Inspection Report
Annual Inspection
Census: 91
Capacity: 134
Deficiencies: 0
Sep 4, 2025
Visit Reason
An unannounced annual inspection visit was conducted to evaluate compliance with licensing requirements and ensure the safety and well-being of residents.
Findings
The facility was found to be generally compliant with regulations, with clean and well-maintained physical plant and resident rooms, proper medication storage, and operational safety equipment. No citations were issued during this inspection.
Report Facts
Residents in assisted living: 57
Residents in memory care: 34
Residents under hospice: 16
Water temperature: 114
Water temperature: 115
Water temperature: 115
Water temperature: 117
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jaime Vado | Licensing Program Analyst | Conducted the inspection and reviewed findings |
| Tina Bagheri Teyebeh | Executive Director | Met with Licensing Program Analyst during inspection |
| Cara Smith | Licensing Program Manager | Named in report header and signature section |
Inspection Report
Complaint Investigation
Census: 88
Capacity: 134
Deficiencies: 0
Jul 22, 2025
Visit Reason
The visit was an unannounced complaint investigation conducted in response to allegations that facility staff did not properly assist a resident with hygiene needs and did not allow the resident to wear their own clothing of choice.
Findings
Based on interviews, observations, and record review, the allegations were found to be unfounded. Staff provided assistance and options for clothing to the resident, and measures were taken to prevent the resident from reusing dirty clothes. No deficiencies were cited.
Complaint Details
The complaint involved allegations that staff did not properly assist resident R1 with hygiene needs and did not allow R1 to wear their own clothing of choice. After investigation including staff and resident interviews, observations, and record review, the allegations were determined to be unfounded.
Report Facts
Capacity: 134
Census: 88
Staff interviewed: 6
Outfit options provided: 2
Preferred shower days: 2
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Christine Kabariti | Licensing Program Analyst | Conducted the complaint investigation and delivered findings |
| Tina Bagheri | Executive Director | Met with Licensing Program Analyst during investigation |
| Jackie Jin | Licensing Program Manager | Named as Licensing Program Manager on report |
Inspection Report
Follow-Up
Census: 82
Capacity: 134
Deficiencies: 1
May 20, 2025
Visit Reason
This visit was an unannounced case management incident follow-up conducted to investigate a prior sexual abuse allegation involving staff (S1) and resident (R1) that occurred on 11/06/2024 and was reported to the Department on 11/07/2024.
Findings
The investigation confirmed that staff (S1) sexually abused resident (R1) without consent, as corroborated by witness statements, surveillance footage, and law enforcement interviews. Staff (S1) was terminated, excluded from the Department, and arrested. A deficiency was cited for failure to prevent this abuse, posing an immediate risk to residents.
Complaint Details
The visit was complaint-related, following a sexual abuse allegation against staff (S1) by resident (R1). The complaint was substantiated based on investigation findings, witness statements, surveillance footage, and law enforcement interviews.
Severity Breakdown
Type A: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| Staff (S1) sexually abused resident (R1) in care, posing an immediate health, safety, and personal rights risk to persons in care. | Type A |
Report Facts
Capacity: 134
Census: 82
Plan of Correction Due Date: May 21, 2025
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Tina Bagheri | Executive Director | Met with Licensing Program Analyst during the visit and reviewed the report |
| Christine Kabariti | Licensing Program Analyst | Conducted the case management incident follow-up visit and authored the report |
| Jackie Jin | Licensing Program Manager | Named as Licensing Program Manager overseeing the case |
Inspection Report
Complaint Investigation
Census: 78
Capacity: 134
Deficiencies: 0
Jan 2, 2025
Visit Reason
The visit was conducted as an unannounced complaint investigation regarding an allegation that the facility lacked supervision and a resident left the facility unassisted.
Findings
The investigation found that the resident named in the allegation was not living at the facility and the allegation was determined to be unfounded. No deficiencies were cited under the California Code of Regulations, Title 22.
Complaint Details
The complaint alleged that a resident with wandering behavior left the facility unassisted. The investigation revealed the resident was not on the facility's roster and the facility had no record of the resident living there. The allegation was found to be false and unfounded.
Report Facts
Facility capacity: 134
Census: 78
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Tina Bagheri | Executive Director | Met during the investigation and provided statements regarding the allegation |
| Kiran Jain | Licensing Program Analyst | Conducted the complaint investigation visit |
| April Cowan | Licensing Program Manager | Named as Licensing Program Manager on the report |
Inspection Report
Census: 80
Capacity: 134
Deficiencies: 0
Nov 12, 2024
Visit Reason
The visit was conducted to hand deliver an immediate exclusion letter for an individual staff member who engaged in conduct inimical to the facility.
Findings
No deficiencies were cited per California Code of Regulations, Title 22. The excluded staff member was immediately terminated after the incident.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Tina Bagheri | Executive Director | Met with Licensing Program Analysts during the visit and named in relation to the immediate exclusion letter and staff termination. |
Inspection Report
Complaint Investigation
Capacity: 134
Deficiencies: 0
Nov 8, 2024
Visit Reason
The visit was conducted as a follow-up on a SOC341 report received on 2024-11-07 regarding an incident of alleged sexual abuse that occurred on 2024-11-06.
Findings
During the unannounced case management incident visit, two staff members were interviewed and various documents related to the incident were obtained. The case management is pending additional investigation.
Complaint Details
The visit was triggered by a complaint alleging sexual abuse involving resident R1. The case management is ongoing and pending further investigation.
Report Facts
Staff interviewed: 2
Staff job applications obtained: 3
Staff declaration statements obtained: 2
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Tina Bagheri | Executive Director | Met with Licensing Program Analysts during the visit and reviewed the report |
| Christine Dolores | Licensing Program Analyst | Conducted the case management incident visit |
| Santino Fortes | Licensing Program Analyst | Conducted the case management incident visit |
Inspection Report
Annual Inspection
Census: 78
Capacity: 134
Deficiencies: 5
Sep 20, 2024
Visit Reason
An unannounced Annual Continuation inspection was conducted to review resident files, medication management, and facility compliance with regulations.
Findings
Multiple deficiencies were found related to unsafe storage of medications, over-the-counter substances, disinfectants, and sharp objects accessible to residents diagnosed with dementia, posing immediate health and safety risks. Additionally, discrepancies were found in centrally stored medication records.
Severity Breakdown
Type A: 4
Type B: 1
Deficiencies (5)
| Description | Severity |
|---|---|
| Over-the-counter medication, alcohol, and toxic substances were accessible to residents diagnosed with dementia, posing immediate health, safety, or personal rights risks. | Type A |
| Knives, matches, firearms, tools, and other dangerous items (specifically 2 scissors) were accessible to residents with dementia, posing immediate health, safety, or personal rights risks. | Type A |
| Disinfectants and cleaning solutions (4 bottles) were accessible and unlocked in a resident's bathroom, posing immediate health, safety, or personal rights risks. | Type A |
| Medications were accessible and unlocked in a resident's room who was unable to administer own medication, posing immediate health, safety, or personal rights risks. | Type A |
| Two out of five centrally stored medication records were not completed accurately, posing potential health, safety, or personal rights risks. | Type B |
Report Facts
Resident files reviewed: 10
Medication files reviewed: 5
Over-the-counter medications observed: 3
Disinfectant bottles observed: 4
Medication record discrepancies: 2
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Tina Bagheri Tayebeh | Executive Director | Met with Licensing Program Analysts during inspection and reviewed report |
| Marcela Yanez | Licensing Program Analyst | Conducted inspection and authored report |
| Simi Rai | Licensing Program Analyst | Conducted inspection |
| Romeo Manzano | Licensing Program Manager | Supervisor of inspection and report |
| S1 | Facility staff who removed unsafe items and medications during inspection |
Inspection Report
Annual Inspection
Census: 77
Capacity: 134
Deficiencies: 0
Sep 13, 2024
Visit Reason
An unannounced Required 1 Year visit was conducted to evaluate the facility's compliance with licensing regulations.
Findings
The inspection included tours of the facility's interior and exterior, verification of food supplies, resident bedrooms, bathrooms, memory care unit safety features, and fire safety equipment. No deficiencies or violations were explicitly noted in the report.
Report Facts
Food supply duration: 2
Food supply duration: 7
Resident bedrooms inspected: 10
Delayed egress exit doors inspected: 6
Fire extinguisher inspection date: Aug 16, 2024
Smoke detector inspection date: Jun 19, 2024
Fire drill dates: 2
Staff records reviewed: 10
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Lucely Tan | Assisted Living Coordinator | Met with LPAs during inspection and report review |
| Gerardo Vallejo | Maintenance Coordinator | Met with LPAs during inspection and report review |
| Tina Bagheri Tayebeh | Administrator | Facility administrator named in report header |
| Marcela Yanez | Licensing Program Analyst | Conducted inspection and signed report |
| Simi Rai | Licensing Program Analyst | Conducted inspection |
| Romeo Manzano | Licensing Program Manager | Named in report |
Inspection Report
Follow-Up
Census: 67
Capacity: 134
Deficiencies: 0
Apr 17, 2024
Visit Reason
The visit was an unannounced case management incident follow-up to investigate an incident report received on 12/06/2023 regarding a resident found with scissors and a minor injury.
Findings
No deficiencies were cited. The resident was allowed to have the scissors based on medical records, and after the incident, the facility conducted a re-assessment, in-service training, and provided a private 24/7 companion for the resident.
Report Facts
Incident report date: Dec 6, 2023
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Tina Bagheri | Executive Director | Met with Licensing Program Analyst during the visit and involved in the incident follow-up |
| Christine Dolores | Licensing Program Analyst | Conducted the unannounced case management incident visit |
Inspection Report
Original Licensing
Capacity: 134
Deficiencies: 0
Sep 26, 2023
Visit Reason
The visit was a pre-licensing inspection conducted to evaluate the facility's readiness for licensing and to ensure compliance with regulatory requirements.
Findings
No issues were noted during the pre-licensing inspection. The facility was observed to be ready for licensing, with proper safety measures, equipment, and supplies in place. The report will be submitted for final review and approval by the Central Application Bureau.
Report Facts
Facility capacity: 134
Census: 0
Fire clearance capacity: 114
Bedridden capacity: 20
Hot water temperature range: 105.8
Hot water temperature range: 118.8
Refrigerator temperature: 35
Freezer temperature: 0
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Tina Bagheri Tayebeh | Administrator | Met with Licensing Program Analyst during pre-licensing visit |
| Simranjit Rai | Licensing Program Analyst | Conducted the pre-licensing inspection |
| Romeo Manzano | Licensing Program Manager | Named in report header and signature section |
Inspection Report
Original Licensing
Capacity: 134
Deficiencies: 0
Sep 1, 2023
Visit Reason
The visit was an initial licensing evaluation conducted via telephone interview with the applicant/administrator to verify identification and confirm understanding of community care facility licensing laws and regulations.
Findings
The applicant/administrator demonstrated understanding of facility operation, admission policies, staffing requirements, restrictive health conditions, general provisions, emergency preparedness, complaints and reporting, and pre-licensing readiness. Signed documentation and photo ID were obtained.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Tina Bagheri Tayebeh | Administrator | Applicant/administrator participating in licensing evaluation and interview. |
| Julia Kim | Licensing Program Manager | Named in report as Licensing Program Manager. |
| Nicole Rouse | Licensing Program Analyst | Named in report as Licensing Program Analyst conducting evaluation. |
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