Oakridge Inn

Type of visit: Required - 1 Year

On 7/28/2026 at approximately 8:05AM, Licensing Program Analyst (LPA), Gina Saucedo conducted an unannounced annual visit to the facility and LPA stated the reason for their visit to the Administrator, Romik Rostomyan. LPA asked for the census, staff and resident files. LPA conducted a physical plant tour at approximately 9:50AM and the following was noted: The facility is a single-story building with three (3) bedrooms, two (2) bathrooms and one separate (1) shower. The facility is currently occupying four (4) residents. There is no designated staff room. The facility has an approved fire clearance for six (6) non-ambulatory residents of which one (1) may be bedridden. Hospice waiver approved for two (2). The living room and dining room were observed to be neat, clean, and organized. The rooms were observed to be properly furnished and in good repair. The facility maintains a comfortable temperature at 77°F. LPA observed a fire extinguisher to be located in the kitchen and dated 02/2026. A working telephone was observed on the kitchen counter. Kitchen: The kitchen was observed to be clean. Sufficient supplies of seven (7) day nonperishable foods and two (2) day perishable foods were observed. Knives/sharps were observed to be kept in a locked kitchen drawer. The cleaning solutions/toxins were observed to be kept locked in an outside storage compartment. Kitchen appliances were observed to be working and in proper condition. Continue to LIC809-C Bedrooms: The residents’ rooms are adequately furnished with appropriate furniture and lighting system. Hallways/passageways are lighted appropriately. Extra linens/covers were observed stored in laundry area located aside the kitchen. Bathrooms: The bathrooms were checked for cleanliness and proper operation. The hot water temperature was measured within regulations at 114.6 °F. LPA observed appropriate grab rails and slip-resistant mats to be in proper condition. Laundry Room: The laundry room was observed to be located near the kitchen. LPA observed cleaning solutions and toxins stored outside in a locked storage compartment. The laundry appliances were observed to be working and in proper condition. Garage: LPA observed there to be no garage located within the premises. Backyard: The backyard of the facility is equipped with a designated shaded area with outdoor furniture for residents. There is no body of water located at the facility. Medications: The medications were observed stored in a locked cabinets located in the kitchen. LPA observed staff and resident files to be kept locked in storage cabinet located in the staff/reception desk area. First-aid kit observed and First-Aid Manuel. Smoke detectors and carbon monoxide observed to be working properly and were tested. Residents/Staff Records: LPA conducted a complete file review of four (4) resident records and three (3) staff records. Administration: LPA observed required postings such as Ombudsman, Emergency Disaster Plan, and Personal Rights, Facility Sketch, YES alongside the entrance leading towards the kitchen. The liability insurance expires on 10/2027 and the Administrative Certificate expires on 11/2026. Exit interview conducted and a copy of this report was provided to the Administrator with no citation (s).the state’s words, verbatim · CDSS document, Jul 28, 2026

Type of visit: Required - 1 Year

On 5/29/2025 at approximately 10:00 AM, Licensing Program Analyst (LPA), Angelica Segovia conducted an unannounced annual visit to the facility. LPA was greeted by the caregiver and stated the reason for their visit. The Administrator, Romik Rostomyan arrived shortly after to assist with today’s visit. LPA asked for the census, Staff/Resident Roster, and Liability Insurance. LPA conducted a physical plant tour at approximately 12:00 PM and the following was noted: The facility is a single-story building with three (3) bedrooms, two (2) bathrooms and one separate (1) shower. The facility is currently occupying four (4) residents. There is no designated staff room. The facility has an approved fire clearance for six (6) non-ambulatory residents of which one (1) may be bedridden. Hospice waiver approved for two (2). Common areas: The living room and dining room were observed to be neat, clean, and organized. The rooms were observed to be properly furnished and in good repair. The facility maintains a comfortable temperature at 75°F. LPA observed a fire extinguisher to be located in the kitchen and dated 02/29/2024. LPA observed required postings such as Long-Term Care Ombudsman, Emergency Disaster Plan, and Personal Rights alongside the entrance leading towards the kitchen. A working telephone was observed. Kitchen: The kitchen was observed to be clean and free from pests. Sufficient supplies of seven (7) day nonperishable foods and two (2) day perishable foods were observed. Knives/sharps were observed to be kept in a locked kitchen drawer. The cleaning solutions/toxins were observed to be kept locked in an outside storage compartment. Kitchen appliances were observed to be working and in proper condition. (continued on LIC 809-C) Bedrooms: The residents’ rooms are adequately furnished with appropriate furniture and lighting system. Hallways/passageways are lighted appropriately. Extra linens/covers were observed stored in laundry area located aside the kitchen. Bathrooms: The bathrooms were checked for cleanliness and proper operation. The hot water temperature was measured within regulations at 119.0 °F. LPA observed appropriate grab rails and slip-resistant mats to be in proper condition. Laundry Room: The laundry room was observed to be located near the kitchen. LPA observed cleaning solutions and toxins stored outside in a locked storage compartment. The laundry appliances were observed to be working and in proper condition. Garage: LPA observed there to be no garage located within the premises. Backyard: The backyard of the facility is equipped with a designated shaded area with outdoor furniture for residents. There is no body of water located at the facility. Medications: The medications were observed stored in a locked cabinets located in the kitchen. LPA observed staff and resident files to be kept locked in storage cabinet located in the staff/reception desk area. First-aid kit observed to be equipped with but not limited to bandages, scissors, digital thermometer, tweezer and First-Aid Manuel. Smoke detectors and carbon monoxide observed to be working properly and were tested. Residents/Staff Records: LPA conducted a complete file review of resident records. Resident records appeared to be complete and updated. Staff records: LPA conducted a complete file review of staff records. Staff record appeared to be complete and updated. There were no immediate health and safety hazard observed during the day of inspection. Exit interview conducted and a copy of this report was provided to the Administrator.the state’s words, verbatim · CDSS document, May 29, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Abeye Duguma met with Romik Rostomyan for a Required One (01) Year visit. LPA explained the reason for the visit. A tour of the physical plant was conducted at 9:30 AM and the following was noted: There is one entrance being utilized at the facility. The facility has a total of three (03) bedrooms and three (03) bathrooms for residents. The facility is fire cleared for six (06) non-ambulatory. The facility is currently occupying four (04) non-ambulatory residents. The facility has outdoor furniture with a covered shaded area for residents and visitors. The facility does not have a swimming pool/body of water. Laundry detergents, cleaning agents and other toxins are locked away. Kitchen is sufficiently stocked with at least two (02) days perishable and seven (07) days non-perishable food. Frozen foods are wrapped and stored appropriately. Food storage and preparation areas are clean and inaccessible to pests. Knives and sharps are observed to be locked and inaccessible to residents. The living and dining room are neat and clean. The facility maintains a comfortable temperature at 72°F. The smoke and carbon monoxide detectors are hardwired, interconnected and observed to be operational. Fire extinguisher is located near the kitchen, observed to be full and last inspected on 02/19/2024. (continued on LIC 809-C) The residents' rooms are adequately furnished with appropriate lighting system. Hallways are well lit. Residents have enough personal hygiene product provided by the licensee. The bathroom was checked for cleanliness and proper operations. The hot water temperature was measured at 119.4°F. Towels and washcloths are not shared. There was enough clean linen available in the cabinets. LPA observed medication and first aid kit to be locked and inaccessible to residents. No health and safety hazards noted during the visit. Exit interview conducted. Copy of this report issued.the state’s words, verbatim · CDSS document, May 12, 2024

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Alberto Lopez conducted the required annual inspection. LPA arrived unannounced and met with DSP Monika Tagvoryan who allow LPA entry and Administrator Romik Rostomyan arrived a short time later and assisted with the inspection today. The facility is licensed for 6 residents ages 60 and over. The fire clearance is approved for Six (6) non-ambulatory residents of which 1 can be bedridden. There is a hospice waiver approved for 2 residents. Currently there are 5 residents at the facility. LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following: Infection Control: The facility staff are using appropriate hand hygiene and gloves while assisting residents with medications. Disposals of trash are done immediately after changing a resident. Staff are still cleaning and disinfecting throughout the day. Facility has sufficient PPE supplies and has an Infection Control Plan needs updating. Operational Requirements: A current Plan of Operation was reviewed. Liability Insurance policy in the amount of $1,000,000.00 each occurrence and #3,000,000.00 in the total annual aggregate is valid and will expire on 10/05/2023. The last fire Drill was conducted on 02/05/2023. Care and supervision to meet the residents needs was observed. Physical Plant & Environment Safety: The facility is a single-story building. Common areas, including the living room, dining room, all appeared clean and were properly furnished except some rooms are missing chairs. The kitchen appeared clean and the appliances and fixtures functional. Entry/exits were free of obstruction. The medications were locked in the medication room. The 3 resident rooms were inspected, and the water temperature measured between 121.6-126.3 degrees F which is not within range of 105 – 120 degrees F. Staffing: There appears to be sufficient staffing at the facility. The Administrator’s certificate expires 11/18/2024 Staff employed are all over the age of 18. Personnel Records-Training: Staff files are maintained at the facility. Staff have current CPR/first aid training and evidence of some on-going training. Resident Records-Incident Reports: Resident files are maintained at the facility and have the following documents in their files - Admission Agreements, Identification & Emergency Information, current Physician's Report, Pre-admission appraisal/Appraisal Needs & Services Plan. Resident Rights-Information: The Complaint poster and Residents personal rights are posted by the main entry. Visiting hours are not posted. Planned Activities: Facility has sufficient space to accommodate indoor and outdoor activities. There are sufficient supplies and equipment to meet resident's physical capability. Food Service: The kitchen was inspected and has sufficient supply of 2-day perishable & 7-day non-perishable food. Kitchen, food preparation area, and storage areas were observed to be clean and sanitary. The food is properly stored in the refrigerator (clean, labeled and well maintained). Pesticides and cleaning supplies are kept away from the food preparation areas. Kitchen is kept clean and free from rodents. Incidental Medical & Dental: The medications are centrally stored and but not in original containers. During the visit today, LPA reviewed 5 residents' medication files and all medications are administered according to Doctor’s orders. Disaster Preparedness: The facility has an Emergency Disaster and Mass Casualty Plan containing emergency evacuation, storage and preservation of medications, The facility conducts emergency drill every 6 months but needs to conduct emergency drill quarterly. for all staff and residents. Residents with Special Health Needs: No residents have prohibited health conditions. Deficiencies cited (See 809D) and technical advisories were also provided. An exit interview was held. A copy of this report, LIC809D, technical advisory notes, and appeal rights were given to Romik Rostomyanthe state’s words, verbatim · CDSS document, Sep 28, 2023

The state marks this report as 7 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.