Correction check·November 13, 2025

At 9:30 AM, Licensing Program Analysts (LPAs) Huma Rahimi and Angela Panushkina conducted an unannounced Plan of Correction (POC) visit to the above-named facility to verify correction of deficiencies cited during the case management visit dated 10/13/2025. Upon arrival LPAs met with the staff #1 (S1), who granted access to the facility. LPA Rahimi requested the phone number for the Administrator. At 10:25am, LPA attempted to contact the Administrator, but no one answered. LPA left a voicemail with a call back number. During the prior complaint visit (control #31-AS-20250828113316 ) conducted on 09/02/2025 and a subsequent visit conducted on 10/13/2025 LPA also contacted the Administrator and both times the Administrator was unable to come to the facility. Therefore, the facility will be cited for not having Administrator available upon request. At 10:30 AM, Mari Akmakchyan, Staff #3, arrived to the facility and LPAs explained the purpose of the visit. During today’s visit, LPAs verified the status of three deficiencies previously cited. The first deficiency, cited under Title 22, Section 87211(a)(1)(D) – Reporting Requirements, was not cleared. Incident report involving Resident #2 (R2) which occurred in the last week of June 2025, was not submitted to Community Care Licensing (CCL). A new citation and civil penalty will be issued. LPAs were informed that the staff training on mandated reporting has not been conducted. The second deficiency, cited under Title 22, Section 87202(a) – Fire Clearance, also remains not cleared. LPAs observed two (2) non-ambulatory residents, identified as R3 and R4, still residing in the facility. The third deficiency, cited under Health and Safety Code Section 1569.17(a)(2) – Criminal Record Clearance. During today's visit, LPA conducted review of the facility guardian and observed that the staff (previously not being fingerprinted) is already associated with this facility. Continue on LIC 809C However, LPAs observed Staff #1 (S1) and Staff #2 (S2), currently present and providing direct care and supervision to residents are not fingerprint cleared and or associated with the facility. LPAs were informed that S1 started working since February 2025 and S2 started working as of today (11/13/2025). Based on today’s observations and interviews, three (3) out of three (3) deficiencies that were previously cited remain not cleared: failure to submit an Unusual Incident/Injury Report, exceeding approved fire clearance by retaining non-ambulatory residents, and Criminal Record Clearance by having two staff (S1 and S2) without proper fingerprint clearance and association to the facility . During today's visit, an additional deficiency was also observed and issued. Civil penalties were discussed and issued where applicable. A follow-up visit will be conducted to verify correction of the cited deficiencies. Deficiencies issued and appeal rights explained. An exit interview conducted and copy of this report signed and delivered.