Sunny Senior Care

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Michael Cava conducted an Annual Required visit and inspection of the facility. LPA met with the licensee, Ani Tigranyan, and explained the reason for the visit. At approximately 9:15am, LPA took a tour of the physical plant. Required postings were observed at the entry area. The smoke alarms and carbon monoxide are dual and interconnected. The facility has one fire extinguisher, located in the kitchen. It was purchased on March 10, 2026 Kitchen: The kitchen appliances and fixtures were functional. LPA found a sufficient amount of perishable and non-perishable food properly stored. Knives were stored in a locked drawer. No cleaning supplies stored in the kitchen. Cleaning supplies stored in the garage. Bedrooms: There are five (5) bedrooms designated for residents' use. Bedrooms #2, #3,#4, and #5 are designated for private use. Bedroom#1 is a shared bedroom. The rooms are furnished with beds, nightstands, chairs, dressers, bedding, and linen. The bedrooms have sufficient lighting and closet space. Bathrooms: The facility has two (2) bathrooms for the residents' use. One is located in the main hallway and one private in Room #2. Both bathrooms were observed to have the proper fixtures, grab bars, and non-skid mats. Water temperature in the bathrooms measured between 111-112 degrees F. No cleaning supplies or hazardous items were present in each bathroom. Common Areas: These included the living room which is equipped with sufficient seating of a couch, recliner, two chairs, television, and a table. There is a fireplace that is properly screened and blocked. Fireplace is non-operational and no tools were present. The dining room table is large enough to accommodate six (6). GARAGE: The garage is attached to the home. Entry is from the outside. The garage is used as storage for cleaning supplies. The garage is inaccessible to the residents. Laundry: Laundry area is located in the garage. Detergents and fabric softeners kept locked in the garage. MEDICATIONS: The medication cabinet is located in the living room. Cabinet is kept locked. Medications and medication records were reviewed for appropriate storage and documentation. There is a complete first aid kit and manual stored inside the medication cabinet. OFFICE/STAFF WORKSTATION: Staff workstation is located by the front entry. Resident Files: Resident files kept locked in cabinet by living room. LPA conducted a file review of resident records to insure compliance of licensing forms. Staff Files: Staff files also kept in cabinet by living room. LPA conducted a file review of staff records to insure forms and training are up to date and compliance with licensing forms. SURROUNDING GROUNDS: The driveway, passageways, and entrance to the home were clear of obstruction. All entry and exit doors have a functional auditory alert when the doors open. The backyard of the facility has a patio and backyard furniture to accommodate the six (6) residents. The facility backyard has sufficient space to hold outdoor activities. There is no swimming pool or any other bodies of water. Pursuant to Title 22 Division 6 of the CA Code of Regulations, no deficiencies were observed during the visit. Exit Interview Conducted and a Copy of the Report Issued.the state’s words, verbatim · CDSS document, Jul 11, 2026

Type of visit: Case Management - Deficiencies

In conjunction with the complaint number 31-AS-20251028093801, Licensing Program Analyst (LPA) Mariana Agban conducted a case management- Deficiencies visit. During the complaint investigation, it was confirmed that no physical file existed for Resident #1 (R1) at the facility. Interview with Staff #1 (S1) revealed that R1 was admitted to the facility on or around November 1, 2025, and remained for a few hours before being transferred to the hospital. Additionally, LPA observed that Room #3 was vacant. During the interview with S1, S1 indicated that Resident #2 (R2) is currently hospitalized. LPA conducted a record review and noted that no Special Incident Report (SIR) had been submitted to Community Care Licensing (CCL). Furthermore, it was discovered that the facility has not had a certified administrator since June 6, 2025. LPA also detected the smell of cigarette smoke during the physical plant tour. When asked, S1 denied smoking and stated that the odor was from a neighbor. Subsequently, a pack of cigarettes and a lighter were found in the kitchen. Moreover, LPA requested the LIC 500 – Personnel Report. S1 stated that only she and one other staff member live and work at the facility; therefore, no employee schedule is in place. Exit interview was conducted, citations were issued, appeal rights were provided, and a copy of this report was signed and delivered.the state’s words, verbatim · CDSS document, Nov 6, 2025

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87506(a) · Plan of correction due date: Nov 13, 2025

(a)The licensee shall ensure that a separate, complete, and current record is maintained for each resident in the facility .. available to facility staff and to licensing agency staff. This requirement was not met as evidence by: Based on information obtained, the Licensee did not comply with the section cited above. There was no physical file existed for Resident #1 (R1) at the facility. This poses a potential health and safety risk to clients in care.the state’s words, verbatim · CDSS document, Nov 6, 2025

Plan of correction: Licensee will conduct in service training reviewing this section of the regulation. Licensee will provide all training materials and signatures of all staff that have attended the training by the POC due date.

From the deficiency page — Deficiency type: Type B · Section cited: CCR87211(a)(1) · Plan of correction due date: Nov 13, 2025

(1)A written report shall be submitted to the licensing agency and to the person responsible for the resident within seven days of the occurrence of any of the events specified in (A) through (D) below... This requirement was not met as evidence by: Based on information obtained, the Licensee did not comply with the section cited above. Licensee did not submit SIR regarding Resident#2(R2) hospitalization. This poses a potential health and safety risk to clients in care.the state’s words, verbatim · CDSS document, Nov 6, 2025

Plan of correction: Licenee agreed to provide Special Incident Report (SIR) for R2's hospitalization by the POC date.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87405(a) · Plan of correction due date: Nov 27, 2025

Administrator - Qualifications and Duties (a) All facilities shall have a qualified and currently certified administrator.. This requirement was not met as evidence by: Based on information obtained, the Licensee did not comply with the section cited above. The facility has not had a certified administrator since June 6, 2025. This poses a potential health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Nov 6, 2025

Plan of correction: Licensee agreed to hire a new administrator and provide all required documents to change the administraor name in the system by the POC date.

From the deficiency page — Deficiency type: Type B · Section cited: CCR87618(b)(3)(c) · Plan of correction due date: Nov 13, 2025

The licensee shall be responsible for the following: (3)Ensuring that the use of oxygen equipment meets the following requirements: (c) Smoking shall be prohibited where oxygen is in use. This requirement was not met as evidence by: Based on observation,the Licensee did not comply with the section cited above. LPA detected the smell of cigarette smoke during the physical plant tour. LPA observed that R4 uses oxgygen. This poses a potential health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Nov 6, 2025

Plan of correction: Licensee will conduct in service training reviewing this section of the regulation. Licensee will provide all training materials and signatures of all staff that have attended the training by the POC due date.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87412(a) · Plan of correction due date: Nov 27, 2025

The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee. Each personnel record shall contain the following information: This requirement was not met as evidence by: Based on information obtained, the Licensee did not comply with the section cited above. Licensee was unable to provide LIC 500 as there was no employee schedule is in place. This poses a potential health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Nov 6, 2025

Plan of correction: Licensee agreed to provide LIC 500 by the POC date.

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Mariana Agban conducted a Pre-Licensing Inspection with Administrator Victoria Hayrapetyan and Licensee Ani Tigranyan. A Change in Ownership (CHOW) Application to operate a Residential Care Facility for the Elderly (RCFE) was received by Community Care Licensing (CCL) on December 3, 2024. A fire clearance was approved on March 19, 2025, for five (5) non-ambulatory residents and one (1) bedridden resident, for a total capacity of six. All bedrooms are cleared for one bedridden resident. A dementia plan of operation has been submitted. A hospice waiver has been requested for six (6) residents pending the Manager's approval. The smoke alarms and carbon monoxide detector are battery-operated and functional. The fire extinguisher is located in the kitchen with a purchase date of 04/15/25. A tour of the physical plant was initiated at approximately 9:45 am and the following was observed: KITCHEN: The facility has a Kitchen area equipped with a refrigerator, microwave oven, and sink. Adequate supplies of perishable and nonperishable food and dining ware accommodated a maximum capacity of six (6). Medications are kept locked in storage cabinet next to the fire extinguisher in the kitchen. BEDROOMS: There are five (5) bedrooms designated for residents' use. Bedrooms #2, #3,#4, and #5 are designated for private use. Bedroom#1 is a shared bedroom. The rooms are furnished with beds, nightstands, chairs, dressers, bedding, and linen. The bedrooms have sufficient lighting and closet space. BATHROOMS: The facility has two (2) bathrooms for the residents' use. One is located in the main hallway and one private in Room #2. Both bathrooms were observed to have the proper fixtures, grab bars, and non-skid mats. Water temperature in the bathrooms measured between 105-109 degrees F. No cleaning supplies or hazardous items were present in each bathroom. (Continue on 809C) COMMON AREAS: These included the living room and dining room. The living room was equipped with furniture, a television, tables, and chairs. The dining area has a dining room table to accommodate six (6). LPA observed a large pantry that is used as extra storage for non-perishable and emergency food supplies and water. There were no visible immediate hazards. There is a functioning telephone on the premises in the living room. GARAGE/Laundry: The garage is attached to the building. Entry to the garage from outside the home. LPA observed the sliding glass door locked. The garage is used as storage. LPA observed storage boxes and cleaning supplies. Laundry detergents are kept locked in the garage and inaccessible to residents. The washer and dryer are located in the garage. LPA observed that the washer and dryer are in good repair. There is another refrigerator in the garage for additional perishable food items. Residents/Staff Records: Residents and staff records were reviewed to ensure compliance. SURROUNDING GROUNDS: The driveway, passageways, and entrance to the home were clear of obstruction. All entry and exit doors have a functional auditory alert when the doors open. The backyard of the facility has a patio and backyard furniture to accommodate the six (6) residents. The facility's backyard has sufficient yard space. In addition to the Pre-Licensing inspection, a Component III power point presentation was also held. Pursuant to Title 22, Division 6 of the CA Code of Regulations, the facility's physical environment appears to be compliant and ready for licensure. CAB will be advised and a copy of this report provided.the state’s words, verbatim · CDSS document, Apr 21, 2025

Type of visit: Office

Facility Type: RCFE Application Type: CHOW Capacity: 6 Census (if any clients in care): COMP II Participants: IKTORYA HAYRAPETYAN AND ANI TIGRANYAN/ADMINISTRATOR AND APPLICANT Interview Method: Telephone interview On 3/26/25], 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 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, Mar 26, 2025