Seniors Dignity Care

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Martha Arroyo arrived at the facility unannounced to conduct the required annual visit today. Upon arrival, the LPA was greeted by staff who then contacted the Administrator and informed them of the visit. The Administrator, Anahit Manukyan arrived at approximately 09:25 a.m., and the reason for the visit was explained. Entrance interview conducted. Beginning at 09:30 a.m., the LPA along with the Administrator toured the physical plant areas inside and outside to ensure there are no health and safety hazards, and facility is in compliance with Title 22 Regulations. The following was observed: Common Areas: Furniture in the common areas, which includes the living room and dining room area was observed to be in good condition at the time of the visit. The facility maintained a comfortable temperature. The LPA observed activity supplies in the common areas accessible to residents in care. The LPA observed two fire extinguishers to be new with a purchase date of 05/21/2026. Required postings were observed throughout the common space. There is a working telephone on premises. First aid kit was observed complete at the time of the visit. Functioning auditory alarm were observed at the time of the visit. No hazards/obstructions observed inside or out. Restrooms: There are two (2) restrooms for resident use. Bathrooms were clean and fixtures were in operating condition. Showers had non-skid surfaces and grab bars. The bathrooms were sufficiently stocked with all necessary supplies. Starting at 09:35 a.m., the hot water temperature was measured in resident bathrooms, and they measured between 105 and 120 degrees Fahrenheit which is within the required range. Personal hygiene items were observed locked and inaccessible at the time of the visit. Report Continued on LIC 809C... Report Continued from LIC 809... Bedrooms: There are three (3) bedrooms for resident use. Bedrooms are designated as shared / double occupancy. Bedrooms were observed to be furnished appropriately and had sufficient lighting. Additional clean linens and towels were observed in a closet by the hallway. Kitchen: The LPA inspected the kitchen/food service area at approximately 09:45 a.m. Knives and sharps were observed in a locked drawer inaccessible to residents in care. Cleaning supplies were observed locked and inaccessible under the kitchen sink. Kitchen appliances were in operable condition. The LPA observed an adequate amount of emergency food and water. The facility has a sufficient supply of perishable and non-perishable food. Refrigerator and food pantry were checked for proper labels and expiration dates. Garage: The garage is attached to the house and was locked at the time of the visit. Backyard: The backyard has a shaded area with adequate furniture for resident use. Washer and dryer were observed in the backyard. Detergents and toxins were observed in a locked cabinet above the washer and dryer. Emergency passageway was observed to be clear of any obstructions. There are two side gates with latching mechanisms for emergency purposes. The LPA observed a shed for storing purposes. No bodies of water noted at the time of the visit. Records: Record review began at approximately 10:00 a.m. Five (5) resident files were reviewed for, but not limited to, the following: signed admission agreements, current medical assessments with TB results, consent for treatment form, preplacement appraisals, appraisals, and current needs and services plan. All files were in order. Three (3) personnel files were reviewed for, but not limited to: personnel record, health assessment with negative TB test results, criminal record clearance, first aid/CPR training, and the appropriate yearly training. All personnel files were complete. The Administrator’s certificate is valid until 05/09/2028. Report Continued on LIC 809C... Report Continued from LIC 809C... Medications: The LPA conducted a medication review at approximately 11:40 a.m. Medications are centrally stored and kept in a locked cabinet by the kitchen. All medications including PRNs were labeled, stored, and locked inaccessible to residents in care. Medications were properly documented on the centrally stored medication & destruction record (CSMDR) at the time of the visit. Medications appear to be administered as prescribed at the time of the visit. Emergency Disaster Planning: During today’s visit, the LPA reviewed the facility's infection control plan and emergency disaster plan, which were observed to be complete and recently reviewed/updated. Emergency disaster drills conducted quarterly as per regulation; last disaster drill conducted on 07/20/2026. No citations issued at this time. Exit interview conducted. A copy of the report was issued.the state’s words, verbatim · CDSS document, Aug 20, 2026

Allegation investigated: Due to staff neglect and lack of supervision, resident sustained multiple bruises.

Licensing Program Analyst (LPA) Martha Arroyo conducted a subsequent complaint visit to deliver findings for the above allegations. The LPA met with Administrator, Anahit Manukyan and explained the reason for the visit. Entrance interview. On 08/19/2025, the Department received a complaint alleging that due to staff neglect and lack of supervision, resident sustained multiple bruises. It was reported that Resident #1 (R1) was noted to have bruising “from head to toe” with prominent bruising on their head and inner thigh area. The complaint was referred to the Community Care Licensing Investigations Branch (IB) and assigned to Investigator Laura Garcia. Report Continued on LIC 9099C... Unsubstantiated Report Continued from LIC 9099... During the initial visit on 08/20/2025, LPA Chochian reviewed and obtained copies of pertinent documents between 01:30 p.m. and 02:00 p.m. and toured the physical plan area at approximately 02:15 p.m. On 02/23/2026, LPA Arroyo conducted an interview with the Administrator at 12:35 p.m. and obtained copies of pertinent documents relevant to the investigation. Investigator Garcia conducted interviews on 09/18/2025, at approximately 06:52 p.m., with the Administrator; at approximately 12:30 p.m., with a staff member; and at approximately 01:00 p.m., 01:30 p.m., and 02:00 p.m. with three residents. Additional interviews were conducted by Investigator Garcia on 10/14/2025, at approximately 04:22 p.m., with a family member; and on 12/03/2025, at approximately 04:00 p.m., with the Home Health Nurse Director. Additionally, hospital records were requested on 08/22/2025 and received on 08/28/2025 and home health records were requested on 01/22/2026 and received the same day. A review of R1’s Physician’s Report dated 05/26/2025 listed R1’s primary diagnosis as dementia, with secondary diagnoses of hypertension, hyperlipidemia, and deep vein thrombosis/pulmonary embolism. The report described R1’s mental condition as confused and disoriented due to dementia; however, R1 was able to follow simple instructions and communicate basic needs. The report further indicated that R1 was non-ambulatory and required standby assistance, had no capacity for self-care, and required assistance with all activities of daily living (ADLs). The investigation revealed that R1 was admitted to the facility on 05/26/2025 with prescriptions for two different blood thinning medications, Eliquis and Pradaxa, which were identified as the primary cause of R1’s bruising. Interviews with staff indicated that R1 was admitted to the facility because R1’s family was unable to continue providing care due to R1’s self-injurious behaviors and significant cognitive decline. Staff reported that R1 exhibited aggressive behaviors toward both self and others within the facility. These behaviors included kicking, biting, spitting, throwing themselves onto the floor, screaming, and defecating and smearing feces throughout the room. The Administrator stated that there was ongoing communication with R1’s primary care physician (PCP) regarding R1’s needs, including requests for medication adjustments and additional support. However, there were reported delays in receiving responses from the PCP. Report Continued on LIC 9099C... Report Continued from LIC 9099C... According to discharge documentation from R1’s hospital visits on 08/06/2025 and 08/12/2025, the issues addressed included a urinary tract infection (UTI), aftercare following hospitalization, major neurocognitive disorder, moderate, with agitation, a history of recurrent deep vein thrombosis, and a gluteal hematoma related to the use of blood thinners. During the 08/12/2025 visit, R1’s PCP discontinued Pradaxa and instructed that R1 continue taking Eliquis as prescribed for recurrent venous thrombosis. R1 was also admitted to home health services with Pegasus Home Health. However, following a hospital visit on 08/19/2025, R1 was placed on hospice care with Luna Hospice, Inc., with a primary diagnosis of senile degeneration of the brain, not elsewhere classified. Interviews conducted with residents revealed that there was constant supervision provided both during the day and at night, and that staff were described as extremely caring. Additionally, three out of three residents interviewed denied any type of neglect or lack of care by facility staff and reported feeling safe while residing at the facility. Based on the information obtained during the course of the investigation, the Department has insufficient evidence to support the allegation, therefore allegation “due to staff neglect and lack of supervision, resident sustained multiple bruises” is deemed Unsubstantiated at this time. Exit interview conducted. Report was reviewed and copy issued.the state’s words, verbatim · CDSS document, Mar 3, 2026 · control 29-AS-20250819122802

Type of visit: Case Management - Deficiencies

Licensing Program Analyst (LPA) Martha Arroyo conducted a Case Management - Deficiencies visit in conjunction with a complaint visit (Complaint Control # 29-AS-20250819122802). The purpose of the visit is to issue citation for a deficiency observed during the investigation. During the course of the investigation, a review of records and interviews conducted revealed that Resident #1 (R1) experienced numerous falls while residing at the facility. The unwitnessed fall, combined with altered mental status, resulted in staff calling 911 and/or hospitalization on 06/20/2025, 07/11/2025, 08/06/2025, 08/12/2025, and 08/15/2025. However, a review of records indicated that a written Unusual Incident/Injury Report (LIC 624) was not submitted to Community Care Licensing (CCLD) within seven (7) days of each occurrence, as required by reporting regulations. The following deficiencies were observed (See LIC 809-D.) and cited from the California Code of Regulations, Title 22 and California Health and Safety Code. Failure to correct the deficiencies may result in civil penalties. Exit interview was conducted. A copy of the report and appeal rights were provided.the state’s words, verbatim · CDSS document, Mar 3, 2026

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87211(a)(1)(D) · Plan of correction due date: Mar 13, 2026

Each licensee shall furnish to the licensing agency such reports as the Department may require, including: Any incident which threatens the welfare, safety or health of any resident… This requirement has not been met as evidenced by: Based on record review and interviews, the Licensee did not comply with the section cited above as the facility did not submit an LIC 624 within 7 days of occurrence for R1’s hospital visits and falls, which posed a potential health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Mar 3, 2026

Plan of correction: The Licensee has agreed to review regulation cited and write a statement of understanding and send proof to CCL no later than POC due date.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Martha Arroyo arrived at the facility unannounced to conduct a required annual visit. Upon arrival, there were two (2) staff and six (6) residents present. The LPA was greeted by the Administrator, Anahit Manukyan and the reason for the visit was explained. Entrance interview conducted. Starting at 09:30 a.m., the LPA along with the Administrator toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. The following was observed: Kitchen: The LPA inspected the kitchen/food service area at 09:32 a.m. Knives and sharps were observed locked and inaccessible in a kitchen drawer. Kitchen appliances were in operable condition. The facility has a sufficient supply of perishable and non-perishable food. Refrigerator and food pantry were checked for proper labels and expiration dates. An adequate amount of emergency food and water was observed; properly stored. At 09:34 a.m., the hot water temperature was measured in the kitchen sink, and it measured at 108.9 degrees Fahrenheit. Common Areas: At the time of the visit, furniture in the common areas was observed to be in good condition. The facility maintained a comfortable temperature. The LPA observed several fire extinguishers to be fully charged with a purchase date of 04/14/2025. Report Continued on LIC 809C... Report Continued from LIC 809... Required postings were observed throughout the common space. Activities were observed in the living room. There is a working telephone on premises. Cameras observed in the common areas. The LPA observed a closet in the hallway with additional clean linens and towels. Emergency exit plans posted throughout the facility. Restrooms: There are two (2) restrooms for resident use and one (1) restroom for staff use only. Resident bathrooms were clean and sanitary and in operating condition with grab bars and non-skid surfaces. The bathrooms were sufficiently stocked with supplies and paper towels. Starting at 09:40 a.m., the hot water temperature was measured in both bathrooms, and they measured between 116.7 and 118.2 degrees Fahrenheit. Bedrooms: There are three (3) bedrooms for resident use. All bedrooms are designated as double occupancy / shared rooms. All resident rooms were observed to be furnished appropriately with clean linens, appropriate furnishings, and sufficient lighting. The LPA observed a staff bedroom on premises. Laundry: Washer and dryer were observed in the backyard locked and inaccessible to residents in care. Detergents were observed in a locked cabinets above the washer and dryer at the time of the visit. Outdoors: The backyard has a covered patio area with patio furniture for resident use. The LPA observed a shed for storage purposes. All passageways were observed to be clear of any obstructions. There are two (2) side gates with latching mechanisms. No bodies of water noted at the time of the visit. Records: The LPA reviewed six (6) Resident Records and four (4) Personnel Records including the Administrator’s file starting at 09:50am. Report Continued on LIC 809C... Report Continued from LIC 809C... Resident files were reviewed for, but not limited to, the following: signed admission agreements, current medical assessments with TB results, LIC627(c) Consent for Treatment form, and current needs and services plan. All files were in order. Personnel files were reviewed for, but not limited to: personnel records, health assessments, criminal record clearances, first aid/CPR training, and the appropriate yearly training. All records were in order. Administrator certificate valid until 05/09/2026. During today’s visit, the LPA obtained copies of the client roster, personnel report, and limited liability insurance. Infection Control / Emergency Disaster Planning: During today’s visit, the LPA reviewed the facility's infection control plan. The facility’s policies and procedures as it pertains to infection control are adequate. The LPA also reviewed the facility's emergency disaster plan, which was observed to be complete and recently reviewed/updated. Emergency disaster drills conducted quarterly as per regulation; the last one being a fire drill which was conducted on 06/14/2025. Medications: Medications review began at approximately 11:15 a.m. The medications are locked in a cabinet adjacent to the kitchen. All medications including PRNs were labeled, stored, and locked inaccessible to residents in care. The LPA observed PRN authorization letters on file. Medications are properly documented on the Centrally Stored Medication and Destruction Records (CSMDR). No citations issued. Exit interview conducted. A copy of the report was provided.the state’s words, verbatim · CDSS document, Aug 12, 2025

Allegation investigated: Staff did not assist resident with their auditory prosthetics. Staff spoke inappropriately to resident. Staff did not meet resident’s grooming needs. Staff left resident in the same clothing for extended periods. Staff did not dispense medication to resident as prescribed.

Licensing Program Analyst (LPA), Martha Arroyo conducted a subsequent complaint visit to the above facility. The purpose of the visit is to deliver findings for the above allegations. The initial complaint visit was conducted on 02/26/2025 by LPA M. Arroyo. On today's visit, LPA Arroyo met with staff, Nurzhan Mamatova and shared findings with the Administrator telephonically. Entrance interview. During the initial visit on 02/26/2025, the LPA conducted a plant tour at 11:10AM, conducted a medication review at 11:30AM, conducted interviews with one staff and four residents between 11:13AM and 2:35PM, and conducted a file review and obtained copies of pertinent documents. Report Continued on LIC 9099C Unsubstantiated Report Continued from LIC 9099... It was alleged that staff did not assist resident with their auditory prosthetics. It was reported that only one (1) hearing aid is working due to facility staff being too busy to assist Resident #1 (R1) in charging their hearing aids. Interviews conducted with staff revealed that R1 is able to put on their hearing aids independently in the mornings. However, R1 was struggling to place the hearing aids back into the charger at night. Staff noted that, due to R1's difficulty with the charger, they decided to charge the hearing aids every night. During the interviews, R1 mentioned that the facility staff charges their hearing aids each night and stated that the staff is helpful. Additionally, residents reported having no concerns about living at the facility and noted that the staff is able to assist if needed. Based on the information obtained and reviewed, the Department has insufficient evidence to support the allegation of “staff did not assist resident with their auditory prosthetics”. Therefore, this allegation is deemed Unsubstantiated at this time. It was also alleged that staff spoke inappropriately to resident. It was reported that facility staff is short tempered and yells at the residents. Interviews conducted with staff revealed that they were unaware of any residents feeling disrespected. Staff stated that residents have not reported instances of staff being rude or yelling at them. Interviews with residents revealed that they find the staff to be nice and polite when assisting them. Additionally, during the interviews, residents denied feeling disrespected by staff while living at the facility and stated that staff has never been rude to them. Furthermore, residents reported having no concerns about living at the facility or the way staff treats them. Based on interviews conducted with staff and residents, the Department has insufficient evidence to support the allegation of “staff spoke inappropriately to resident”. Therefore, this allegation is deemed Unsubstantiated at this time. It was also alleged that staff did not meet resident’s grooming needs and staff left resident in the same clothing for extended periods. It was reported that facility staff is not encouraging residents to brush their hair and teeth and R1 is always left in their nightgown. During the plant tour on 02/26/2025, the LPA observed five residents living at the facility, all of whom appeared to be well-groomed. Interviews conducted with residents revealed that staff assist with either showers or sponge baths 2 to 3 times a week. Report Continued on LIC 9099C... Report Continued from LIC 9099C... Residents stated that they have a set schedule for when they will receive a shower. Additionally, residents reported being changed every day. Furthermore, R1 stated that they have nightgowns, which were gifted to them, that they prefer to use daily. However, both staff and R1 stated that they ensure the nightgowns are kept clean, as they are rotated and washed every other day. Based on the information obtained, the Department has insufficient evidence to support the allegations of “staff did not meet resident’s grooming needs” and “staff left resident in the same clothing for extended periods”. Therefore, these allegations are deemed Unsubstantiated at this time. It was further alleged that staff did not dispense medication to resident as prescribed. It was reported that facility staff is not giving R1 their pain medication which allows them to be more mobile. A review of R1’s medication list indicates that R1 was prescribed Acetaminophen (Tylenol) 500mg Oral Tablets, to take 2 tablets every 6 hours as needed for pain or fever. Additionally, a review of R1’s centrally stored medication and destruction record (CSMDR) revealed that Tylenol 500mg (100 tablets) was started on 01/13/2025. The medication review showed that R1 has been given 2 Tylenols twice a day since the start date. Interviews conducted with staff and residents confirmed this, as staff stated that R1 has been taking 2 Tylenols twice a day since it was prescribed, and R1 reported taking their pain medication every day, once in the morning and again in the evening. Furthermore, during interviews, residents stated that they receive their medication daily from staff and reported no concerns. Based on records reviewed and interviews conducted, the department has insufficient evidence to support the allegation of “staff did not dispense medication to resident as prescribed”. Therefore, this allegation is deemed Unsubstantiated at this time. Exit interview conducted. No citations issued. Copy of the report was provided.the state’s words, verbatim · CDSS document, Mar 20, 2025 · control 29-AS-20250221163141

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Brian Balisi conducted a pre-licensing visit to the above noted facility. The LPA met with applicant Anahit Manukyan. This is a Change of Ownership (CHOW). The facility is currently licensed under Seniors Serenity #565850208 A dementia program was included in the plan of operation. A Hospice Waiver has been requested. The current capacity is for six (6) clients. The fire clearance was granted for five (5) non-ambulatory clients and one (1) bedridden client. There are currently five (5) residents in care. The facility is one story. At approx. 10:00am, a physical plant tour was conducted inside and out. The facility has four (4) private resident bedrooms. Resident rooms #1, #2 and #3 have a direct exit to the outside. Bedroom #2 is approved for one (1) bed-ridden resident. There are no fire sprinklers in the facility. All resident bedrooms were observed to be equipped with fire door. All resident rooms are set up with beds, nightstands, lamps, chests of drawers, chairs and closet space. The beds are furnished with box springs, comfortable mattress and clean linen; which includes, a mattress pad, top and bottom linens, pillowcases, blanket (if needed) and a bedspread. Lighting in the rooms appeared adequate. In addition, no bedroom was used as a passageway to another room, bath or toilet. There is a staff room at the facility located on left side of hallway. LPA observed room to be inaccessible to residents in care. For NOC , there will be awake night staff only. All rooms were free of odors. All window screens were clean and maintained in good repair. There are three (3) bathrooms total. The resident bathroom(s) have a shower with non-skid materials. The toilet and shower have grab bars. The hot water temperature was tested in the bathrooms and the kitchen and was found to be within the range of 105*F and 120*F. Resident and staff records are to be stored inaccessible in a hallway closet. Medications are centrally stored inaccessible in a locked cabinet in the kitchen. The first aid supplies were complete , including a thermometer and a current version of a first aid manual. First aid was observed stored in cabinet in living room. Kitchen knives are stored in accessible in a drawer to the right of the sink. Stove burners are rendered inaccessible to the residents by placing a safety lock on them when not in use. The supply of dishes, utensils, pots, pans and drinkware is adequate. The freezer was maintained at zero degrees Fahrenheit (0*F) and the refrigerator was maintained at 40*F. The supply of nonperishable food is adequate. There are no pesticides (poisons) or toxins stored in any food storage area or preparation area with utensils. Appliances in the kitchen were clean and all appeared functional at the time of the visit. Trash cans had tight fitting lids. No flies or other vermin were observed. The common areas were appropriately furnished, and the lighting was adequate. There is a television and other entertainment equipment, games and/or activity supplies in the living room. There was sufficient space to accommodate both indoor and outdoor activities. Night lights were maintained in hallways and passageways to non private bathrooms. There is no fireplace in the living room. The facility has emergency exit signs . The facility has a furnace, which is able to heat rooms that residents occupy to a minimum of 68 degrees Fahrenheit; and, they have central air conditioning and are able to cool rooms to a comfortable range, not to exceed 85 degrees Fahrenheit. The facility smoke alarm system is battery operated. The smoke detector and carbon monoxide detectors were tested and functioned properly during the time of visit. Fire extinguishers were observed fully charged and last serviced in June 15, 2024. The laundry room is located in the rear of the facility. Cleaning supplies and toxins were observed stored here and the room will be inaccessible to residents in care. There is an attached garage that is only accessible from the exterior of the home. LPA observed extra furniture and other supplies for facility use along with a supply of emergency food. Continued from 809-C Continued from 809-C There is cabinet located in the main hallway that stored an adequate supply of extra bed and bath linens. Cabinets are to be locked and inaccessible to residents in care. There is a functioning telephone on the premises. The emergency exiting plans/sketch are posted throughout. The emergency telephone numbers and other required postings are posted in the kitchen. The exterior passageways were clean and clear of any obstructions. There is a covered patio area in the rear of the home. LPA observed appropriate furniture for outdoor use. The outside area was observed to be large enough to conduct outdoor activities. There is no body of water observed at this time. Component III and interviews were conducted in conjunction with the visit. No corrections required on a pre-licensing visit at this time. Exit interview conducted. Report issued and provided to Licensee. This report will be sent to the Centralized Application Bureau (CAB). You will be notified by the CAB Analyst when your license has been approved. You are not allowed to begin operating until you have been notified that your license has been approved by the CAB Analyst. Failure to comply could affect approval of your license.the state’s words, verbatim · CDSS document, Jul 29, 2024

Type of visit: Office

Component II completion: Successful Facility Type: RCFE Application Type: CHOW Capacity: 6 Census (if any clients in care): 5 COMP II Participants: Name - Anahit Manukyan CEO/Administrator Interview Method: Telephone interview On June 7, 2024, 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, Jun 7, 2024