Twin Oaks Guest Home

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Tuesday Cabiness arrived at the facility to conduct an annual inspection. Upon arrival, LPA observed that the property was no longer operating as a licensed facility. The premises were closed, with no staff or residents present. The property was locked; however, LPA was able to view the interior through the windows and observed that the building appeared vacant and under remodeling and construction. LPA then observed an adjacent property located at the rear of the facility with the front door open. LPA approached and observed three individuals inside the back house. LPA spoke with a female individual, who confirmed that the front property had previously operated as a facility but was now closed and no longer in operation. The individual contacted the current property owner, Mark Yule, who spoke with LPA by phone. Mr. Yule stated that he is the new owner of the property and intends to submit a new application to operate as a Residential Care Facility for the Elderly (RCFE). He reported that construction and remodeling are currently in progress and that his application is pending submission. LPA also contacted the former Licensee/Administrator, Tami Akahosi, who confirmed that the facility is closed. Ms. Akahosi stated she has retired and does not wish to continue operating the facility. She further reported that the facility license remains posted at the property and that the new owner holds the keys to the premises. LPA will contact Mr. Yule to request that the facility license be mailed to Community Care Licensing. At this time, the facility is closed and no longer operating as a licensed RCFE. A copy of this report will be emailed to the former Licensee for her records.the state’s words, verbatim · CDSS document, Oct 18, 2025

Allegation investigated: Licensee did not follow facility closure procedures.

At 10:35a.m., Licensing Program Analyst (LPA) Antonia Alvizar-Ettima conducted an unannounced initial visit to investigate the above stated allegation. LPA noticed a note on the door and contacted Licensee/Administrator via-phone and indicated they were out visiting other facilities and current heading back to the facility. At approximately 11:20a.m. LPA met with the Licensee/Administrator and explained the reason for the visit. At about 11:30a.m., LPA Alvizar-Ettima requested the closure notice, staff and residents roster, as well as the rosters for residents that had already moved out. At 11:40a.m., LPA and Licensee/Administrator conducted physical plant tour. Between 12:00- 12:20p.m., LPA conducted interviews with resident (R1) and Licesee/Adminstrator. LPA Alvizar- Ettima asked questions relevant to the nature of the complaint. In addition, LPA reviewed available rosters for facility residents and already moved out residents. Licensee did not follow facility closure procedures. Substantiated It was alleged that the facility is closing without giving the residents a 60 days written notice. Prior to this visit on 04/25/2025 at 1:10pm, LPM Naira Margaryan spoke with the Licensee/Administrator, Tami Akahoshi and verified that facility is closing due to sell of the property. Licensee indicated that had no knowledge that Licensing Office must be notified about facility closure and had to follow specific procedures for facility closure. At the time of visit, Licensee/Administrator revealed the same information. LPA was informed that residents received verbal notice of closure on 04/04/25. Licensee/Administrator informed LPA that a 60 day closure notice was drafted and a copy was issued to one (01) of the residents on 04/25/25 and on 04/26/25 the other three (03) residents received the notices. During this visit three (03) out of four (04) residents were already relocated. Resident (01) interviewed revealed that staff did provide a 60 days notice. At approximately 11:00a.m., LPA Alvizar- Ettima contacted relocated sites to verify that three (03) residents have been relocated to the sites identified by the Licensee/Administrator. Based on inspection, observation, interviews and record review there is enough supporting information to verify the allegation. Therefore, the allegation is Substantiated. Licensee/Administrator was informed to contact Licensing Office to provide relocation information of the resident that is still at the facility. Under the Health and Safety Code 1569.682 the following deficiency were cited and recorded on LIC 809D. No health and safety hazard were noted during this visit. Exit interview is conducted. Copy of report was issued to the Licensee/Administrator.the state’s words, verbatim · CDSS document, Apr 28, 2025 · control 31-AS-20250424083805

From the deficiency page — Deficiency type: Type B · Section cited: HSC 1569.682(a)(2) · Plan of correction due date: Apr 28, 2025

Transfer of resident upon forfeiture of license or change in use of facility... closure plan...(a)...shall, prior to transfe- rring a resident ... (2) Provide each resident or the responsible person with a written notice no later than 60 days before the intended eviction. Based on interview Licensee/Administrator informed LPM Margaryan and LPA Alvizar-Ettima that a 60 day closure notice was drafted and a copy was issued to one (01) of the residents on 04/25/25 and on 04/26/25 the other three (03) residents received the notices.the state’s words, verbatim · CDSS document, Apr 28, 2025

Plan of correction: Licensee/Administrator is now aware of the requirement to give residents a 60 day closure notices. POC cleared upon contact with LPM Margaryan and LPA Alvizar-Ettima Licensee/Administrator made the corrections by creating closure notice corrections & added eviction clause to the 60 day notice dated 04/25/25

Allegation investigated: Staff did not comply with infectious control requirements.

Licensing Program Analyst (LPA) Mariana Agban conducted an unannounced subsquent complaint visit for the above allegation. LPA arrived and met with the Adminisistrator Tami Akahoshi and explained the reason for the visit. LPA conducted a physical plan tour, to ensure health and safety of the residents are protected and are in compliance with Title 22 Regulations. Allegation: Staff did not comply with infectious control requirements. It was alleged that staff did not comply with infectious control requirements, which led to two residents becoming sick, and one of the residents passed away. LPA conducted records review, which indicated that R3 passed away due to cardioraspitory failure. Hospital records indicated that R3 was present at USC Verdugo Hills Hospital with severe kidney pain. Interview with Staff#1(S1) revealed that S1 had symptoms of cold and did not take sick leave to prevent the spread of the disease. Although S2 mentioned that the facility had stopped group dining and activities, the facility staff did not comply with the facility's infection control plan. (Continue on 9099C) Substantiated The facility's infectious control plan indicates on page 5 that if symptoms of any kind of disease or illness appear in a staff member, the facility will enforce the sick leave restriction policy to prevent the spread of disease or illness. Based on the information obtained, the allegation is deemed substantiated at this time. Exit interview conducted, citation issued and copy of this report delivered.the state’s words, verbatim · CDSS document, Apr 24, 2025 · control 31-AS-20250324092718

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87465(a)(9) · Plan of correction due date: Apr 28, 2025

(9) The licensee shall ensure that infection control practices are maintained in the facility as specified in Section 87470, Infection Control Requirements Based on interviwes and record review, the administrator did not comply with the section cited above. S1 had symptoms of cold and did not take sick leave to prevent the spread of the disease which poses a potential health, safety or personal rights risk to residents in carethe state’s words, verbatim · CDSS document, Apr 24, 2025

Plan of correction: Administrator will provide a statement understanding this section of California code regulation

Allegation investigated: Insufficient Staff to meet resident’s needs.

Licensing Program Analyst (LPA) Mariana Agban conducted an unannounced initial complaint visit for the above allegation. LPA arrived and met with the Adminisistrator Tami Akahoshi and explained the reason for the visit. LPA requested copies of pertinent information which includes and not limited to LIC 500,Resident Roster, Resident #1(R1) Admission Agreement, Physician Report, Appraisal Needs and Services. LPA conducted a physical plan tour, to ensure health and safety of the residents are protected and are in compliance with Title 22 Regulations. Today's investigation consisted of interviews with 4 out of 4 residents, 2 staff members and record review. Allegation: Insufficient Staff to meet resident’s needs. It was alleged that the facility had insufficient staff to meet Resident#1's (R1) needs. Interview with Staff#1 (S1) denies the allegation. S1 stated that there are enough staff to assist with the dependent residents at the facility. S1 mentioned that Resident#1 (R1) had multiple falls due to R1's weakened knees. S1 confirmed calling R1's family member to assist in lifting R1. (Continue on 9099 C) Substantiated LPA reviewed Staff Roster (LIC 500) and observed insufficient staff are working at the facility. Based on information information obtained the allegation is deemed Substantiated at this time. Exit interview conducted, citation issued, appeal rights given and copy of this report delivered.the state’s words, verbatim · CDSS document, Apr 3, 2025 · control 31-AS-20250324092718

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87411(a) · Plan of correction due date: Apr 8, 2025

Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs. This requirement was not met as evidenced by: Based on interviews the facility does not have adequate staff to care for residents. This pose a potential health & safety risk to the residents in care.the state’s words, verbatim · CDSS document, Apr 3, 2025

Plan of correction: Administrator will email LPA LIC500 showing adequate staff coverage by the POC date.

The state marks this report as 4 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Rosaura Valenzuela conducted an unannounced One (1) Year Required annual inspection. LPA met with administrator Tami Akahoshi and explained the purpose of the visit. A tour of the physical plant was conducted at 1:15 PM and the following were noted: The main door is the only entrance being utilized for entry. The facility has seven (7) bedrooms and four (4) bathrooms currently occupying five (5) residents in five (5) private bedrooms. One (1) bedroom and one (1) bathroom is designated for staff use. The facility is fire cleared for six (6) non-ambulatory residents and has hospice waiver for two (2). Physical environment was checked for cleanliness and condition. Walls, windows, ceilings, floors and floor coverings, and doors were checked, the following was noted: Living and dining room furniture were also checked. The living room is neat and clean along with the dining room. The facility maintains a comfortable temperature at 76°F. The smoke detectors are hardwired and inter connected and observed to be operational. The fire extinguisher was filled and last checked on 03/24. There is carbon monoxide detector installed at the facility. The front porch of the facility has outdoor furniture, with a covered shaded area for residents. The front and backyard passageways were clear of any obstruction. There is no body of water in the facility. Continue on 9099C The garage is detached from home and currently being used as frozen foods, tools, supplies, cleaning solutions and other toxins storage. Food Service/Kitchen area was sufficiently stocked with two (2) days perishable and seven (7) days non-perishable food. Frozen foods are properly wrapped and stored appropriately. Food storage and preparation areas are clean and inaccessible to pests. Dishwashing liquid and laundry detergents are kept at a locked cabinet near the laundry area. The laundry area is located adjacent to the kitchen. Knives and sharps are observed to be also kept in the locked. The Residents' rooms are adequately furnished with appropriate furniture and lighting system. Residents have sufficient amounts of personal hygiene product which is provided by the licensee. Staff Rooms: Staff rooms are locked. No medications are observed in the staff room. The bathrooms were checked for cleanliness and proper operation. LPA observed the appropriate grab bars for each toilet, bathtub and shower. The hot water temperature measured at a range 105.4°F. Towels and washcloths are not shared. There is enough clean linen available in stock at the linen cabinet. Medications: LPA observed medication in the kitchen cabinet to be locked and inaccessible to residents. First aid kit is observed to be with complete tools and supplies. No health and safety issues noted at the time of this visit. Exit interview conducted and copy of this report was issued.the state’s words, verbatim · CDSS document, Aug 26, 2024