13 pages; the online copy we transcribed has 8. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Christine Yee conducted an unannounced required Annual Inspection using the complete CARE Inspection Tool and was let into the home by Naira Aghajanyan, Staff. Rebeka Durgaryan, Administrator was contacted by staff and LPA Yee was advised that Laura Hovhannisyan, Designated Responsible Staff would conduct today's visit since she was on vacation. A completed LIC308 - Designation of Facility Responsibility was observed in the staff's file. Ms. Hovhannisyan arrived a little later to conduct the visit. The reason for today's visit was provided. The home is a single storey family home consisting of 5 bedrooms, 3 full bathrooms of which one is designated for staff use, a living room, dining room, a den, office and a kitchen. All five bedrooms are now used by residents. The facility is fire cleared for 1 BEDRIDDEN and 5 NON-AMBULATORY residents. Bedroom #2, located in the back right hand corner, is designated for Bedridden use On today's visit, LPA Yee reviewed 6 resident files, 7 staff files, and completed the following 2 domains of the CARE Inspection Tool 1. Infection Control and Personnel Records/Staff Training. A quick tour of the 5 residents rooms was conducted to verify the use of each room due to changes observed from previous visits conducted to the facility. Bedroom #5, by the front door was formerly designated for Staff use was observed with 1 resident and Bedroom #4, directly by the dining room was formerly used for storage was observed with 1 resident in a hospital bed with full bed rails. Bedroom #3 has 2 beds with 2 residents, Bedroom #2 was observed with 2 beds and Bedroom #1 was observed with 2 beds and 1 resident. A total of 8 beds were observed and the facility is licensed for a capacity of 6. The facility may only have beds for the capacity CONTINUED ON LIC809-D for which it is approved. The Licensee needs to do the following: Per file review, the facility does not have physicians orders on file for all centrally stored medications and needs to contact the prescribing physician to obtain copies of the Physician orders. the facility needs to remove all full bed rails and half bed rails that are being utilized by residents that are on hospice but it is not included in their hospice care plan and half bed rails if there is no doctor's order for the use of the rails and provide evidence to the Department of removal. the facility is providing quarterly simulated class room drills with all staff present during the morning shift but are not conducting unannounced simulated fire drills during different shifts. the facility needs to update the facility sketch to include room numbers, location of shutoff valves and the meeting point in an emergency. Resident #1 does not have a primary diagnosis noted on the Physician's report Resident #4's Physician Report does not indicate if the resident is able to leave the facility unassisted. The facility electrician was at the facility today to repair a smoke detector. During this visit, the hard wired smoke detectors in the all residents rooms, living room and the combination smoke/carbon monoxide detector located in the office and outside bedroom #3 were tested and were all operational. Due to time constraints and issues with obtaining records a return visit is needed to complete the annual inspection. Any deficiencies not cited on today's visit will be cited on a return visit. Exit interview was conducted.the state’s words, verbatim · CDSS document, Mar 27, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Christine Yee conducted an unannounced required Annual Inspection using the complete CARE Inspection Tool and was let into the home by Naira Aghajanyan, staff. Rebeka Durgaryan, Administrator was contacted by staff and she arrived at 10:44 *am to conduct the visit. The reason for today's visit was provided. The home is a single storey family home consisting of 5 bedrooms, 3 full bathrooms, a living room, dining room, a den, office and a kitchen. The three back bedrooms are used by residents, the bedroom located by the front common bathroom is used for storage and the bedroom located by the front door is used as a staff room. The home has a fire place with the gas capped off and the fire grates dismantled. The facility is fire cleared for 1 BEDRIDDEN and 5 NON-AMBULATORY residents. Bedroom #2 is designated for Bedridden use. On today's visit all 12 domains of the CARE Inspection Tool was reviewed, 6 resident and 6 staff files were reviewed and a tour of the entire facility, inside and outside was conducted and the following were observed: the living room, dining room and kitchen all contained the required furnishings and appliances related to the designated use of the room. sufficient perishable foods for a minimum of 2 days and non-perishable foods for a minimum of 7 days were observed. Bedroom #1 located to the left back of the facility was observed with 2 hospital beds, 2 chairs, 2 small dressers with 2 lamps and a closet that was missing its doors. No night stands were provided The back den was observed with a sofa and a stand. The back door was opened and the auditory device was not operational Bedroom #2 was observed with 2 hospital beds, 1 tall dresser, 2 night stands, 1 lamp, 2 portable closets and 2 chairs. Overhead lighting was observed and provided sufficient lighting. The exit door was opened and the auditory device mounted on the door was not operational the common bathroom designated for resident use was observed with a shower stall, a sink, a toilet, grab bars, shower chair and a non-skid mat. Located in the residents' bathroom is the washing machine and dryer. Water was tested and the temperature read 119.6 degrees Fahrenheit Bedroom #3 was observed with 2 hospital beds equipped with full bed rails that were lowered, 1 tall dresser, 1 lamp, 1 chair and a closet. Administrator was advised that the full rails are not permitted but was advised that they are not used and confirmed by Staff #2. The fourth bedroom located by the dining room was observed used for storage of wheelchairs and a hospital bed. Administrator was advised that the hospital bed may not be used by any residents as this would put the facility in violation of their fire clearance and the recommendation was made to dismantle the bed or placed in storage elsewhere. The common bathroom was observed with a shower stall, a toilet and a sink. The bathroom contained 2 shower chairs, grab bars, a non-skid mat. Water temperature was tested and read 117.6 degrees Fahrenheit. The fifth bedroom is used for storage and a bed was also observed. Per the Administrator she and night staff use the room when working nights. The office located behind the dining room has cabinets for storage and a computer. The common bathroom located behind the dining room is equipped with a shower, a toilet and a sink and is designated solely for staff use. The facility has liability insurance that meets Title 22 requirements First Aid Kit and manual was observed and met Title 22 requirements. Plenty linens were observed in the closets located by the dining room The facility has 2 fire extinguishers, one located in the kitchen and one in the back den. The smoke/carbon monoxide combination detectors were tested and were operational The front yard was observed with tables and chairs and the back yard had chairs and a folded umbrella. Also located in the backyard was a storage shed. A ramp was observed in the back leading out from bedroom #2. Overall, the facility, inside and outside were observed to be clean and well maintained. Deficiencies cited under California Code of Regulations, Title 22, Division 6, Chapter 8. Any deficiencies not cited today will be addressed on a return visit. Exit Interview was conducted, APPEALS RIGHTS discussed and a copy was given.the state’s words, verbatim · CDSS document, Mar 11, 2024

Allegation investigated: . Facility staff did not dispense medications as prescribed. 2. Facility staff yelled at resident. 3. Facility staff did not treat resident with dignity 4, Facility staff did not safeguard resident's belongings 5. Facility staff did not allow resident to leave the facility

Licensing Program Analyst (LPA) Christine Yee conducted a subsequent unannounced complaint visit to conduct further investigation of the above allegations and was let into the home by Naira Aghajanyan, Staff. Rebeka Durgaryan, Administrator was contacted by staff and she arrived at 11:56am to conduct the visit. The reason for today's visit was explained. On 2/9/22, LPA Angel Ascencio conducted an initial unannounced complaint visit to investigate the above allegations and met with Naira Aghajanyan, staff since the Administrator could not attend. During the initial visit, LPA along with staff member conducted a physical plant tour, inside and outside, to ensure there are no safety hazards at 10:45 a.m., reviewed resident files at 11:15 a.m., and conducted resident interviews at 1:53 p.m. LPA Ascencio determined that further investigation is needed. LPA will return at a later time to conclude the investigation. Unfounded On today's visit, LPA Yee reviewed all 6 resident files beginning at 12:01pm , reviewed resident medications at 1:30pm, interviewed the Administrator and Staff #1 together at 1:15pm. Residents were not interviewed on today's visit as the only resident who has lived at the facility since the facility opened in March 2021 has dementia and is a bad historian. All the other 5 residents have lived here since various dates in 2023 and 2024 and would not have knowledge of any residents who lived at the facility in 2022. Per interview with the Administrator and Staff #1, regarding the above allegations, they remember a male LPA was here at the facility to investigate the complaint. When the LPA arrived at the facility he enquired about the facility's address and provided the name of the resident he was looking for that was specifically named in the complaint. The male LPA was told the facility's address and he was also told that they did not have any resident by the name he provided. They told him that he was at the wrong address because the LPA provided a completely different address for the home. Based on the initial complaint report generated on 2/9/22, the male LPA was identified as Angel Ascencio. LPA Ascensio conducted interviews with the residents and asked everyone how they were doing and if everything was okay. Residents and Staff #1 were asked if there were any thefts at the facility and was told that there were no thefts at the facility. Again, staff stated that they did not have any resident living at the facility with the name LPA Ascencio had provided to staff. LPA Ascencio apologized to the staff and left. Per the Administrator and Staff #1, they never received a copy of the initial complaint report. Based on the information obtained, there was no evidence to support the allegations, therefore the above allegations are deemed unfounded at this time. A finding of unfounded means that the allegation is either false, could not have happened, and/or is without a reasonable basis. Exit interview was conductedthe state’s words, verbatim · CDSS document, Feb 20, 2024 · control 29-AS-20221202135058

Type of visit: Case Management - Deficiencies

Licensing Program Analyst (LPA) Christine Yee conducted an unannounced case management visit due to the deficiencies noted on today's visit and met with Rebeka Durgaryan, Administrator. The reason for today's visit was explained. LPA Yee reviewed all 6 residents files and observed that the residents files were incomplete: Resident #1 - it is unknown if the doctor determined if resident is able to leave the facility without assistance. It is also unknown if the resident has any valuables to declare Resident #2 - it is unknown if the resident is able to leave the facility unassisted, the Physician's report does not provide the resident's primary and secondary diagnosis Resident #3 - it is unknown if the resident has any valuables Resident #4 - it is unknown if the resident can leave the facility unassisted Resident #5 - moved in on 12/28/23 and does not have a Physician's report with the results of a TB test, no medical consent forms, Resident Rights, no Preplacement Assessment, Appraisal Needs and Services, Resident Rights Resident #6 does not have evidence of a TB test Deficiencies were cited under California Code of Regulations, Title 22, Division 6, Chapter 8. Exit interview was conducted, APPEALS RIGHTS discussed and a copy was giventhe state’s words, verbatim · CDSS document, Feb 20, 2024

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87506(a) · Plan of correction due date: Feb 27, 2024

87506 Resident Records: Resident Records. A separate, complete, and current record shall be maintained for each resident in the facility, readily available to facility staff and to licensing agency staff and shall contained specified information. This requirement was not met as evidenced by: Files for Resident #1 - Resident #6 were missing information noted on the LIC809 report and this is a potential risk to the personal rights and a health risk to the residents in care.the state’s words, verbatim · CDSS document, Feb 20, 2024

Plan of correction: The Licensee will read Title 22, Section 87506 in its entirety to ensure that all resident files contain the required information noted in the section. Licensee will reivew all resident files for completeness and submit a signed written statement that the Section was read and all files were reviewed and contains all the required information by 2/27/24