Pine Haven

We haven’t transcribed this report yet. The complete document is on the state’s site.

We haven’t transcribed this report yet. The complete document is on the state’s site.

Type of visit: Case Management - Deficiencies

On 07/21/2026, an office meeting for a Non-Compliance Conference was held. During the meeting the following was addressed. The Department conducted an annual inspection on 05/19/2026 and a case management visit on 6/27/2026. During the inspections, multiple citations were issued to the facility. Upon review of the facility file, it was found that the Administrator on record is not present in the facility and the Licensee did not submit a complete packet for the new administrator to oversee facility operations. A deficiency is being cited in accordance with California Code of Regulations, Title 22, Division 6 on the attached 809D. An exit interview was conducted. A Plan of Correction was reviewed and developed with the Licensee. A copy of this report and appeal rights were discussed and provided to Licensee, Sandeep Dhand, whose signature confirms receipt of this document.the state’s words, verbatim · CDSS document, Jul 21, 2026

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87405(a) · Plan of correction due date: Jul 22, 2026

87405(a)All facilities shall have a qualified and currently certified administrator… The administrator shall have sufficient freedom from other responsibilities and shall be on the premises a sufficient number of hours to permit adequate attention to the management and administration of the facility… this requirement was not met as evidenced by: Based on observations and interviews, the Licensee did not comply with section 87405 when the facility did not appoint an administrator to be on the premises a sufficient number hours to manage facility operations, which is a potential health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Jul 21, 2026

Plan of correction: Plan of Correction Licensee agrees to appoint an administrator and submit required documents to the Fresno CCL office for review and approval by the POC due date.

Type of visit: Required - 1 Year

Licensing Program Analysts (LPA) B. Miranda conducted an unannounced visit today for the facility’s annual inspection. LPA introduced themselves and was allowed entrance into the facility. LPA met with Sundeep Dhand Administrator. Facility is licensed for 6 residents and has a current census of 5. There is 1 resident on hospice and 1 with a home health care. Water temperature was checked in the kitchen which read at 113.5 degrees Fahrenheit. LPA was not able to verify when fire extinguisher was purchased/serviced, but still has charge. Smoke and carbon monoxide detectors were tested and in working order. Sandeep Dhand Administrator's Certification expires September 25, 2027. Staff files were reviewed. LPA was not able to verify staff training, and S1 is not cleared to be at the facility assisting residents. Resident files were reviewed, and does not have inventory list for R1, R2, or R4. R1 does not have a correct admission agreement on file for current facility. R2 does not have doctor orders for full bed rails. Facility did not provide a completed log for disaster drills. First aid kit on site and complete. Toxins and cleaning supplies were not locked and were accessible in laundry area and under kitchen sink. Follow-up visit will be conducted to verify medication is stored properly and complete. LPA inspected the interior and the exterior of the facility including the common living spaces, resident bedrooms, bathrooms, medication cart, kitchen, garage and outdoor areas. Bedrooms were clean, properly furnished, with adequate lighting, and in good repair. Food supply is not adequate for 2-day perishable and 7-day nonperishable. LPA observed pool to have 3 entry/exit gates, 2 were not locked. LPA observed the following deficiencies: Knives accessible in kitchen drawer Lighter accessible in kitchen drawer Cleaning supplies accessible in laundry area and under kitchen sink Pool has 3 entry/exit gates, 2 were not locked Admission agreement for R1 is not for correct facility Inventory list for R1, R2 and R4 are not complete Food supply was no sufficient for 2 days perishable and 7 days non-perishable. Staff training not accessible for review S1 does not have clearance and was at the facility while caring for residents R5 has injectable medication and physician report states they cannot given their own injectable Double dead bolt on front door gate (follow-up visit will be conducted at a later time for this) Deficiencies observed were cited during today's inspection per California Code of Regulations, Title 22. LPA is requesting the following documents: LIC 500 Personnel Report, LIC 308 Designation of Administrative Responsibility, LIC 610-E the Emergency Disaster Plan and copy of current Administrator’s Certificate to update the facility file. Listed documents shall be sent to Licensing by May 26, 2026. Exit interview conducted and a copy of this report LIC809, LIC809D, and appeal rights were provided to Sandeep Dhand.the state’s words, verbatim · CDSS document, May 19, 2026

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Shawna Doucette arrived to the facility announced to conduct the Pre licensing visit. LPA Shawna Doucette met with Licensee/Administrator Albert Ayvazyan who granted LPA entry into the facility. LPA toured facility. Common rooms have adequate furnishings and lighting. All of the resident bedrooms have all the required furnishings and adequate lighting. Hot water temperature in bathrooms measured at 107 degrees F. LPA observed a supply of extra bed linens and personal hygiene and grooming products. Kitchen observed to have dishes, plates, utensils. Knives are locked in a drawer in the kitchen. Cleaning supplies are stored in a locking cabinet in the office/ laundry room. Medications are locked in a medication cart. First aid kit contains all the required items. A fire extinguisher is present and has a service date of 01/29/2025. Smoke detectors and carbon monoxide were operating. Outside of the facility toured. Exits open free of obstruction. The residence has door alarms upon entering and exiting the facility. No outside hazards were observed. Facility has a pool which has a locking gate and is inaccessible to residents. All required postings are posted. Facility phone number will be (661) 374-8418. Component III was conducted during pre-licensing visit with Applicants. I have found that applicant has met all pre licensing requirements. LPA will submit documentation to CAB in Sacramento for final review prior to license being issued.the state’s words, verbatim · CDSS document, May 27, 2025

Type of visit: Office

Component II completion: Successful Facility Type: RCFE Application Type: INITIAL Capacity: 6 Census (if any clients in care): 0 COMP II Participants: Hrant Danakian CEO/ Albert Ayvazyan Administrator Interview Method: Teams meeting On May 9, 2025, Applicant/Administrator participated in COMP II. Identification of the applicant and administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, applicant and 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. Signed LIC 809 with copy of photo ID have been obtained. During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of the 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, May 9, 2025