Inspection Reports for GEM Oaks
1060 Calle Las Trancas, Thousand Oaks, CA 91360, United States, CA, 91360
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Inspection Report
Annual Inspection
Census: 5
Capacity: 6
Deficiencies: 0
Sep 12, 2025
Visit Reason
The inspection was an unannounced required annual visit to evaluate the facility's compliance with Title 22 regulations.
Findings
The facility was found to be in compliance with all applicable regulations, with no citations issued. The physical plant, resident and personnel records, infection control, emergency planning, and medication management were all satisfactory.
Report Facts
Number of resident files reviewed: 6
Number of personnel files reviewed: 5
Number of resident rooms: 7
Number of resident rooms with exterior exits: 2
Number of restrooms: 4
Number of refrigerators checked: 2
Number of residents whose medications were reviewed: 3
Hot water temperature range in resident restrooms: 105.6-116.1
Kitchen faucet hot water temperature: 118.6
Number of self-latching gates in backyard: 2
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Elmira Sabyrova | Administrator | Facility Administrator present during inspection and involved in entrance interview |
| Erica Mosley | Licensing Program Analyst | Conducted the inspection visit |
| Ernis Sabyrov | Facility Designee | Greeted Licensing Program Analyst and assisted during inspection |
Inspection Report
Annual Inspection
Census: 4
Capacity: 6
Deficiencies: 2
Sep 10, 2024
Visit Reason
The inspection was an unannounced required annual visit to evaluate the facility's compliance with Title 22 regulations and ensure health and safety standards are met.
Findings
The facility was generally found to be in compliance with health and safety regulations, including fire safety, kitchen and common area conditions, and infection control plans. However, two deficiencies were cited related to medication administration inconsistencies and lack of a current annual medical assessment and reappraisal for a resident with dementia.
Severity Breakdown
Type B: 2
Deficiencies (2)
| Description | Severity |
|---|---|
| One medication for each of two residents had changes in orders, but the amount of medications distributed did not match the days elapsed since the changes, posing a potential health risk. | Type B |
| One resident with dementia did not have an annual medical assessment nor a current reappraisal, posing a potential health and safety risk. | Type B |
Report Facts
Residents' medications reviewed: 2
Resident with dementia: 1
Private resident bedrooms: 6
Staff interviewed: 3
Resident interviewed: 1
Emergency disaster drills frequency: 4
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Kelly Dulek | Licensing Program Analyst | Conducted the inspection and authored the report |
| Kristin Heffernan | Licensing Program Manager | Oversaw the inspection process |
| Elmira Sabyrova | Administrator | Facility administrator involved in plan of correction agreements |
Inspection Report
Annual Inspection
Census: 5
Capacity: 6
Deficiencies: 4
Sep 13, 2023
Visit Reason
The Licensing Program Analyst arrived unannounced to conduct a required annual visit to ensure the facility's compliance with Title 22 Regulations and health and safety standards.
Findings
The inspection found multiple deficiencies including expired food items in the refrigerator, unlocked refrigerated medications, accessible cleaning supplies and medications, and hot water temperatures exceeding regulatory limits. The administrator took immediate corrective actions during the visit and agreed to plans of correction for all deficiencies.
Severity Breakdown
Type A: 4
Deficiencies (4)
| Description | Severity |
|---|---|
| Multiple expired food items were identified in the refrigerator posing an immediate health and safety risk. | Type A |
| Unlocked refrigerated medications were observed which need to be kept in a lock box. | Type A |
| Cleaning supplies, over the counter medications, vitamins, and refrigerated medications were accessible to residents with dementia, posing an immediate health and safety risk. | Type A |
| Faucets delivering hot water in bathrooms were delivering water about 120 degrees Fahrenheit, exceeding the maximum allowed temperature and posing an immediate health and safety risk. | Type A |
Report Facts
Facility capacity: 6
Census: 5
Plan of Correction due date: Sep 14, 2023
Hot water temperature: 122.5
Hot water temperature: 128.6
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Elmira Sabyrova | Administrator | Facility administrator present during inspection and named in findings related to medication and food safety |
| Elsie Campos | Licensing Program Analyst | Conducted the inspection and authored the report |
| Jeralyn Ann Pfannenstiel | Licensing Program Manager | Supervisor overseeing the inspection |
Inspection Report
Annual Inspection
Census: 5
Capacity: 6
Deficiencies: 0
Sep 26, 2022
Visit Reason
The inspection was an unannounced Required 1-Year Annual Inspection with a focus on Infection Control, conducted as the first annual inspection following the pre-licensing visit on 2021-09-16.
Findings
The facility was found to be in compliance with Title 22 regulations, with no health or safety hazards observed. Infection control practices were adequate, including proper signage, PPE supply, symptom screening, and vaccination of all staff. No citations were issued.
Report Facts
Days of perishable food supply: 7
Days of non-perishable food supply: 2
Hot water temperature: 118.4
Hot water temperature: 110.7
Facility capacity: 6
Resident census: 5
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Elmira Sabyrova | Licensee / Administrator | Met during inspection and discussed infection control practices |
| Martha Arroyo | Licensing Program Analyst | Conducted the inspection visit |
| Desaree Perera | Licensing Program Manager | Named in report header and signature section |
Inspection Report
Original Licensing
Capacity: 6
Deficiencies: 0
Sep 16, 2021
Visit Reason
An announced pre-licensing visit was conducted to evaluate the facility for licensure and compliance with regulations.
Findings
The facility was found compliant with regulations, with no corrections needed at the time of the visit. The facility has appropriate fire clearance, safety equipment, furnishings, and emergency preparedness measures in place.
Report Facts
Facility capacity: 6
Census: 0
Number of bedrooms: 6
Number of bathrooms: 3.5
Hot water temperature: 114.8
Hot water temperature: 116.6
Hot water temperature: 118.4
Hot water temperature: 113
Non-perishable food supply: 7
Perishable food supply: 2
Number of exit doors: 6
Number of resident bedrooms furnished: 5
Number of bathrooms for resident use: 3
Number of ramps: 2
Number of fence gates: 2
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Elmira Sabyrova | Administrator | Facility representative met during inspection |
| Martha Guzman Chavez | Licensing Program Analyst | Conducted the pre-licensing visit |
| Desaree Perera | Licensing Program Manager | Named in report header |
Inspection Report
Original Licensing
Capacity: 6
Deficiencies: 0
Sep 7, 2021
Visit Reason
Initial licensing evaluation conducted via telephone call with the administrator to confirm understanding of licensing requirements and program policies.
Findings
The applicant and administrator successfully completed the Component II evaluation, demonstrating understanding of facility operation, staff qualifications, program policies, and other licensing requirements. No deficiencies or violations were noted.
Report Facts
Capacity: 6
Census: 0
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Elmira Sabyrova | Administrator/Licensee | Participated in COMP II telephone call and confirmed understanding of licensing requirements |
| Jude De La Concepcion | Licensing Program Manager | Named as Licensing Program Manager on report |
| Marisa Holabird | Licensing Program Analyst | Named as Licensing Program Analyst on report |
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