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Inspection visit

Routine inspection

MY ELDERLY HOMELicense 1958506181 citation on this visit
1 citation recorded

Inspector’s narrative

What the inspector wrote

Licensing Program Analyst (LPA) Trevor Byrne arrived at the facility unannounced to conduct the required annual visit at 10:16 AM. LPA met with facility staff who contacted the facility Administrator Diana Tavmasyan. The Administrator arrived to the facility at 10:18 AM. Entrance interview was conducted and the reason for the visit was explained. Beginning at 10:20 AM the LPA, along with the facility Administrator toured the physical plant areas inside and outside to ensure there are no health and safety hazards and that facility is in compliance with Title 22 Regulations. The following was observed: OUTDOOR SPACE: The facility had adequate shaded seating outdoors for resident use. LPA observed all emergency exits to be clear from obstructions. LPA observed two (2) emergency exit gates at the facility. LPA observed cameras located throughout the outdoors of the facility. All ramps were non-slippery and all railings were observed to be secured. KITCHEN : The LPA observed the kitchen area to be clean. Kitchen appliances appeared to be in operable condition. The facility had a sufficient supply of two (2) days perishable and seven (7) days non-perishable food. LPA observed the kitchen to contain secured drawers which contained knives and other sharp objects. Additionally, LPA observed secured cabinets and a secured minifridge which contained resident medications. CONTINUED ON LIC 809C. COMMON AREAS : This includes the dining area, living room, and hallway. LPA observed the dining area to contain adequate seating and a dining table for resident use. LPA observed the living room to contain adequate seating, a television, and activities for resident use. LPA observed the hallway to contain secured storage which contained cleaning supplies, laundry supplies, extra linens, and additional activities. Additionally, the hallway contained the facility’s washer and dryer. LPA observed the dining area to contain a wall mounted fire extinguisher which was fully charged and last serviced on 01/12/2025 which is outside of the range required by regulation. LPA informed the Administrator who agreed to have the extinguisher serviced. LPA observed the dining area to contain a locked cabinet which contained resident, staff, and facility files. BEDROOMS : There are six (6) bedrooms in the facility all are single occupancy resident rooms. LPA and the Administrator toured all six (6) bedrooms. All resident rooms observed were furnished appropriately with clean linens, appropriate furnishings, and sufficient lighting. All bedrooms contained direct exits to the outdoors of the facility. BATHROOMS : There are three (3) bathrooms at the facility, two (2) are shared, and one (1) is private. All resident bathrooms observed were clean and were equipped with nonskid surfaces. Grab bars were observed in all showers and near all toilets, all were properly secured. The water temperature was measured to be between 109.6 and 119.8 degrees Fahrenheit, which is in compliance with regulation. RECORD REVIEW: Record review began at 10:45 AM. Staff and Resident records were reviewed for documents including, but not limited to: health screening, TB test, staff training records, fingerprint clearance, resident physician's report, needs and service appraisal, consent forms, and personal rights. Six (6) resident files were reviewed. All resident files contained all required documentation and signatures. LPA observed two (2) residents at the facility to be identified by their physician as being bedridden. LPA reviewed the facility’s fire clearance and observed that the facility was only cleared to retain one (1) bedridden resident. LPA notified the Administrator that retaining two (2) bedridden residents violated the facility’s fire clearance and that this is a zero-tolerance violation. LPA informed the Administrator that a civil penalty in the amount of $500 is being assessed on today’s date (04/21/2026) for a violation of the facility’s fire clearance. The Administrator expressed understanding and agreed to notify the fire department that they have a bedridden resident residing in a non-bedridden approved room. Five (5) staff files were reviewed. All staff filed contained all required documentation and trainings. CONTINUED ON LIC 809C. MEDICATION REVIEW: Medication review began at 12:52 PM. Medications for three (3) of six (6) residents were observed. All medications were stored properly and were appropriately documented on their respective centrally stored medication and destruction record sheets. No deficiencies were observed during medication review. INFECTION CONTROL/EMERGENCY DISASTER PLANNING: During today’s visit, the LPA reviewed the facility's infection control practices and the facility's emergency disaster plan. The facility’s policies and procedures as they pertain to infection control are adequate. Emergency disaster drills are conducted quarterly; the facility’s last completed disaster drill was conducted on 03/18/2026. The facility’s emergency disaster plan is up to date and is adequate. Both the infection control plan and the emergency disaster plan are reviewed/updated annually by the facility’s Administrator. INTERVIEWS: LPA interviewed two (2) residents. The residents interviewed stated that the staff treat them well and are attentive to their needs. No residents interviewed had any concerns with the facility. LPA interviewed two (2) staff members. Both staff members interviewed were knowledgeable on the resident’s rights, the forms of abuse, and the appropriate reporting procedures for suspected abuse. During today’s visit LPA obtained a copy of the facility’s LIC 500, resident roster, updated disaster plan, and current liability insurance. Pursuant to Title 22 of the CA Code of Regulations, the following deficiencies were cited and civil penalty assessed (refer to LIC 809-D): Exit interview conducted and copy of the report was issued and appeal rights provided.

Citations

1 citation recorded*CCLD

What does Type A vs Type B mean?

Type A. Serious citation. Imminent or substantial risk to children. The regulator requires corrective action immediately and may impose a civil penalty.

Type B. Lower-severity citation. Corrective action required, no imminent risk. The regulator monitors compliance on the next visit.

  • 87202(a)Type A

    Based on record review, the licensee did not comply with the section cited above as two residents were identified by their physician as being bedridden, one of which was not residing in a bedridden approved room when the facility was only approved to retain one bedridden resident. Additionally, the facility's fire extinguisher was not serviced annually which poses an immediate safety risk to persons in care.

FAQ · About this visit

Common questions about this visit

What happened during the April 21, 2026 inspection of MY ELDERLY HOME?

This was a inspection inspection of MY ELDERLY HOME on April 21, 2026. 1 citation were issued: 1 Type A (serious).

Were any citations issued to MY ELDERLY HOME on April 21, 2026?

Yes, 1 citation was issued (1 Type A, 0 Type B). The first citation was for: "Based on record review, the licensee did not comply with the section cited above as two residents were identified by the..."

What type of inspection was this?

This was a inspection inspection. inspection inspections are conducted by CCLD as part of their licensing oversight.

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