Inspection Reports for Raya’s Paradise, Inc III
1533 North Stanley Avenue, Los Angeles, CA 90046, CA, 90046
Back to Facility ProfileInspection Report Summary
Most inspections found no deficiencies, showing the facility consistently maintained a clean, safe, and well-kept environment with proper care and supervision for residents. The most recent report from October 27, 2025, had no deficiencies and noted no health or safety risks during an unannounced visit. Earlier reports included a few isolated deficiencies, such as a substantiated complaint in August 2024 where a resident was injured due to improper assistance and a missing Special Incident Report in October 2024. Other minor issues involved missing medications in September 2023 and absent grab bars in bathrooms in April 2022, but these were isolated and addressed. Several complaint investigations were substantiated only in the cases mentioned, while most visits found no problems, indicating improvement and stable compliance over time.
Deficiencies (last 5 years)
Deficiencies (over 5 years)
0.8 deficiencies/year
Deficiencies are regulatory violations found during state inspections.
80% better than California average
California average: 4 deficiencies/yearDeficiencies per year
4
3
2
1
0
Census
Latest occupancy rate
36% occupied
Based on a October 2025 inspection.
This facility has shown a decline in demand based on occupancy rates.
Census over time
Inspection Report
Census: 4
Capacity: 11
Deficiencies: 0
Oct 27, 2025
Visit Reason
An unannounced case management visit was conducted to perform health checks and a physical plant inspection of common areas including living/dining room, resident rooms, and bathrooms.
Findings
No health and safety risks were observed during the visit.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Tuesday Cabiness | Licensing Program Analyst | Conducted the unannounced case management visit. |
| Maria Castellanos | Staff member met with during the visit. | |
| Brian Rosales | Executive Director | Notified via phone about the reason for the visit. |
Inspection Report
Census: 5
Capacity: 11
Deficiencies: 0
Oct 17, 2025
Visit Reason
An unannounced case management visit was conducted to inspect the physical plant including common areas, resident rooms, bathrooms, and kitchen for health and safety compliance.
Findings
No health and safety risks were observed during the visit. The inspection included physical plant checks and food supply inspection in the kitchen.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| George Tristan | Met with Licensing Program Analyst during the visit. | |
| Brian Rosales | Executive Director | Notified via phone about the reason for the visit. |
Inspection Report
Census: 6
Capacity: 11
Deficiencies: 0
Oct 17, 2025
Visit Reason
Unannounced case management visit to conduct health and safety observations.
Findings
No health and safety issues were observed during the visit. Residents appeared comfortable and staff were providing care and supervision.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Raymond Comer | Licensing Program Analyst | Conducted the unannounced case management visit. |
| Moti Gamburd | Administrator | Facility administrator met with Licensing Program Analyst during the visit. |
Inspection Report
Census: 6
Capacity: 6
Deficiencies: 0
Oct 10, 2025
Visit Reason
The visit was an unannounced case management visit to conduct health and safety observations at the facility.
Findings
No health and safety issues were observed during the visit. Residents were comfortable and receiving appropriate care and supervision.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Kevin Moscoso | Scheduling Coordinator | Met with Licensing Program Analyst during the visit and discussed the reason for the visit. |
| Michael Gamburd | Administrator | Named as facility administrator. |
| Ray Comer | Licensing Program Analyst | Conducted the unannounced case management visit. |
| Nichelle Gillyard | Licensing Program Manager | Named as Licensing Program Manager on the report. |
Inspection Report
Census: 6
Capacity: 11
Deficiencies: 0
Oct 10, 2025
Visit Reason
An unannounced case management visit was conducted to perform health and safety observations at the facility.
Findings
No health and safety issues were observed during the visit. Residents appeared comfortable and staff were observed providing care and supervision.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Brian Rosales | Administrator | Met with during the inspection visit. |
| Raymond Comer | Licensing Program Analyst | Conducted the unannounced case management visit. |
Inspection Report
Census: 5
Capacity: 11
Deficiencies: 0
Oct 6, 2025
Visit Reason
An unannounced case management visit was conducted to perform a physical plant inspection of common areas including living/dining room, resident rooms, and bathrooms.
Findings
No health and safety risks were observed during the visit. The exit interview and a copy of the report were provided to the House Manager.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Kevin Moscoso | House Manager | Present during the visit and informed of the reason for the visit. |
| Maria Castellanos | Staff | Met with Licensing Program Analyst and informed of the reason for the visit. |
| Brian Rosales | Executive Director | Notified and on his way to the facility during the visit. |
Inspection Report
Census: 6
Capacity: 6
Deficiencies: 0
Oct 3, 2025
Visit Reason
Unannounced case management visit to conduct health and safety observations.
Findings
No health and safety issues were observed during the visit. Staff were observed providing care and supervision to residents, and activities were conducted to assist residents with mobility exercises.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Raymond Comer | Licensing Program Analyst | Conducted the unannounced case management visit and observations. |
| Michael Gamburd | Administrator | Facility administrator met with Licensing Program Analyst during the visit. |
| Brian Rosales | Met with Licensing Program Analyst during the visit. | |
| Nichelle Gillyard | Licensing Program Manager | Named as Licensing Program Manager on the report. |
Inspection Report
Census: 6
Capacity: 11
Deficiencies: 0
Oct 3, 2025
Visit Reason
The visit was an unannounced case management visit to conduct a facility health and safety observation.
Findings
No health and safety issues were observed during the visit. Two facility caregivers were observed providing care and supervision to residents.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Brian Rosales | Administrator | Met with Licensing Program Analyst during the visit. |
Inspection Report
Census: 6
Capacity: 6
Deficiencies: 0
Sep 25, 2025
Visit Reason
An unannounced case management visit was conducted to perform health and safety observations at the facility.
Findings
During the visit, residents were observed to be comfortable and no health or safety issues were identified. Staff were seen providing care and supervision appropriately.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Michael Gamburd | Administrator | Named as the facility administrator met during the visit. |
| Brian Rosales | Met with Licensing Program Analyst during the visit. | |
| Raymond Comer | Licensing Program Analyst | Conducted the inspection visit. |
| Nichelle Gillyard | Licensing Program Manager | Named as Licensing Program Manager on the report. |
Inspection Report
Census: 6
Capacity: 11
Deficiencies: 0
Sep 25, 2025
Visit Reason
The visit was an unannounced case management visit to conduct a facility health and safety observation.
Findings
No health and safety issues were observed during the visit. Residents were comfortable and staff were observed providing care and supervision.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Brian Rosales | Administrator | Met with the Licensing Program Analyst during the visit. |
| Raymond Comer | Licensing Program Analyst | Conducted the unannounced case management visit. |
| Moti Gamburd | Administrator/Director | Named as facility administrator/director in the report header. |
Inspection Report
Census: 6
Capacity: 11
Deficiencies: 0
Sep 22, 2025
Visit Reason
An unannounced case management visit was conducted to perform health checks and inspect the physical plant of the facility.
Findings
No health and safety risks were observed during the visit after inspection of common areas including living/dining room, resident rooms, bathrooms, and kitchen area.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Tuesday Cabiness | Licensing Program Analyst | Conducted the unannounced case management visit. |
| Maria Castellanos | Staff member met during the visit and informed of the reason for the visit. | |
| Brian Rosales | Executive Director | Contacted by staff during the visit. |
Inspection Report
Census: 6
Capacity: 6
Deficiencies: 0
Sep 19, 2025
Visit Reason
The visit was an unannounced case management visit to conduct health and safety observations at the facility.
Findings
No health and safety issues were observed during the visit. Residents were comfortable and staff were observed providing care and supervision.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Kevin Moscoso | Administrator designee | Met with Licensing Program Analyst during the inspection visit. |
Inspection Report
Census: 7
Capacity: 11
Deficiencies: 0
Sep 19, 2025
Visit Reason
The visit was an unannounced case management visit to conduct health and safety observations at the facility.
Findings
During the visit, residents and staff were interviewed and observed, with no health and safety issues noted. Residents appeared comfortable and well cared for.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Kevin Moscoso | Administrator designee | Met with Licensing Program Analyst during the inspection visit. |
Inspection Report
Census: 6
Capacity: 11
Deficiencies: 0
Sep 8, 2025
Visit Reason
An unannounced case management visit was conducted to perform health checks and a physical plant inspection of common areas including living/dining room, resident rooms, bathrooms, and kitchen area.
Findings
No health and safety risks were observed during the visit. The exit interview and a copy of the report were provided to the Executive Director.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Maria Castellanos | Staff met with Licensing Program Analyst during the visit. | |
| Brian Rosales | Executive Director | Contacted by staff during the visit and present at the facility. |
| Tuesday Cabiness | Licensing Program Analyst | Conducted the unannounced case management visit. |
Inspection Report
Census: 5
Capacity: 6
Deficiencies: 0
Sep 4, 2025
Visit Reason
An unannounced case management visit was conducted to perform a facility health and safety observation, including review of documentation and a physical plant inspection.
Findings
No health and safety issues were observed during the visit. The Licensing Program Analyst conducted a tour, interviews, medication audit, and reviewed records with no deficiencies noted.
Report Facts
Residents receiving hospice services: 3
Facility capacity: 6
Current census: 5
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Raymond Comer | Licensing Program Analyst | Conducted the inspection and met with the Administrator. |
| Brian Rosales | Administrator | Met with the Licensing Program Analyst during the visit. |
Inspection Report
Census: 7
Capacity: 11
Deficiencies: 0
Sep 4, 2025
Visit Reason
Unannounced case management visit to conduct a facility health and safety observation and health checks.
Findings
No health and safety issues were observed during the visit. The facility was found clean, appropriately furnished, and equipped with necessary safety features. Medication audit and resident interviews were completed without incident.
Report Facts
Residents receiving hospice services: 2
Facility bedrooms: 8
Facility bathrooms: 2
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Raymond Comer | Licensing Program Analyst | Conducted the inspection and audit. |
| Brian Rosales | Administrator | Met with Licensing Program Analyst during the visit. |
| Moti Gamburd | Administrator/Director | Named as facility administrator/director. |
Inspection Report
Census: 6
Capacity: 11
Deficiencies: 0
Aug 25, 2025
Visit Reason
An unannounced health and safety case management visit was conducted to review facility conditions, client and staff records, and ensure compliance with licensing requirements.
Findings
The facility was observed to be clean and well-maintained with appropriate furnishings and sufficient supplies. No deficiencies or violations were explicitly stated in the report.
Report Facts
Number of resident bedrooms: 9
Number of bathrooms: 10
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Brian Rosales | Executive Director | Participated in the visit and exit interview |
| Kevin Moscoso | House Manager | Arrived during the visit |
| Vanessa Navarro | Med-tech | Greeted Licensing Program Analyst and allowed entry |
| Raven Matthews | Caregiver/Staff | Observed on duty during the visit |
Inspection Report
Annual Inspection
Census: 6
Capacity: 11
Deficiencies: 0
Jul 21, 2025
Visit Reason
An unannounced annual inspection visit was conducted to evaluate the facility's compliance with licensing requirements.
Findings
The facility was found to be in compliance with health and safety standards, with no immediate hazards observed. The physical plant, kitchen, medication storage, resident and staff records were all found to be in good order and properly maintained.
Report Facts
Capacity: 11
Census: 6
Disaster drills last conducted: Apr 1, 2025
Fire extinguisher service date: Jan 7, 2025
Room temperature: 75
Hot water temperature: 112
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Raymond Comer | Licensing Program Analyst | Conducted the inspection and authored the report |
| Moti Gamburd | Administrator | Facility Administrator met during inspection |
Inspection Report
Annual Inspection
Census: 4
Capacity: 11
Deficiencies: 0
Jun 27, 2025
Visit Reason
An unannounced annual inspection visit was conducted at the facility to evaluate compliance with licensing requirements and assess the physical plant, safety, and resident care conditions.
Findings
The facility was found to be clean, well-maintained, and in compliance with safety and health regulations. No health or safety hazards were observed during the inspection, and all required safety equipment and documentation were current and properly maintained.
Report Facts
Fire extinguisher service date: Feb 20, 2025
Room temperature: 75
Hot water temperature: 108
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Raymond Comer | Licensing Program Analyst | Conducted the inspection and authored the report |
| Eva Miller | Licensing Program Manager | Named as Licensing Program Manager on the report |
| Moti Gamburd | Administrator | Facility Administrator met during inspection |
| Brian Rosales | Met with Licensing Program Analyst during inspection |
Inspection Report
Annual Inspection
Census: 5
Capacity: 6
Deficiencies: 0
Jun 26, 2025
Visit Reason
An unannounced annual inspection visit was conducted to evaluate the facility's compliance with licensing requirements and assess the physical plant, safety systems, and resident care environment.
Findings
The facility was found to be clean, well-maintained, and compliant with safety and health regulations. No health or safety hazards were observed, and all required systems such as fire detection and infection control plans were in place and functioning properly.
Report Facts
Capacity: 6
Census: 5
Fire extinguisher inspection date: Mar 4, 2025
Disaster drills date: May 25, 2025
Room temperature: 76
Hot water temperature: 113.5
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Raymond Comer | Licensing Program Analyst | Conducted the inspection and authored the report |
| Michael Gamburd | Administrator | Facility Administrator met during inspection |
| Brian Rosales | Met during inspection | |
| Eva Miller | Licensing Program Manager | Named Licensing Program Manager overseeing the inspection |
Inspection Report
Census: 7
Capacity: 11
Deficiencies: 0
Jun 11, 2025
Visit Reason
An unannounced site visit was conducted for the purpose of obtaining records including census, resident roster, physician reports, and other licensing documents.
Findings
The visit involved obtaining various records and documents from the facility. No specific deficiencies or violations were detailed in the report.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Brian Rosales | Administrator | Met with Licensing Program Analyst during the inspection visit. |
| Gina Saucedo | Licensing Program Analyst | Conducted the unannounced site visit. |
| Troy Agard | Licensing Program Manager | Named as Licensing Program Manager on the report. |
Inspection Report
Census: 5
Capacity: 11
Deficiencies: 0
Jun 11, 2025
Visit Reason
An unannounced site visit was conducted for the purpose of obtaining records including census, resident roster, physician reports, and other documentation.
Findings
The Licensing Program Analyst obtained various records during the visit and conducted an exit interview. No specific deficiencies or violations were noted in the report.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Gina Saucedo | Licensing Program Analyst | Conducted the unannounced site visit and obtained records. |
| Brian Rosales | Administrator | Met with Licensing Program Analyst during the visit. |
| Moti Gamburd | Administrator/Director | Named as facility administrator/director. |
Inspection Report
Census: 4
Capacity: 6
Deficiencies: 0
Jun 10, 2025
Visit Reason
The visit was an unannounced site visit conducted for the purpose of obtaining records.
Findings
During the visit, the Licensing Program Analyst obtained various records including census, resident roster, physician report, admission agreement, and rent payment source. No deficiencies or violations were explicitly stated in the report.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Farrahnaz Javanmardi | Caregiver | Met with during the inspection visit. |
Inspection Report
Complaint Investigation
Census: 6
Capacity: 6
Deficiencies: 1
Oct 31, 2024
Visit Reason
The visit was conducted as a case management-deficiencies visit in conjunction with complaint 31-AS-20230927105732 to investigate the complaint.
Findings
It was confirmed that the Licensee failed to submit a Special Incident Report (SIR) for Resident 1 regarding the development of a pressure injury. A file review did not find the required SIR on file, resulting in deficiencies cited.
Complaint Details
Complaint 31-AS-20230927105732 was investigated and substantiated by confirming the Licensee's failure to submit the required Special Incident Report for Resident 1.
Severity Breakdown
Type B: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| Failure to submit Special Incident Report (SIR) for Resident 1 regarding the development of the pressure injury as required within seven days following the occurrence. | Type B |
Report Facts
Capacity: 6
Census: 6
Plan of Correction Due Date: Nov 22, 2024
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Mariana Agban | Licensing Program Analyst | Conducted the complaint investigation and case management-deficiencies visit |
| Eva Miller | Licensing Program Manager / Supervisor | Supervisor and Licensing Program Manager named in the report |
Inspection Report
Annual Inspection
Census: 6
Capacity: 11
Deficiencies: 0
Aug 20, 2024
Visit Reason
An unannounced annual inspection visit was conducted to evaluate the facility's compliance with licensing requirements and assess the physical plant, resident care, and safety measures.
Findings
The facility was found to be clean, well-maintained, and in compliance with safety and health regulations. No immediate health or safety hazards were observed. All required postings, fire safety equipment, and infection control measures were in place and functional.
Report Facts
Fire extinguishers: 3
Bedrooms: 8
Bathrooms: 2
Resident files reviewed: 6
Staff files reviewed: 6
Hot water temperature: 111
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Brian Rosales | Facility Administrator | Met with Licensing Program Analyst during inspection and named in exit interview |
| Raymond Comer | Licensing Program Analyst | Conducted the inspection visit |
| Eva Miller | Licensing Program Manager | Named as Licensing Program Manager on the report |
Inspection Report
Annual Inspection
Census: 10
Capacity: 11
Deficiencies: 0
Jun 11, 2024
Visit Reason
An unannounced annual visit was conducted to evaluate the facility's compliance with licensing requirements and assess the physical plant, resident records, and staff records.
Findings
The facility was found to be clean, well-maintained, and in compliance with health and safety standards. No immediate health or safety hazards were observed. Resident and staff records were complete and current.
Report Facts
Disaster drills last conducted: Mar 15, 2024
Fire extinguisher service date: Feb 12, 2024
Hot water temperature: 114.8
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Brian Rosales | Facility Administrator | Met during inspection and named in report |
| Raymond Comer | Licensing Program Analyst | Conducted the inspection |
| Eva Miller | Licensing Program Manager | Named in report |
Inspection Report
Annual Inspection
Census: 6
Capacity: 6
Deficiencies: 0
Apr 8, 2024
Visit Reason
A required unannounced annual visit was conducted to evaluate the facility's compliance with licensing regulations and standards.
Findings
The facility was inspected for cleanliness, safety, and compliance with infection control protocols. No immediate health or safety hazards were observed, and all required systems and documentation were found to be current and in good condition.
Report Facts
Disaster drills last conducted: Apr 2, 2024
Fire extinguisher inspection service date: Mar 26, 2024
Hot water temperature: 116.5
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Brian Rosales | Administrator | Met during inspection and discussed reason for visit |
| Raymond Comer | Licensing Program Analyst | Conducted the inspection |
| Eva Miller | Licensing Program Manager | Named as Licensing Program Manager |
Inspection Report
Annual Inspection
Census: 4
Capacity: 6
Deficiencies: 1
Sep 23, 2023
Visit Reason
An unannounced 1-year annual visit was conducted to evaluate compliance with licensing requirements and assess the facility's safety, maintenance, and operational standards.
Findings
The facility was generally found to be clean, safe, and in good repair with proper furnishings and safety equipment. However, a deficiency was noted regarding missing medications for one resident, posing a potential health and safety risk.
Deficiencies (1)
| Description |
|---|
| Missing medications for Resident 2-3 (R2-3) in violation of medication labeling and maintenance requirements. |
Report Facts
Residents present: 4
Total licensed capacity: 6
Staff records reviewed: 4
Disaster drill date: Jan 29, 2023
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Brian Rosales | Administrator | Assisted with the inspection and was involved in medication deficiency observation |
| David Espana | Licensing Program Analyst | Conducted the inspection and authored the report |
| Ulysses Coronel | Licensing Program Manager | Supervisor of the licensing evaluation |
Inspection Report
Annual Inspection
Census: 8
Capacity: 11
Deficiencies: 0
Sep 23, 2023
Visit Reason
An unannounced 1-Year Annual visit was conducted to evaluate the facility's compliance with licensing requirements and assess the physical plant and operational conditions.
Findings
The facility was found to be clean, well-maintained, and in compliance with safety and health regulations. All bedrooms and bathrooms were appropriately furnished and equipped, fire safety equipment was present and operational, and COVID-19 prevention measures were in place. No deficiencies or violations were noted in the report.
Report Facts
Bedrooms: 8
Bathrooms: 2
Fire clearance capacity: 11
Residents receiving hospice: 1
Fire extinguishers: 3
Water temperature range: 105
Water temperature range: 120
Double occupancy bedrooms: 1
Bathrooms not used for showers: 1
Cupboards storing activities: 2
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| David España | Licensing Program Analyst | Conducted the inspection visit |
| Moti Gamburd | Administrator | Facility administrator who assisted with the visit |
| Brain Rosales | Administrator | Facility administrator who assisted with the visit |
Inspection Report
Complaint Investigation
Census: 9
Capacity: 11
Deficiencies: 1
Aug 24, 2023
Visit Reason
The inspection visit was an unannounced complaint investigation triggered by an allegation that a resident sustained an unexplained fracture while in care.
Findings
The investigation found that on 02/28/2023, a resident was improperly assisted during incontinent care without use of a Hoyer Lift, resulting in the resident sliding down the bed and sustaining injuries. The incident was not documented or reported timely by staff. The allegation was substantiated based on interviews, observations, and record review.
Complaint Details
The complaint was substantiated. The allegation was that a resident sustained an unexplained fracture while in care. The investigation confirmed the injury was due to improper assistance by staff.
Severity Breakdown
Type A: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| Failure to comply with CCR 87464(d) Basic Services by not meeting the resident's needs, posing an immediate Health, Safety or Personal Rights risk to persons in care. | Type A |
Report Facts
Capacity: 11
Census: 9
Deficiency count: 1
Plan of Correction Due Date: Aug 29, 2023
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Nicholas Reed | Licensing Program Analyst | Conducted the complaint investigation and authored the report |
| Hector Edward | Senior Investigator | Assisted in the complaint investigation |
| Brian Rosales | Executive Director | Met with Licensing Program Analyst during investigation |
| Moti Gamburd | Administrator | Facility administrator named in report header |
Inspection Report
Routine
Census: 8
Capacity: 11
Deficiencies: 0
May 26, 2022
Visit Reason
The inspection was a required one-year unannounced infection control visit to evaluate compliance with health and safety regulations.
Findings
The facility was found to be clean, well-maintained, and compliant with infection control and safety standards. No deficiencies were cited, and a technical assistance report was issued.
Report Facts
Bedrooms: 8
Bathrooms: 2
Fire extinguishers: 3
Double occupancy bedrooms: 1
Water temperature: 106.7
Water temperature: 115.7
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| LaQueena Lacy | Licensing Program Analyst | Conducted the inspection and authored the report |
| Brain Rosales | Facility manager met with the Licensing Program Analyst during the inspection |
Inspection Report
Annual Inspection
Census: 9
Capacity: 11
Deficiencies: 1
Apr 7, 2022
Visit Reason
The inspection was a required one-year unannounced infection control visit to assess compliance with health and safety regulations.
Findings
The facility was generally clean, well-maintained, and compliant with infection control and safety standards, but a deficiency was cited for missing grab bars in bathrooms, posing a potential health and safety risk.
Deficiencies (1)
| Description |
|---|
| Appropriate grab bars were not installed around the toilet or shower area in bathrooms. |
Report Facts
Capacity: 11
Census: 9
Water temperature: 106.7
Water temperature range: 105.1
Water temperature range: 113.2
Plan of Correction Due Date: Apr 14, 2022
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| LaQueena Lacy | Licensing Program Analyst | Conducted the inspection and cited deficiency |
| Naira Margaryan | Licensing Program Manager | Supervisor of the inspection |
Inspection Report
Annual Inspection
Census: 6
Capacity: 6
Deficiencies: 0
Mar 16, 2022
Visit Reason
One (1) Year Required - Infection Control visit conducted as an unannounced annual inspection to evaluate compliance with infection control and facility safety standards.
Findings
The facility was found to be in compliance with infection control protocols including PPE availability, mask usage, and COVID-19 signage. The physical plant was inspected and found clean, safe, and well-maintained with operational fire safety equipment and appropriate food storage. Medication and hazardous items were secured and inaccessible to residents.
Report Facts
Bedrooms: 6
Full bathrooms: 1
Half bathrooms: 4
Non-ambulatory residents: 5
Bedridden residents: 1
Residents under hospice care: 2
Facility temperature: 78
Hot water temperature: 114.1
Fire extinguisher last inspection date: Jan 31, 2022
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Abeye Duguma | Licensing Program Analyst | Conducted the inspection and met with facility executive director |
| Robin Culver | Executive Director | Facility representative met during inspection |
Inspection Report
Annual Inspection
Census: 8
Capacity: 11
Deficiencies: 0
Jun 24, 2021
Visit Reason
An unannounced Required One (1) year Infection Control inspection was conducted to evaluate compliance with health and safety regulations.
Findings
The facility was found to have appropriate COVID-19 prevention protocols, sufficient PPE stock, clean and operational living areas, and proper safety equipment including smoke detectors and fire extinguishers. The medication cart was locked and inaccessible to residents, and food supplies were adequate.
Report Facts
Bedrooms: 9
Bathrooms: 11
Shared rooms: 2
Private rooms: 7
Food supply - perishable days: 2
Food supply - non-perishable days: 7
Hot water temperature: 120
Facility temperature: 76
First aid kits: 1
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Ruby Cruz | Administrator | Met with Licensing Program Analyst during inspection |
| Rosaura Valenzuela | Licensing Program Analyst | Conducted the inspection |
| Naira Margaryan | Licensing Program Manager | Named in report header |
Inspection Report
Annual Inspection
Census: 7
Capacity: 11
Deficiencies: 0
Jun 4, 2021
Visit Reason
The inspection was a required unannounced 1-year annual visit to evaluate the facility's compliance with regulations.
Findings
The Licensing Program Analyst toured the facility and observed compliance with COVID-19 mitigation protocols including temperature checks, mask wearing, and hand washing stations. No health or safety concerns were identified during the visit.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Patrick Shanahan | Licensing Program Analyst | Conducted the facility inspection and authored the report. |
| Ruby Cruz | Executive Director | Met with the Licensing Program Analyst during the inspection. |
| Moti Gamburd | Administrator | Named as facility administrator. |
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