San Gabriel Valley Training Center

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Nune Margaryan conducted an annual required visit. LPA met with Administrator Vivian Sison and explained the reason for the visit. The physical plant was inspected along with medications, food supply, and residents and staff records. The facility is licensed to serve (12) Non-Ambulatory Residents, with a Hospice Waiver approved for (3) Residents. All residents at the facility are serviced by the San Gabriel/Pomona Regional Center. The facility is in a residential area. LPA toured the home and inspected 12 resident bedrooms, 6 Jack and Jill restrooms, 2 walk-in showers, 1 live in staff bedroom, one staff room, 1 staff bathroom, kitchen, 2 laundry rooms, dining room, living room, activity room / sunny room and outside activity area located in the backyard / courtyard. The back yard / courtyard is well maintained and there are no pools or large bodies of water. There is a shaded seating / patio area for the residents located in the backyard with proper furnishing. Passageways and exits are free of obstruction. Resident bedrooms were checked. Each bedroom is equipped with the proper furnishings. Bedrooms also have sufficient closet space. The bathrooms and showers were toured. The hot water temperature was tested and measured within Title 22 Regulation guidelines. Laundry rooms were inspected. LPA observed laundry detergent are locked and inaccessible to clients. Clean towels and extra linen were observed in a hallway closet. Continue 809C The kitchen was inspected. There is sufficient perishable and non-perishable food. All the appliances are clean and working properly. Sharps are locked and are inaccessible to clients. Smoke detectors and carbon monoxide detectors are operable and in compliance. Several fire extinguishers were observed and are fully charged. Last fire/disaster/earthquake drill was conducted on 8/30/26. LPA observed the centrally stored medications to be locked in the cabinet located in the kitchen and inaccessible to residents. The first aid kit was observed and found to be in compliance with the Title 22 Regulations. LPA reviewed 4 resident’s files and observed that all files are updated. 3 staff records were reviewed to confirm health screenings, training, and fingerprint clearances. LPA reviewed residents medications. Medications are documented properly and given as prescribed. Exit interview was conducted. Copy of this report was provided to Vivian Sision.the state’s words, verbatim · CDSS document, Sep 11, 2026

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Nune Margaryan conducted an unannounced case management visit to this facility. LPA met with Licensee Charles Thomas Cook and Administrator Vivian Sision and explained the purpose of the visit. On 12/22/25, Resident #1 (R1) was admitted to the facility and the facility did not conduct a pre-admission appraisal prior to accepting the resident. On 01/05/25, LPA Margaryan requested R1’s records such as pre-admission appraisal, admission agreement, IPP and physician’s report. LPA has not received R1’s records. Also based on additional information obtained, the level of care is not appropriate for R1, and the Regional Centers are not in support of the placement. Per the California Code of Regulations (CCR), Title 22, Division 6, Chapter 8, the following deficiency is observed and cited (Refer to LIC 809D). Exit Interview Conducted / Appeal Rights Discussed / A Copy of Report was issued and provided to the Licensee.the state’s words, verbatim · CDSS document, Jan 8, 2026

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87457(c) · Plan of correction due date: Jan 12, 2026

Pre-Admission Appraisal (c) Prior to admission a determination of the prospective resident's suitability for admission shall be completed and shall include an appraisal of their individual service needs in comparison with the admission criteria specified in Section 87455, Acceptance and Retention Limitations. This requirement is not met as evidenced by: On 12/22/25, Resident #1 (R1) was admitted to the facility and the facility did not conduct a pre-admission appraisal prior to accepting the resident.the state’s words, verbatim · CDSS document, Jan 8, 2026

Plan of correction: Appraisal needs to be done for every resident prior admission. License / Administrator will review Title 22, Section 87457, and will send the statement about proper assessment by POC due date.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Nune Margaryan conducted an annual required visit. LPA met with Administrator Vivian Sison and explained the reason for the visit. LPA used the infection control tool to evaluate the facility. The physical plant was inspected along with medications, food supply, and residents and staff records. The facility is licensed to serve (12) Non-Ambulatory Residents, with a Hospice Waiver approved for (3) Residents. The facility currently has 11 residents all of which are serviced by the San Gabriel/Pomona Regional Center. The facility is in a residential area. LPA toured the home and inspected 12 resident bedrooms, 6 Jack and Jill restrooms, 2 walk-in showers, 1 live in staff bedroom, one staff room, 1 staff bathroom, kitchen, 2 laundry rooms, dining room, living room, activity room / sunny room and outside activity area located in the backyard / courtyard. The back yard / courtyard is well maintained and there are no pools or large bodies of water. There is a shaded seating / patio area for the residents located in the backyard with proper furnishing. Passageways and exits are free of obstruction. LPA observed storage room door in the back of the facility was open during visit. Cleaning supplies and sprays were observed unlocked and accessible to residents. Resident bedrooms were checked. Each bedroom is equipped with the proper furnishings. Bedrooms also have sufficient closet space. The bathrooms and showers were toured. The hot water temperature was tested and measured within Title 22 Regulation guidelines. Laundry rooms were inspected. LPA observed laundry detergent are locked and inaccessible to clients. Clean towels and extra linen were observed in a hallway closet. Continue 809C The kitchen was inspected. There is sufficient perishable and non-perishable food. All the appliances are clean and working properly. Sharps are locked and are inaccessible to clients. Smoke detectors and carbon monoxide detectors are operable and in compliance. Several fire extinguishers were observed and are fully charged. Last fire/disaster/earthquake drill was conducted on 09/29/25. LPA observed the centrally stored medications to be locked in the cabinet located in the kitchen and inaccessible to residents. The first aid kit was observed and found to be in compliance with the Title 22 Regulations. LPA reviewed 5 resident’s files and observed that all files are updated. 4 staff records were reviewed to confirm health screenings, training, and fingerprint clearances. LPA reviewed residents medications. Medications are documented properly and given as prescribed. Deficiency was noted on LIC 809D. Exit interview was conducted. Copy of this report and appeal rights were provided to Vivian Sision.the state’s words, verbatim · CDSS document, Oct 7, 2025

Allegation investigated: Facilty did not have hot water

The purpose of this report 8/21/2025 is to conduct additional interviews regarding the above allegation. At today's visit 8/21/2025 interviews were conducted with Residents R1- R4 and Staff S1- S4 The following was completed on subsequent visit on 8/12/2025: The pupose of this report is to investigate the allegation Facilty did not have hot water. LPA did not investigate this allegation at the initial complaint visit conducted on 07/03/2025. This allegation was listed on the initial complaint dated 06/26/2025. At today's visit Resident R1 and Staff S1 were interviewed. LPA checked the shower temperature in Resident R1's room. Water Temperature Logs were reviewed. On 07/03/2025 the following occurred: Licensing Program Analyst (LPA) Glenn Trueman conducted the initial complaint visit regarding the allegations listed above. LPA arrived unannounced and met with Staff S #2. The purpose of the visit was explained. Unsubstantiated LPA obtained copies of the resident and staff rosters. LPA toured the kitchen, dining room, and Resident Rooms 4, 6, 8.10 and 11. Interviews were held with the Administrator telephonically, Staff #1 - #3, and Residents #1 - #5. In regards to the allegation Facility did not have hot water, the temperature check of the shower in Resident R1's room was observed to measure between 105F. and 120 F. Water temperature Log was reviewed and it showed that water was checked 2x daily on 06/24, 07/01, 07/28 and 08/12 and it was revealed that Resident R1 did have hot water. Interview with Resident R1 who stated that he used the shower today and the shower had hot water. At today's visit 8/21/2025 Staff S1- S4 all stated the water is hot for showering. Stated there has not been any complaints. Stated it is checked everyday and documented. All said if anything needs fixing it is done immediately and reported verbally, by text and written documentation. Residents R1-R4 all stated they have hot water when showering. All stated it is checked everyday. Said any problems they fix it immediately. .Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are Unsubstantiated.the state’s words, verbatim · CDSS document, Aug 21, 2025 · control 28-AS-20250626185654

Allegation investigated: Staff are inappropriately locking the facility refrigerators from the clients Staff are mishandling the clients personal funds Facilty did not have hot water

The pupose of this report is to investigate the allegation Facilty did not have hot water. LPA did not investigate this allegation at the initial complaint visit conducted on 07/03/2025. This allegation was listed on the initial complaint dated 06/26/2025. At today's visit Resident R1 and Staff S1 were interviewed. LPA checked the shower temperature in Resident R1's room. Water Temperature Logs were reviewed. On 07/03/2025 the following occurred: Licensing Program Analyst (LPA) Glenn Trueman conducted the initial complaint visit regarding the allegations listed above. LPA arrived unannounced and met with Staff S #2. The purpose of the visit was explained. LPA obtained copies of the resident and staff rosters. LPA toured the kitchen, dining room, and Resident Rooms 4, 6, 8.10 and 11. Interviews were held with the Administrator telephonically, Staff #1 - #3, and Residents #1 - #5. Unsubstantiated In regards to the allegation Staff are inappropriately locking the facility refrigerators from the clients, based on information gathered and interviews conducted it was revealed that a waiver was granted by Department of Social Services per California Code of Regulations, Title 22. Resident's 1-5 all stated that they get all their meals and a snack. Said there are staff here and they can ask them for anything in specific they want. All stated that they can also go to small frig which is always open with snacks. Pantry is also open with a variety of snacks. Staff stated that there is 24 hour care and residents can always get foods they ask for. Said they are adequately staffed to supervise meal and snack times. Stated that there is a small frig that has a variety of snacks. Said there are accessible food storage areas adequately stocked. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are Unsubstantiated. In regards to the allegation Staff are mishandling the clients personal funds, based on information gathered and interviews conducted Staff #S1 revealed that Resident # R1's money was never mishandled. The amount was $193.50 owed by Resident #R1 and that never changed. Stated that she inadvertently listed for Resident #R1 as April Rate portion and ARM (used to describe overall amenities provided). Said it should have only said April Rate portion (Rent). Resident's #R1- #R5 all stated that their personal funds have never been mishandled and it has always gone smoothly.Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are Unsubstantiated. In regards to the allegation Facilty did not have hot water, the temperature check of the shower in Resident R1's room was observed to measure between 105F. and 120 F. Water tempersture Log was reviewed and it showed that water was checked 2x daily on 06/24, 07/01, 07/28 and 08/12 and it was revealed that Resident R1 did have hot water. Interview with Resident R1 who stated that he used the shower today and the shower had hot water. .Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are Unsubstantiated.the state’s words, verbatim · CDSS document, Aug 12, 2025 · control 28-AS-20250626185654

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87468.1(a)(2) · Plan of correction due date: Jul 7, 2025

Personal Rights of Residents in all Facilities Residents in all residential care facilities for the elderly shall have all of the following personal rights: To be accorded safe, healthful and comfortable accommodations, furnishings and equipment. This requirement is not met as evidenced by: Based on interviews conducted and tour of resident rooms licensee failed to have Resident R#3 be accorded safe, healthful and comfortable accommodations, furnishings and equipment with Resident R# 3 not having a lock on the bathroom door which posed a potential risk to residents in care.the state’s words, verbatim · CDSS document, Aug 12, 2025

Plan of correction: Facility to ensure by POC due date that resident rooms all have locks on their bathroom doors. During tour of resident rooms LPA observed locks on the bathroom door. Deficiency cleared.

Allegation investigated: Staff are inappropriately locking the facility refrigerators from the clients Staff are mishandling the clients personal funds

Licensing Program Analyst (LPA) Glenn Trueman conducted the initial complaint visit regarding the allegations listed above. LPA arrived unannounced and met with Staff S #2. The purpose of the visit was explained. LPA obtained copies of the resident and staff rosters. LPA toured the kitchen, dining room, and Resident Rooms 4, 6, 8.10 and 11. Interviews were held with the Administrator telephonically, Staff #1 - #3, and Residents #1 - #5. In regards to the allegation Staff are inappropriately locking the facility refrigerators from the clients, based on information gathered and interviews conducted it was revealed that a waiver was granted by Department of Social Services per California Code of Regulations, Title 22. Resident's 1-5 all stated that they get all their meals and a snack. Said there are staff here and they can ask them for anything in specific they want. All stated that they can also go to small frig which is always open with snacks. Pantry is also open with a variety of snacks. Unsubstantiated Staff stated that there is 24 hour care and residents can always get foods they ask for. Said they are adequately staffed to supervise meal and snack times. Stated that there is a small frig that has a variety of snacks. Said there are accessible food storage areas adequately stocked. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are Unsubstantiated. In regards to the allegation Staff are mishandling the clients personal funds, based on information gathered and interviews conducted Staff #S1 revealed that Resident # R1's money was never mishandled. The amount was $193.50 owed by Resident #R1 and that never changed. Stated that she inadvertently listed for Resident #R1 as April Rate portion and ARM (used to describe overall amenities provided). Said it should have only said April Rate portion (Rent). Resident's #R1- #R5 all stated that their personal funds have never been mishandled and it has always gone smoothly. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are Unsubstantiated.the state’s words, verbatim · CDSS document, Jul 3, 2025 · control 28-AS-20250626185654

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87468.1(a)(2) · Plan of correction due date: Jul 7, 2025

Personal Rights of Residents in all Facilities Residents in all residential care facilities for the elderly shall have all of the following personal rights: To be accorded safe, healthful and comfortable accommodations, furnishings and equipment. This requirement is not met as evidenced by: Based on interviews conducted and tour of resident rooms licensee failed to have Resident R#3 be accorded safe, healthful and comfortable accommodations, furnishings and equipment with Resident R# 3 not having a lock on the bathroom door which posed a potential risk to residents in care.the state’s words, verbatim · CDSS document, Jul 3, 2025

Plan of correction: Facility to ensure by POC due date that resident rooms all have locks on their bathroom doors. During tour of resident rooms LPA observed locks on the bathroom door. Deficiency cleared.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Tena Herrera conducted the required annual inspection. LPA arrived unannounced and met with Vivian Sison and explained the purpose for today’s visit. The facility is licensed to serve (12) Non-Ambulatory Residents, with a Hospice Waiver approved for (3) Residents. The facility currently has 12 Residents all of which are serviced by the San Gabriel/Pomona Regional Center. This is a single-story facility located in La Punete, Ca. A tour of the facility includes: (12) Resident Bedrooms with at total of (6) Jack and Jill Restrooms, two (2) live-in staff bedrooms, one (1) staff bathroom, one staff lounge, kitchen, dining room, living room, linen closets, 2 laundry rooms, and enclosed "out door area" and court yard. LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit todays visit and the initial visit and observed the following: Infection Control: Staff are cleaning and disinfecting throughout the day. Facility has sufficient PPE supplies and has an Infection Control Plan maintained at the facility. Operational Requirements: The facility has an approved fire clearance, and maintains the required liability insurance. Signal System was tested and was operable during visit. Physical Plant & Environment Safety: LPA toured facility, residents’ bedrooms were checked and closet/drawer space to accommodate each resident comfortably was available. The outdoor and passageways are free of obstruction. No bodies of water were observed at the facility. There are no security bars or weapons on the premises. Hygiene products are readily available for residents. The hot water temperature was tested throughout the facility and measured within the required range of 105-120 degrees F. All storage areas for cleaning solutions, toxins, knives, and hazardous items are kept in a locked and are inaccessible to residents. Smoke detectors and carbon monoxide detectors are operable and in compliance. There fire extinguisher was observed and is fully charged. Last fire/disaster/earthquake drill was conducted on 8/15/24. (Continued on LIC809-C) Staffing: There appears to be sufficient staffing at all times in the facility. Personnel Records-Training: Staff has criminal record clearance, current First-Aid/CPR/AED training along with training in postural supports, medication assistance, and other ongoing training are documented in personnel files. LPA reviewed 5 staff files with no issues observed. Administrator Vivian Sison certificate expires 7/1/2026. Resident Records-Incident Reports: Resident files are kept in a secure location and have the following documents in their files - Pre-admission appraisal/Appraisal Needs & Services Plan, Admission Agreements, Identification & Emergency Information and current Physician's Report. LPA reviewed 6 Resident Files with no issues observed. Residents Rights-Information: Residents are provided with telephone and internet at the facility. The facility has the following posters posted: Residents Rights, Complaint Poster, and Ombudsman. Planned Activities: Facility provides scheduled activities and have a variety of activities to choose from within the facility. There is an outdoor activity area available for the residents. Food Service: The kitchen was observed for the ability to prepare and serve food. LPA observed an appropriate food supply of two (2) days of perishables and one week (7 days) of non-perishables. Incidental Medical & Dental: Medication is properly labeled and are centrally stored in a closet and are in their original containers. Disaster Preparedness: The facility has an Emergency Disaster Plan with contact numbers and at least 2 relocation sites. Per California Code of Regulations, Title 22, and California Health and Safety Code, there were no deficiencies observed during the visit. Exit interview held and a copy of the report will be emailed to Vivian Sison.the state’s words, verbatim · CDSS document, Sep 17, 2024