Sonoma Grove

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Cuadra arrived unannounced to conduct a required Annual inspection and met with Licensee Alex Varshavsky. There are currently two resident receiving hospice services within their waiver approval. Required postings observed. LPA/Licensee toured the building and grounds. The facility was found to be clean and common areas of facility was at comfortable temperature. LPA observed at least two day supply of perishable and seven day supply of non-perishable food. Food items were found to be stored in a health and safe manner. All bedrooms were furnished per regulation. Extra hygiene products and linens were available. Resident bathrooms all had grab bars and non-skid flooring were observed. Water temperature in sink accessible to residents in care in bathroom measured at 109.8 and 108.5 degrees F which is within the allowable range of 105 to 120 degrees F. Fire extinguishers were last inspected October, 2025. During the tour of the facility, LPA pulled the call alert pendant from a resident's room, and staff arrived timely to assist resident. Smoke/Carbon Monoxide detectors located throughout the facility are hardwired and serviced by Nemesis Fire, last serviced on July 28, 2026. Facility’s last quarterly disaster drills were conducted on June 15, 2026. Facility has a backup generator for use during a power outage. Auditory alarms were working properly. Activities and menu calendar were posted. No deficiencies cited during today's visit. LPA will return at a later unannounced date to review resident and staff files, medication and medication records review. Exit interview conducted with Licensee and copy of this report was given.the state’s words, verbatim · CDSS document, Sep 4, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Cuadra arrived unannounced to conduct a required Annual inspection and met with Administrator/Licensee Alex Varshavsky. There are currently five residents receiving hospice services. Annual fees are current. Required postings observed. At approximately 9:30am LPA/Administrator toured the building and grounds. The facility was found to be clean and common areas of facility was at comfortable temperature. LPA observed at least two-day supply of perishable and seven-day supply of non-perishable food. Food items were found to be stored and handle in a health and safe manner with open items were labeled with dates. All bedrooms were furnished per regulation. LPA inspected areas of concern from the last annual, items including night lamps, broken windows, fireplace screen, shower curtains and adequate bed springs were found within compliance. Extra hygiene products and linens were available. Resident bathrooms all had grab bars and mats were observed. Water temperature in sink accessible to residents in care in bathroom measured at 109.8 and 110.7 degrees F which is within the allowable range of 105 to 120 degrees F. Fire extinguishers were last inspected 10/23/2024. During the tour of the facility, LPA pulled the call alert pendant from a resident's room, then staff was alerted by the sound and arrived timely to assist resident. Smoke/Carbon Monoxide detectors located throughout the facility are hardwired and serviced quarterly by Nemesis Fire, last serviced on 6/12/25. Facility’s last quarterly disaster drills were conducted 7/18/2025. Facility has a backup generator for use during a power outage. Auditory alarms were working properly. Activities and menu calendar were posted. Continue on LIC809C... Continued from LIC809... LPA initiated file review at 10:10am of ten residents and six staff records. Two out of ten residents (R1 & R2) care plan was updated, but not signed by resident's responsible party. According to Licensee, their responsible parties are hard to get a hold of them, but LPA have advice the Licensee to document their attempts. All six staff have required CPR/1st aid certificates and 20 hours of annual training completed. LPA confirmed that the facility is using the department's approved vendor for training materials. Alex Varshavsky Administrator Certificate 7019479740 expires 7/15/2026. At approximately 12:30pm LPA/Med Tech conducted a spot check of medication and medication records. Medication is centrally stored in a locked cabinet. LPA observed that the facility have implemented a system of adding start dates to bottles and list on Centrally Stored Medication Log as suggested as best practices by LPA. Licensee agreed to submit updated copies of the following by not later than 10/15/25: LIC500- Personnel Report, LIC308- Designation of Responsibility and copy of Liability Insurance Deficiencies cited from the California Code of Regulations, Title 22, Division 6 of California Regulation and the Health and Safety Code. Appeal rights given and discussed with Licensee. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Exit interview conducted with Administrator and a copy of this report was given.the state’s words, verbatim · CDSS document, Oct 1, 2025

Type of visit: POC

Licensing Program Analyst (LPA) Christi Coppo arrived unannounced to conduct a plan of correction visit and was greeted by Administrator Alex Varshavsky. On 9/16/24 LPA conducted required annual inspection and found the following water temperature measurements in sinks accessible to residents: room #7 measured at 99 degrees F, room #8 measured at 84 degrees F, room #11 at 96 degrees F, room #12 measured at 97 degrees F, and room #16 measured at 87 degrees F, all of which were outside of the allowable range of 105 to 120 degrees F. Deficiency citation was issued. Today, 12/19/24, at approximately 11:25am, LPA and Admin went together to measure the water temperature in rooms #7, #8, #11, #12, and #16, respectively. The following water measurements were observed in degrees F: 105.2 in room #7 105.0 in room #8 105.2 in room #11 106.2 in room #12 105.3 in room #16 All water temperature measurements were within the allowable range of 105 to 120 degrees F. The plan of correction for deficiency of regulation 87303(e)(2) is therefore now considered satisfied. No deficiencies cited. Exit interview conducted with Administrator and a copy of this report was given.the state’s words, verbatim · CDSS document, Dec 19, 2024

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Christi Coppo arrived unannounced to conduct a required Annual inspection and was greeted by corporate board member, Julia Latifi. Administrator Alex Varshavsky arrived later. At approximately 9:30am LPA toured the building and grounds. The facility was found to be clean and common areas of facility have portable air conditioner and four overhead air conditioner. However, rooms do not have portable air conditioners. Rooms have small fans. LPA discussed with Admin adding a small portable air conditioner for each room, especially during the summer months when temperatures reach over 100 degrees F, as it is probable that fans do not cool rooms under 85 degrees F. LPA observed at least a 2 day supply of perishable and 7 day supply of non-perishable food. Food items were not found to be stored in a safe manner with open items that were not covered and sealed; open loaf of bread with bread pieces spilled on the floor, open and uncovered box of croissants, flour in a metal container covered in plastic wrap labeled 12/12/23, sour cream tub and cream cheese tub opened but not labeled with date (deficiency cited, see 809D). All bedrooms were equipped with night stand, and chest of drawers. Six [6] our of sixteen [16] rooms had lamps present but were not working. Room #2 has a broken bathroom window, LPA found a wooden spoon lodged between window and window sill to keep the window open. Room #8 has a broken window, the inner frame of the window is broken and separated from the glass. Room #10 has a hole in the wall opposite of the beds. (deficiency cited, see 809D). Extra hygiene products and linens were available. Resident bathrooms all had grab bars and anti-slip strips present. The main bathroom did not have required bath mat and community/unassigned towels present. Water temperature in sink accessible to residents in care in main bathroom measured at 105.2 degrees F which is within the allowable range of 105 to 120 degrees F. Continued on 809C... Continued from 809... However, water temperature in sink accessible to resident in room #7 measured at 99 degrees F, in room #8 measured at 84 degrees F, in room #11 at 96 degrees F, in room #12 measured at 97 degrees F, and in room #16 measured at 87 degrees F which are all outside of the allowable range of 105 to 120 degrees F (deficiency cited, see 809D). LPA observed urine on toilet chair in room #2 along with spots of a dried brownish reddish substance. Curtains in room #14 had brown substance in various spots (deficiency cited, see 809D). Fire extinguishers were last inspected 10/23/2023. Smoke/Carbon Monoxide detectors located throughout the facility are hardwired and serviced quarterly by Nemesis Fire, last serviced on 8/21/2024. Facility’s last quarterly disaster drills were conducted 9/2/2024. Facility has a backup generator for use during a power outage. At approximately 11:30am LPA conducted review of 6 staff records. Five [5] out of six [6] staff did not have at least 20 hours of annual training completed. (deficiency cited, see 809D). LPA and Admin discussed training materials and the possibility of utilizing an approved vendor for training to complete staff training requirements. Facility will submit current training materials to CCL for approval. At approximately 1:30pm LPA and Med Tech conducted a spot check of medication and medication records. Medication is centrally stored in a locked cabinet. LPA discussed with Med Tech adding date started to bottles and list on Centrally Stored Medication Log as best practices. At approximately 2:30pm LPA conducted a review of 6 resident records. R5 most current appraisal dated 2/1/2023 (deficiency cited, see 809D). Residents R1, R2, R3, and R4 all have bedridden status but facility has fire clearance for two bedridden residents. LPA and Admin discussed either notifying the local fire department of additional bedridden residents via fax or submit to licensing an updated LIC200 along with an updated facility sketch and CCL will request an inspection to update fire clearance for bedridden allowance. Admin chose to submit an updated LIC200 and facility sketch. Once received CCL will submit to local fire department. Continued on 809C(2)... Continued from 809C... Alex Varshavsky Administrator Certificate 7019479740 expires 7/15/2026. All fees are current as of this time. Updated copies of the following documents were requested for facility file and are to be submitted to CCL within 30 days of this visit: LIC500- Personnel Report LIC308- Designation of Responsibility Liability Insurance Deficiencies cited from the California Code of Regulations, Title 22, Division 6 of California Regulation and the Health and Safety Code. Appeal rights given and discussed with Licensee. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Exit interview conducted with Administrator and a copy of this report was given.the state’s words, verbatim · CDSS document, Sep 10, 2024

The state marks this report as 17 pages; the online copy we transcribed has 7. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

Licensing Program Analysts Cuadra and Coppo arrived unannounced to conduct an Annual Required Inspection and met with Licensee/Administrator, Alex Varshavsky. Licensee/owner Julia Latifi arrived later. Facility currently has Hospice Waiver for 10 residents including 2 bedridden residents allowed. LPAs/Administrator initiated a tour of the facility around 9:00am and made the following observations: Facility was a comfortable temperature. Passageways were free from obstructions. Not all resident rooms were furnished per Title 22 regulation 87307(3)(B): room numbers 2,3,4,and 9 all were missing a lamp for each resident, Technical Advisory given. Water temperature in sink accessible to residents in care measured at 102.2 degrees F which is within allowable range of 105 to 120 degrees F. Extra hygiene products and linens were available. Bathrooms had required bath mats and grab bars.Facility has at least two days of perishable and seven days of non-perishable foods. Required postings were observed. At approximate 9:15am LPAs/Administrator observed 4 out 5 fire extinguishers were last inspected 09/28/2022 which is out of compliance per Title 22 regulation 87202(a). Smoke alarms/Carbon Monoxide detectors were tested and operational per fire inspection tag serviced on 02/10/2023. Last fire drill conducted 09/14/2023. At approximately 10:00am LPAs/Administrator started file review of five staff files and ten resident files. 10 out of 10 residents' Care Plans were not signed by a responsible party as required per Title 22 regulation 87463(c). R10 did not have a care plan and their admission agreement was not signed by their responsible party. Also, residents (R7 and R9) who have a diagnosis of dementia, did not have a current medical assessments within the last 12 months as required per regulation. LPAs discussed with Administrator the importance of having care plans, medical assessments, and admission agreements signed. Administrator agreed to update residents' files to be in compliance with Title 22 regulations to avoid further citations. Continued on LIC809C continued from 809.. At approximately 12:30pm LPAs/Licensee found that 5 out of 5 staff members did not have their training records. The records were not maintained or updated. 3 out of 5 staff have required First Aid and CPR certificates. Administrator Certificate for Administrator, Alexander Varshavsky 6052513740 expires 07/03/2023 (pending). LPAs/Licensee had a discussion about staff training record requirements and Licensee agreed to review and update staff records as well as implement organizational system. At approximately 1:30pm LPAs/Administrator conducted a spot check of medications and observed residents' (R2, R11, R12, R13 & R14) medications are been crushed. However, LPAs were informed by Licensee that there are no physician's crush orders on file to crush medications for residents as required per regulation 87465 (a)(5)(D). Also, Centrally stored medication records have not been maintained current as required by 87465 (a)(6). Based on record review, the facility has not contacted a pharmacy to review their medication management at least twice per year as required by regulation H&S 1569.69 (g). At approximately 2:00pm LPAs/Administrator observed facility's resident alert signal does not produce auditory signal loud enough to alert staff when residents need assistance as required per regulation 87303 (i)(1)(B). Administrator provided LPAs a copy of their liability insurance and a copy of current lease. Licensee/Administrator to submit updates of the following documents by 11/02//2023: LIC 308 Designation of Responsibility forms. LIC 500 Personnel Summary Deficiencies cited from the California Code of Regulations, Title 22, Division 6 of California Regulation. Appeal rights given. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Exit interview conducted with Licensee/owner and a copy of this report was given.the state’s words, verbatim · CDSS document, Oct 19, 2023

The state marks this report as 8 pages; the online copy we transcribed has 7. You can request the full file from the county licensing office.