Sequoia Grove Assisted Living

Type of visit: Case Management - Deficiencies

Licensing Program Analyst’s (LPA) M. Vega and H. Vang arrived at the facility unannounced to conduct a Case Management for deficiencies. LPA’s were granted entry by Staff 1 (S1), LPA’s met with Administrator - Keghouhy "Kay" Handian a short time later. On 01/22/2026 and 03/18/2026 LPAs requested documents and again though email on 04/22/2026, 04/27/2026 and 05/11/2026, (documents previously requested are for two separate complaints, 24-AS-20260115153001 and 24-AS-20260316153751) by M. Vega. Documents requested are: payment issued by responsible parties for those residents. On 08/13/2026, LPA M. Vega and M. Garza conducted a Case Management requesting the following: for R1 and R2, payments rendered for R1 (11/14/2024 - 05/30/2025) and R2 (08/13/2022 - 12/31/2024) made by responsible parties in the form of bank statements. The deadline for the following documentation to be submitted by close of business 08/20/2026. As of this date, the requested documents have not been submitted by the Administrator. Complaints 24-AS-20260812101505, 24-AS-20260115153001 and 24-AS-20260316153751 need Financial records in form of bank statements to be submitted by administrator. Deficiencies are being cited in accordance with California Code of Regulations, Title 22, Division 6 on the attached LIC 809D. Exit interview conducted and a plan of correction was reviewed and developed with the Licensee. A copy of this report and appeal rights were provided to Administrator, whose signature on this form confirms receipt of this document.the state’s words, verbatim · CDSS document, Aug 28, 2026

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87755(c) · Plan of correction due date: Aug 31, 2026

(c) The licensing agency shall have the authority to inspect, audit, and copy resident or facility records upon demand during normal business hours... Removal of records shall be subject to the requirements in Sections 87412(f), 87506(d), and 87508(b). Based on record review, the Licensee did not comply with section 87755 when the Licensee did not provide Financial records in the form of bank statements when requested by the department, which is a potential health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Aug 28, 2026

Plan of correction: Administrator stated that will submit Fanancial records in the form of bank statements to LPA M Vega though email on 08/31/2026

Type of visit: Case Management - Deficiencies

On 08/13/2026 Licensing Program Analysts (M. Garza and M. Vega) arrived at the facility at the facility to conduct an unannounced visit. LPAs met with Administrator, Keghoughy Handian, explained reason for visit and was permitted entry into the facility. This case management visit is being conducted for deficiencies observed during a visit conducted today for complaint #24-AS-20260812101505. During visit LPAs toured the facility inside and out and observed the following: Back sliding door listed as an fire exit on the facility sketch is not properly opening and closing. LPAs attempted to open and close the door with difficulty. LPA's observed the rollers on the door not to be functioning properly and in an emergency would be hard for the staff to open and get the residents out of the facility. This poses and immediate health safety and or personal rights risk to residents in care. Deficiency cited per California Code of Regulations, Title 22 on 809D. If not corrected the deficiency will have a direct impact to residents in care. Exit interview completed with Licensee, Keghoughy. A copy of this report provided.the state’s words, verbatim · CDSS document, Aug 13, 2026

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87303 · Plan of correction due date: Aug 14, 2026

87203 Fire Safety All facilities shall be maintained in conformity with the regulations adopted by the State Fire Marshal for the protection of life and property against fire and panic. This requirement was not met as evidence by: LPAs observations of the back sliding door listed as an fire exit not properly opening and closing. In an emergency making it difficult for the staff to open and get the residents out of the facility.the state’s words, verbatim · CDSS document, Aug 13, 2026

Plan of correction: Licensee stated they will have someone come out and look at it. Licensee will make repairs as required. A work order/receipt will be provided to CCL by POC date as proof of correction.

Type of visit: Case Management - Deficiencies

On 08/07/2026, an Non-Compliance Conference (NCC) was held due to concerns observed by the Department during annual inspections and complaint investigations. During the investigation of complaint # 24-AS-20260316153751 and complaint # 24-AS-20260115153001, the Department requested documentation regarding the complaint and have not received the requested documents as of this date. A review of the facility’s compliance history further revealed that several of these deficiencies have previously been discussed with the Licensee Representative/Administrator during prior inspections. Although the Administrator had knowledge of identified concerns, appropriate corrective measures were not implemented. Deficiencies are being cited in accordance with California Code of Regulations, Title 22, Division 6 on the attached 809D. Exit interview conducted and a plan of correction was reviewed and developed with the Licensee. A copy of this report and appeal rights were provided to Licensee, whose signature on this form confirms receipt of this document.the state’s words, verbatim · CDSS document, Aug 7, 2026

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87405(d)(2) · Plan of correction due date: Aug 21, 2026

87405 Administrator - Qualifications and Duties (d) The administrator shall have (2)Knowledge of and ability to conform to the applicable laws, rules and regulations… This requirement was not met as evidenced by: Based on observation, record reviews, and interviews, the Licensee did not comply with section 87405 when the licensee was informed of concerns regarding the facility operations and did not implement corrective measures which is a potential health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Aug 7, 2026

Plan of correction: Licensee agrees to review section 87405 and submit a written statement detialing the steps the facility will take to ensure the requirements for this section is met, to include a target date of when the corrections will be implemented and a list of training topics, to the Fresno CCL office by the POC

Type of visit: Required - 1 Year

On 7/15/26 Licensing Program Analyst (LPA) J. Leffall arrived unannounced to conduct an Annual Inspection. LPA introduced self, stated the purpose of the visit, and was greeted by Staff (S1) Rosa Chavarria. LPA was granted entry. 5 residents were present during inspection. Administrator Keghoughy Handian arrived shortly after LPA’s arrival. LPA toured facility with A1. The facility was observed to be at a comfortable temperature, clean, in good repair, and no passageway obstructions or fire hazards were observed inside. An adequate supply of perishable and non-perishable food was observed. Samples of resident’s medications were checked and observed unlocked in in refrigerator. Clients’ MARS was reviewed. Multiple medications for R1 were observed not initialed by staff after morning administering. Fire extinguisher reviewed with a purchase date of: 8/15/2. Fire drill completed on 3/6/26. Clients' bedrooms were toured and reviewed. Cleaning chemicals were observed stored and locked in closet. Residents bedrooms observed to be adequately furnished with bed, dresser, and adequate lighting. All bathrooms are toured and observed to be operational. Resident bathrooms observed to have a non-skid mats in shower. Hot water temperature was tested at a range of 110.8 degrees 113 in 2 bathrooms. Outside of facility toured. Outside observed free of debris. Side gate was self-closing and self-latching. Outside was observed with adequate outdoor seatings available for clients. Freezer temperature observed at 0 degrees F and refrigerator temperature maintained at 37 degrees F. Smoke detectors and carbon monoxide were tested and observed to be operational. Sharps were observed in unlocked kitchen drawer and accessible to residents. Samples of staff files reviewed to have 1 missing required document. All client files reviewed to have multiple missing documents. The following deficiencies are being cited on the attached 809D and in accordance with California Code of Regulations, Title 22, Division 6. Exit Interview conducted. LPA is requesting the following documents be submitted to the Fresno CCL office by 7/29/26: Current copy of Administrator Certificate, Designation of Facility Responsibility (LIC308), Administrator Organization (LIC 309), Affidavit regarding Client/Resident Cash Resources (LIC 400), Liability Insurance-RCFE, Emergency and Disaster Plan (LIC 610E), Personnel Report (LIC500), Register of Facility Clients/Residents for (LIC9020A) A copy of this report with Appeal Rights were provided to Administrator, whose signature on this form confirms receipt of this report.the state’s words, verbatim · CDSS document, Jul 15, 2026

Type of visit: Required - 1 Year

On 8/15/2025 Licensing Program Analyst arrived at the facility to complete an unannounced annual visit. LPA met with Care Giver, Sharron Camera explained reason for visit and was permitted entry into the facility. Licensee, Keghoughy Handian arrived a some time later. LPA completed a tour of the facility inside and out. A health and safety check was completed on residents in care. 5 resident was present during visit. 2 residents currently on hospice. Pathways and doors were clear and free from obstruction. Facility was without odor. Common areas were adequately furnished, and adequately lit. Smoke detectors and carbon monoxide detectors were present and operational at time of visit. Fire extinguisher last serviced on 8/15/25 . Last fire drill on conducted on 7/15/25. Resident rooms observed to have the required furnishings and with adequate lighting. Sharps, chemicals and medications were located in locked cabinets/closets and cupboards. LPA observed sufficient seating under covered patio areas. The following issues were observed during today’s visit: 1 non-ambulatory resident observed to reside in bedroom #5 (ambulatory room). 1 bedridden resident observed in bedroom #1. Hallway bathroom observed with broken cabinet/drawer handles in need of repair. Bedroom #5 observed with a 4x6 inch hole at bottom of door screen in need of repair. Garage door observed with pad lock with facility 7 day non-perishable food source inaccessible to residents in care. Bedroom # bathroom sink stopper broken and in need of repair. Side yard gates (2) not opening/closing properly in need of repair. Dryer exhaust in need of cleaning. 4 inch drop off sidewalks observed in need of filling. Resident records not available for review/accessible during visit. CONT... CONT... Deficiencies cited per California Code of Regulations, Title 22, deficiencies are being cited on the attached 809D. If not corrected, the violation with have a direct risk to the health, safety and/or personal rights of residents in care. ****An immediate civil penalty assessed for fire clearance deficiencies in the amount of $500.**** LPA requested the following documents to be submitted to CCL by 8/22/25: current copy of Administrator’s Certificate, Administrator Organization (LIC 309), Designation of Administrative Responsibility (LIC 308), Emergency Disaster Plan (LIC 610-D), Personnel Report (LIC 500), Register of Facility Clients/Residents (LIC 9020) and a current copy of liability insurance in order to update the facility file. ***Licensee was offered and accepted TSP*** Exit interview was conducted with Licensee, Kay. A plan of correction was developed by Licensee and reviewed by LPA. A copy of this report, deficiencies, and appeal rights were discussed and provided to Licensee.the state’s words, verbatim · CDSS document, Aug 15, 2025

Type of visit: Required - 1 Year

On 8/28/2024, Licensing Program Analysts (LPAs) K. Kaur and R. Bruce arrived unannounced to conduct an annual inspection. LPAs completed a tour of the facility with Administrator/ Licensee Keghougy Handian. The facility has no residents at this time. LPAs toured the facility with the Administrator. Tour started at Bedroom # 2. Living room observed to have an office space. Medications, first aid kit observed locked in Office Space .Tour continued to sitting room, which was equipped with adequate sofas and recliners for seating. The dining room is equipped with a table and chairs. LPAs observed a 7-day supply of non-perishable. Knives were locked in the kitchen cabinet. Cleaning supplies observed locked in the cabinet next in the laundry cabinets. The laundry area toured and observed with locks on cabinets. Residents' bedrooms were observed to be adequately furnished with beds, dresser, and adequate lighting. Mattresses and linen were in good condition. Extra linen and towels are available in the hallway closet. Bathrooms were clean and appropriately stocked. Water temperature was within range at 109 degrees. LPAs observed grab bars installed by toilet and non-skid mats in place. Smoke alarm detectors and Carbon monoxide detectors installed and operational. Adequate outside space for rest and recreation Sufficient seating observed under a covered patio. The fire extinguisher in entryway was serviced 6/24/2024. Backyard gate is self-closing and self-latching. Facility observed with required postings. Currently facility has no staff. Administrator records reviewed. LPA is requesting the following documents be submitted to the Fresno CCL office once updated: Current copy of Administrator Certificate, Designation of Facility Responsibility (LIC308), Administrator Organization (LIC 309), Affidavit regarding Client/Resident Cash Resources (LIC 400), Emergency and Disaster Plan, Personnel Report (LIC500), Register of Facility Clients/Residents LIC9020. An exit interview was conducted with Licensee. Report signed on-site; a copy of this report was provided.the state’s words, verbatim · CDSS document, Aug 28, 2024

The state marks this report as 4 pages; the online copy we transcribed has 1. You can request the full file from the county licensing office.