6 Reports
Inspection Report — Jan 8, 2026
Annual Inspection State
Date: Jan 8, 2026
Visit Reason
Licensing Program Analyst Nune Margaryan conducted an Annual Required visit and inspection of the facility to assess compliance with licensing requirements.
Findings
The facility was generally found to be clean, well-maintained, and compliant with safety and operational standards. However, a deficiency was cited due to a staff member lacking a required criminal record clearance, posing an immediate risk to residents.
Citations (1)
Staff member did not have a criminal record clearance prior to working in the licensed facility.
Report Facts
Deficiencies cited: 1
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Diana Castellanos | Administrator | Facility Administrator who assisted with the inspection visit |
| David Fontecha | Staff | Staff member met during inspection |
| Nune Margaryan | Licensing Program Analyst | Conducted the annual inspection |
| Wei Siew Ho | Licensing Program Manager | Named in report header and deficiency section |
Inspection Report — Jan 16, 2025
Annual Inspection State
Date: Jan 16, 2025
Visit Reason
An unannounced annual inspection was conducted using the CARE inspection tool to evaluate compliance with licensing requirements for the facility.
Findings
The facility was found to be in good repair with clean and sufficient living areas, adequate food supplies, and proper safety equipment. One deficiency was noted regarding the use of full bed rails on a resident not on hospice care, which poses a potential safety risk.
Citations (1)
Use of full bed rails on resident #2's bed who is not on hospice care, posing a potential health, safety, or personal rights risk.
Report Facts
Residents present: 6
Staff files reviewed: 5
Residents files reviewed: 5
Fire drill date: Nov 6, 2024
Fire extinguisher last checked: Oct 8, 2024
Water temperature: 118.5
Plan of Correction due date: Jan 23, 2025
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Mary G Flores | Licensing Evaluator | Conducted the inspection and signed the report |
| Nicol Wesley | Licensing Program Analyst | Conducted the inspection |
| David Fontecha | Caregiver | Met with LPAs during inspection |
| Tony Vasallo | Supervisor | Supervisor named in report |
| Diana Castellanos | Administrator | Administrator certificate observed |
| Mariam Nikogsyan | Facility representative during exit interview |
Inspection Report — Dec 2, 2023
Annual Inspection State
Date: Dec 2, 2023
Visit Reason
An unannounced annual visit was conducted using the CARE inspection tool to evaluate compliance with licensing regulations for a residential care facility for the elderly.
Findings
The facility was generally in good repair and clean, but several deficiencies were noted including medication labeling and storage issues, water temperature below required levels, missing pre-admission appraisal for a resident, lack of posted complaint information, and incomplete staff training records.
Citations (7)
Resident #4's medication was observed without a prescription label which poses an immediate health, safety or personal rights risk.
Resident #4's medication was not stored in its original container, posing an immediate health, safety or personal rights risk.
Water temperature in bathroom tested at 86.3 degrees F, below the required 105-120 degrees F, posing a potential health, safety or personal rights risk.
Resident #3 does not have a pre-admission appraisal on file, posing a potential health, safety or personal rights risk.
Poster (PUB 745) was not posted in the facility, posing a potential health, safety or personal rights risk.
4 out of 5 staff files reviewed did not have initial training provided for staff #2-#5, posing a potential health, safety or personal rights risk.
4 out of 5 staff files reviewed did not have 20 hours of annual training for staff #2-#5, posing a potential health, safety or personal rights risk.
Report Facts
Water temperature: 86.3
POC Due Date: Dec 4, 2023
POC Due Date: Dec 8, 2023
Staff files missing initial training: 4
Staff files missing annual training: 4
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Hakob Gevorkyan | Caregiver | Met with Licensing Program Analyst during inspection |
| Nvard Gevorkian | Administrator | Named in exit interview and responsible for corrective actions |
| Mary G Flores | Licensing Program Analyst | Conducted the inspection and authored the report |
| Tony Vasallo | Supervisor | Supervisor overseeing the licensing evaluation |
Inspection Report — Nov 29, 2022
Annual Inspection State
Date: Nov 29, 2022
Visit Reason
An unannounced annual visit was conducted focusing on infection control, medication, and food review.
Findings
The facility was generally clean and in good repair with sufficient food and safety equipment; however, a deficiency was noted due to the lack of physician's orders for half bed rails for two residents, posing an immediate health and safety risk.
Citations (1)
Lack of physician's orders for half bed rails for residents #3 and #4.
Report Facts
Residents observed with half bed rails without physician's orders: 2
Residents reviewed for medication: 3
Resident files reviewed: 5
Staff files reviewed: 3
Water temperature: 114.6
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Nvard Gevorkian | Administrator | Named in relation to the inspection and deficiency findings |
| Mary G Flores | Licensing Program Analyst | Conducted the inspection |
| Melanya Khachatryan | Caregiver | Met with Licensing Program Analyst during inspection |
Inspection Report — Jun 21, 2022
Complaint Investigation State
Date: Jun 21, 2022
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by an allegation that the facility was not allowing residents to choose the hospice service of their choice.
Complaint Details
Complaint alleged that the facility was not allowing residents to choose hospice service of their choice. The complaint was investigated and found to be unfounded.
Findings
The investigation found that the alleged resident did not reside at the facility and that residents are given the choice to select their hospice agency. Three residents were currently under hospice care from two different agencies. The complaint was determined to be unfounded due to insufficient evidence supporting the allegations.
Report Facts
Residents interviewed: 5
Residents under hospice care: 3
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Mary G Flores | Licensing Program Analyst | Conducted the complaint investigation visit |
| Nvard Gevorkian | Administrator | Facility administrator interviewed during investigation |
Inspection Report — Feb 7, 2022
Annual Inspection State
Date: Feb 7, 2022
Visit Reason
Licensing Program Analyst Mary Flores conducted an unannounced annual visit focusing on infection control, medication, and food review.
Findings
The facility was found to be in compliance with no deficiencies cited. Observations included proper food supplies, locked sharps and chemicals, adequate lighting and furniture, safe water temperature, working smoke/carbon monoxide detectors, and adherence to COVID-19 screening recommendations.
Report Facts
Residents present: 6
Water temperature: 111.7
Medication review: 2
Staff files reviewed: 2
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Nvard Gevorkian | Administrator | Administrator present during inspection and named in report |
| Lida Gasparyan | Caregiver | Caregiver present during inspection and named in report |
| Mary Flores | Licensing Program Analyst | Conducted the inspection visit |
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