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Inspection visit

Follow-up on corrections

BLUE SKY MANOR INCLicense 3060057921 citation on this visit
1 citation recorded

Inspector’s narrative

What the inspector wrote

Licensing Program Analysts (LPAs) Jessica Cho and Samer Haddadin arrived at the facility unannounced on a Case Management- Deficiencies visit. Deficiency was observed during the investigation conducted on March 18, 2025 into Complaint Control #: 22-AS-20250127111244 . LPAs met with Program Director Sona Hakobyan and explained the purpose of the visit. LPA requested copies of pertinent resident documentation which includes the Resident Roster identifying residents enrolled in the health insurance program, Personnel Report Summary, and pertinent resident information. During the course of the investigation mentioned above, it was determined that residents, under the publicly funded health insurance plan, are temporarily housed at the facility on short term. Based on the review of the plan of operation, the licensee is not operating the facility in accordance with the terms specified in the plan of operation approved by the Department by not adhering to their program description and has acknowledged that the program was introduced after licensure. Therefore, based on observations, interviews, and record review, a deficiency is being cited as per the Title 22, Division 6, Chapter 8 of the California Code of Regulations. Refer to the LIC809-D. An exit interview was conducted with Administrator Gabriel Airapetian in person and on the phone with Chief Executive Officer Albert Zakaryan, and a copy of this report and appeal rights were provided at exit.

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.

  • 87208(a)Type B

    87208 Plan of Operation (a) "The licensee shall have and maintain a current, written definitive plan of operation for the facility. The licensee shall operate the facility in accordance with the terms specified in the plan of operation and may be cited for not doing so..."This requirement was not met as evidenced by: Based on interviews and record review, the facility is/did not comply with the section cited above by not adhering to the plan of operation approved by Department which poses a potential Health, Safety, or Personal Rights risk to persons in care.

FAQ · About this visit

Common questions about this visit

What happened during the May 1, 2025 inspection of BLUE SKY MANOR INC?

This was a other inspection of BLUE SKY MANOR INC on May 1, 2025. 1 citation were issued: 1 Type B.

Were any citations issued to BLUE SKY MANOR INC on May 1, 2025?

Yes, 1 citation was issued (0 Type A, 1 Type B). The first citation was for: "87208 Plan of Operation (a) "The licensee shall have and maintain a current, written definitive plan of operation for th..."

What type of inspection was this?

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

SourceView on CCLDView original report

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Data from CCLD public records. Last updated . If you believe any information is inaccurate, report it here.