Follow-up on corrections·July 21, 2025

Licensing Program Analyst (LPA) Trevor Byrne arrived to the facility at 09:59 AM to conduct an unannounced Case Management visit at the facility today. LPA met with staff #1 (S1) who contacted the facility Administrator Emma Avetisyan. The Administrator stated that they are unable to come to the facility during today’s visit but has designated S1 to sign this report on their behalf. Entrance interview was conducted and the reason for the visit was explained. During today’s visit LPA conducted a physical plant tour, reviewed three (3) resident files, and conducted interviews with the Administrator, one (1) staff member, one (1) witness, and two (2) residents between 10:05 AM and 03:00 PM. During interviews and file review LPA observed Resident #1 (R1) and resident #2 (R2)’s files. LPA observed both R1 and R2 to be identified on their medical assessments as “non-ambulatory”. Interviews with the Administrator, S1, and R1 revealed that both R1 and R2 are unable to reposition in bed without the assistance of staff. LPA informed the Administrator that this is a change in condition of the residents and an updated medical assessment is required. LPA informed the Administrator that they were recently cited during the required annual visit on 07/09/2025 for a violation of CCR 87463(f). LPA informed the Administrator that this is a repeat violation of the same regulation within a twelve (12) month period. LPA informed the Administrator that a civil penalty in the amount of $250 is being assessed on today’s date (07/21/2025) for a repeat violation. ` Continued on LIC 809C. During interviews with S1 and the Administrator LPA was informed of the recent hospitalization of R2 on 07/12/2025. LPA reviewed the facility’s file for submitted incident reports and did not observe a report submitted for R2. LPA informed the Administrator who confirmed that they are aware that reports must be submitted to the licensing agency and the resident’s responsible party no later than seven (7) days following the occurrence of the incident. LPA informed the Administrator that they were recently cited for a violation of CCR 87211(a)(1) on 04/29/2025. LPA informed the Administrator that this is a repeat violation of the same regulation within a twelve (12) month period. LPA informed the Administrator that a civil penalty in the amount of $250 is being assessed on today’s date (07/21/2025) for a repeat violation. The following deficiencies and civil penalties were cited (refer to LIC 9099D). This report was read to the Administrator via telephone call. A copy of the report was printed, appeal rights were provided, and exit interview was conducted.