Inspection Report Summary
Most inspections found no deficiencies, with the facility consistently maintaining clean and safe living areas, secure medication storage, and proper safety equipment. The most recent report from July 28, 2025, was perfect with no deficiencies noted. Earlier reports showed some issues, including improper use of postural supports restricting resident movement, unapproved structural changes, and a privacy violation due to a camera in residents’ rooms, which was promptly corrected. Several complaint investigations were unsubstantiated, and minor issues like unlocked cleaning supplies were isolated. The facility appears to have improved over time, with recent inspections showing no deficiencies after addressing prior concerns.
Deficiencies per Year
4
3
2
1
0
High
Census Over Time
Census
Capacity
Inspection Report
Annual Inspection
Census: 4
Capacity: 6
Deficiencies: 0
Jul 28, 2025
Visit Reason
An unannounced annual inspection was conducted to evaluate compliance with licensing requirements and assess the physical plant and facility operations.
Findings
The facility was found to be in good repair with clean living areas, properly maintained bedrooms and bathrooms, secure medication storage, and adequate safety measures including operable smoke and carbon monoxide detectors. No citations or deficiencies were issued during the inspection.
Report Facts
Capacity: 6
Census: 4
Food supply: 7
Fire extinguisher date: 2025
Liability insurance expiration: 2025
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Arsen Der-Aprahamian | Administrator | Met with Licensing Program Analyst during inspection |
| Gina Saucedo | Licensing Program Analyst | Conducted the inspection |
| Troy Agard | Licensing Program Manager | Named as Licensing Program Manager on report |
Inspection Report
Annual Inspection
Census: 4
Capacity: 6
Deficiencies: 0
Aug 7, 2024
Visit Reason
The inspection was an unannounced annual inspection conducted to evaluate compliance with licensing requirements for the facility.
Findings
The facility was toured inside and out, with observations noting clean and well-maintained living areas, bedrooms, bathrooms, and kitchen. Safety features such as locked medication storage, operable smoke and carbon monoxide detectors, and a fire extinguisher were confirmed. No citations were issued during the exit interview.
Report Facts
Licensed capacity: 6
Resident census: 4
Food supply duration: 7
Building permit date: Mar 28, 2024
Liability insurance expiration: 202412
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Gina Saucedo | Licensing Program Analyst | Conducted the inspection and authored the report |
| Arsen Der-Aprahamian | Administrator | Facility administrator met during inspection |
| Julieta Avagyan | Caregiver | Met with Licensing Program Analyst during inspection |
| Troy Agard | Licensing Program Manager | Named as Licensing Program Manager on the report |
Inspection Report
Complaint Investigation
Census: 3
Capacity: 6
Deficiencies: 0
Jan 8, 2024
Visit Reason
The visit was an unannounced complaint investigation conducted in response to a complaint received on 2023-12-14 regarding allegations of staff causing injury, not changing residents' clothing, restraining residents, and inadequate supervision.
Findings
Based on resident and staff interviews, observations, and record reviews, all four allegations were found to be unsubstantiated. No injuries were observed, residents' clothing was changed regularly, doctor’s orders were present for restraints, and adequate supervision was provided.
Complaint Details
The complaint included allegations that staff caused injury to residents, did not change residents' clothing for multiple days, restrained residents without doctor’s orders, and did not provide adequate supervision. All allegations were unsubstantiated after investigation.
Report Facts
Capacity: 6
Census: 3
Number of allegations: 4
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Gina Saucedo | Licensing Program Analyst | Conducted the complaint investigation |
| Arsen Der-Aprahamian | Administrator | Facility administrator present during the investigation |
Inspection Report
Complaint Investigation
Census: 3
Capacity: 6
Deficiencies: 2
Dec 19, 2023
Visit Reason
Licensing Program Analysts conducted a case management visit in conjunction with a complaint visit to evaluate the facility and address deficiencies noted during a prior visit on 9/28/23.
Findings
Deficiencies were cited related to personal accommodations and services, including improper use of rooms and lack of a written physician order for postural support for a resident, posing an immediate health and safety risk.
Complaint Details
The visit was complaint-related and conducted as a case management visit in conjunction with a complaint investigation. No corrections from the prior visit on 9/28/23 had been addressed as of 12/19/2023.
Severity Breakdown
Type A: 2
Deficiencies (2)
| Description | Severity |
|---|---|
| Bed in storage room, staff accommodations in a garage and ADU structure not designated as staff rooms in the plan of operation or facility sketch. | Type A |
| Failure to ensure resident has a written order for postural support placed on resident's bed, posing an immediate health and safety risk. | Type A |
Report Facts
Capacity: 6
Census: 3
Deficiencies cited: 2
Plan of Correction Due Dates: 12
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Arsen Der-Aprahamian | Administrator | Met with during inspection; discussed deficiencies and plan of correction |
| Tihesha Smith | Licensing Program Analyst | Conducted inspection and authored report |
| Naira Margaryan | Licensing Program Manager | Supervisor overseeing inspection |
Inspection Report
Complaint Investigation
Census: 3
Capacity: 6
Deficiencies: 1
Dec 19, 2023
Visit Reason
An unannounced complaint investigation visit was conducted in response to a complaint alleging that staff do not accord a reasonable level of privacy to residents in care.
Findings
The investigation substantiated the allegation that a camera was present in the rooms of two residents, violating their privacy rights. The licensee/administrator immediately removed the camera, and the deficiency was cleared at the time of the visit.
Complaint Details
The complaint was substantiated based on observations and interviews. The allegation was that staff did not accord a reasonable level of privacy to residents, specifically due to a camera in residents' rooms.
Severity Breakdown
Type A: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| Failure to ensure residents' privacy due to presence of a camera in residents' rooms, violating personal rights as per CCR 87468.2(a)(1). | Type A |
Report Facts
Capacity: 6
Census: 3
Deficiencies cited: 1
Plan of Correction Due Date: Dec 20, 2023
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Gina Saucedo | Licensing Program Analyst | Conducted the complaint investigation and signed the report |
| Arsen Der-Aprahamian | Administrator | Facility administrator present during investigation and named in findings |
| Tihesha Smith | Licensing Program Analyst | Assisted in conducting the complaint investigation |
| Troy Agard | Licensing Program Manager | Named as Licensing Program Manager on report |
Inspection Report
Annual Inspection
Census: 4
Capacity: 6
Deficiencies: 3
Sep 28, 2023
Visit Reason
The inspection was an unannounced 1-year case management annual continuation visit to ensure compliance with Title 22 regulations and assess the facility's health and safety conditions.
Findings
The inspection found deficiencies including improper use of postural supports restricting resident movement, unapproved structural changes without required permits, and staff accommodations not designated in the plan of operation. These deficiencies posed immediate health, safety, or personal rights risks and require correction.
Severity Breakdown
Type A: 3
Deficiencies (3)
| Description | Severity |
|---|---|
| Use of a cloth strap to restrict resident’s movement such as falling out of a chair, violating postural support regulations. | Type A |
| Facility made structural changes without notifying CCLD or obtaining required building permits. | Type A |
| Staff accommodations observed in areas not designated as staff rooms in the plan of operation or facility sketch, including a bed in storage and a garage converted to staff living space. | Type A |
Report Facts
Capacity: 6
Census: 4
Deficiencies cited: 3
Plan of Correction Due Date: Sep 29, 2023
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Arsen Der-Aprahamian | Administrator | Facility administrator present during inspection |
| Naira Margaryan | Licensing Program Manager | Conducted inspection and cited deficiencies |
| Tihesha Smith | Licensing Program Analyst | Conducted inspection and cited deficiencies |
| Gina Saucedo | Licensing Program Analyst | Conducted inspection |
Inspection Report
Annual Inspection
Census: 4
Capacity: 6
Deficiencies: 0
Sep 12, 2023
Visit Reason
An unannounced required 1-year inspection was conducted to ensure compliance with Title 22 Regulations and to check for health and safety hazards.
Findings
The facility was observed to be in compliance with regulations, with common areas clean and appropriately furnished, sufficient food supply for residents, medications securely stored, and functional appliances. The inspection was not fully completed due to time constraints and will be finished later.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Arsen Der-Aprahamian | Administrator | Met with during inspection and greeted Licensing Program Analysts. |
| Tihesha Smith | Licensing Program Analyst | Conducted the inspection and authored the report. |
| Gina Saucedo | Licensing Program Analyst | Conducted the inspection. |
| Naira Margaryan | Licensing Program Manager | Named in the report as Licensing Program Manager. |
Inspection Report
Annual Inspection
Census: 4
Capacity: 6
Deficiencies: 1
Aug 10, 2022
Visit Reason
The inspection was an unannounced annual inspection conducted to evaluate the facility's compliance with licensing requirements.
Findings
The facility was generally clean and properly furnished with adequate infection control measures and safety equipment. However, a deficiency was noted regarding the improper storage of a cleaning chemical bottle in an unlocked cabinet under the kitchen sink.
Severity Breakdown
Type A: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| Cleaning supply bottle located in an unlocked cabinet under the kitchen sink. | Type A |
Report Facts
Capacity: 6
Census: 4
Plan of Correction Due Date: Aug 10, 2022
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Joscelyn Martinez | Licensing Program Analyst | Conducted the inspection and noted the deficiency |
| Arsen Der-Aprahamian | Administrator | Facility administrator met during inspection |
| Nichelle Gillyard | Licensing Program Manager | Supervisor overseeing the inspection |
Inspection Report
Complaint Investigation
Capacity: 6
Deficiencies: 0
Jul 27, 2022
Visit Reason
The inspection was conducted as part of an investigation related to complaint control #29-NP-20220222171126, which was determined to be unrelated to this facility.
Findings
No health and safety concerns were observed during the visit. An interview was conducted with a resident relevant to the complaint investigation, and an exit interview was completed.
Complaint Details
The complaint investigation was unrelated to this facility.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Arsen Der-Aprahamian | Administrator | Spoke with Licensing Program Analyst over the phone regarding the inspection. |
| Elsie Campos | Licensing Program Analyst | Conducted the unannounced collateral inspection and interview with resident. |
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