Routine inspection·October 15, 2025

Licensing Program Analyst (LPA) Christi Coppo arrived unannounced to conduct a required Annual inspection and was greeted by caregiver. Licensee German Sinitsyn arrived later. Facility currently has twelve (12) residents in care none of which are currently on hospice. Aida Reznik Administrator Certificate 7010118740 expires 4/11/27. All fees are current as of this time. Upon arrival, LPA observed residents restrained in wheelchairs. LPA obtained photographic and video evidence of restraints. LPA observed resident (R1) in wheelchair with gait belt being used as restraint. Gait belt was fastened and threaded with belt release placed behind resident in back of wheelchair, inaccessible to resident to release. LPA observed resident (R2) in wheelchair with fabric belt wrapped around their chest area and tied in a knot behind their wheelchair, inaccessible to resident to release. LPA observed resident (R3) in wheelchair with velcro fabric belt wrapped twice around their chest area and back of wheelchair, secured by velcro and the end of the belt tucked into the back right hand side their wheelchair, inaccessible to resident to release ( deficiencies cited, see 809D ). At approximately 10:30am LPA toured the building and grounds. The facility was found to be clean and at a comfortable temperature. LPA observed at least a 2 day supply of perishable and 7 day supply of non-perishable food. Food was found to be stored in a safe manner with open items covered and labeled with opened dates present. LPA observed kitchen cabinet under sink to contain disinfectants and cleaning supplies. Cabinet has magnetic locking mechanism, but lock was malfunctioning at the time of inspection, it was sticking such that when the door closed the lock did not latch. LPA showed malfunction to licensee, Continued on 809C... Continued from 809... licensee got the lock to function properly but licensee will purchase new lock and replace. All other cleaning products and laundry soaps were found inaccessible to residents in care. All bedrooms were equipped with lighting, night stand, and chest of drawers. Lamp in room #8 functions but light bulb wiring loose and could present as a hazard. LPA showed licensee potential hazard; licensee discarded lamp and will replace. All bedrooms were clean and in good repair. However, LPA noticed strong smell of feces in closet of room #7. LPA found source of feces smell in drawer of night stand located in the closet. Bottom drawer had a pile of feces approximately 3 inches high and 6 inches long, covering the entire back right hand corner of the drawer. Pile of feces had some areas of crusting ( deficiency cited, see 809D ). Extra hygiene products and linens were available. Resident bathrooms had required bath mats and grab bars. Water temperature in sinks measured at 111.4 degrees F in the kitchen, 113.7 degrees F in the bathroom of room #2, and 112.4 in the bathroom of room #3, all of which are within the allowable range of 105 to 120 degrees F. Fire extinguishers were last inspected 1/15/25. Smoke/Carbon Monoxide detectors located throughout the facility were operational. Facility has hardwired fire alarm which is serviced by vendor, last date of service was June 2025 per sticker on box. Facility’s last quarterly disaster drill was conducted on 9/2/25. Facility has a backup generator for use during a power outage. At approximately 12:00pm LPA conducted a review of six (6) out of twelve (12) resident files. No deficiencies cited. At approximately 1:45pm LPA conducted a review of six (6) of eight (8) staff records. No deficiencies cited. At approximately 2:30pm LPA and Licensee conducted a spot check of medication and medication records. Medication is centrally stored in a locked cabinet located in the kitchen. LPA discussed with licensee ensuring that all discontinued medication orders are maintained on file. No deficiencies cited. Continued on 809C(2). . . Continued form 809C... Updated copies of the following documents were requested for facility file and are to be submitted to CCL within 30 days of this visit: LIC500- Personnel Report LIC308- Designation of Responsibility Deficiencies cited from the California Code of Regulations, Title 22, Division 6 of California Regulation and the Health and Safety Code. Appeal rights given. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Exit interview conducted with licensee and a copy of this report was given.