Routine inspection·March 18, 2026

Licensing Program Analyst (LPA) Trevor Byrne arrived at the facility unannounced to conduct a required annual visit at 09:44 AM. LPA met with facility staff member Emma Elazyan (S1) who contacted the facility administrator Emma Avetisyan. The Administrator informed LPA that they were unable to come to the facility at the time of the visit. Facility representative Meri Tarposhyan (S2) arrived to the facility at approximately 11:50 AM. Entrance interview was conducted and the reason for the visit was explained. The following was observed: MEDICATION REVIEW: Medication review began at 09:55 AM. Medications for six (6) of six (6) residents were observed. LPA observed Resident #1’s (R1) medications to be improperly documented on their centrally stored medication and destruction record sheet (CSMDR). LPA informed S2 who stated that the medications arrived at the facility at approximately 08:00 PM the previous night (03/17/2026) and had not yet been documented on the CSMDR. Additionally, LPA observed one (1) medication from Resident #2 (R2) to not be logged appropriately on their CSMDR. During medication review LPA observed a total of twenty three (23) medications across all six (6) residents to have errors in the medication count. LPA and S2 observed the CSMDRs for all six (6) residents and confirmed that the amount of medications remaining in the bottles did not match the amount of medications that should be left based on the recorded start date and medication administration instructions. S2 was unable to provide LPA with a justification as to why the medication count was incorrect. This deficiency was cited under a complaint report for this facility. No deficiency for this violation is being generated under this report. Continued on LIC 809C. RECORD REVIEW: Record review began at 11:50 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. Four (4) staff files were reviewed. One (1) staff file was not located at the facility for LPA's review. LPA informed S2 that all personnel records shall be maintained at the facility for review. Four (4) staff files were observed to contain expired 1st aid certifications. Six (6) resident files were reviewed. One (1) resident file was observed to contain a blank Appraisal Needs and Services (ANS) plan, and two (2) resident files contained ANS that were created more than twelve (12) months prior. LPA informed S2 that appraisals shall be updated in writing as frequently as necessary or once every 12 months, whichever occurs first, to note significant changes in condition. LPA observed two (2) resident admission agreements to be missing the rate for all basic services which the facility is required to provide. LPA observed Resident #3 (R3)’s resident file to contain a physician’s report dated 11/05/2024. LPA informed S2 and the Administrator that Community Care Licensing Division (CCLD) is requesting an updated physician’s report for R3 due to a changes in the condition of R3 since the report was created. Due to time constraints LPA will return at a later date to conduct a physical plant tour, a review of the infection control plan and emergency disaster plan, interviews with residents and staff, and to collect copies of pertinent documents. The facility Administrator was unable to come to the facility to sign this report but has designated S1 to sign on their behalf. This report was read to the Administrator via telephone call. Pursuant to Title 22 of the CA Code of Regulations, the following deficiencies were cited (refer to LIC 809-Ds): Exit interview conducted and copy of the report was issued and appeal rights provided.