Facility Evaluation Report

Licensing Program Analysts (LPAs) Jose Gary Tan and Michael Cava conducted a Case Management (CM) visit to the facility to follow up on deficiencies that were issued during an annual that was made by LPA Cava and Angela Panushkina on 09/24/25. LPAs met with staff, Atri Shoun, and advised him of the visit. The administrator, Lala Soghomya, joined after. During the visit on 09/24/25, the licensee was cited for the following:

Section- 87202(a)(1) Fire Clearance. LPAs Panushkina and Cava identified four (4) residents that were non-ambulatory. The facility is licensed for six (6) ambulatory only

Section 87355(e)(1) Criminal Record Clearance. LPAs Panushkina and Cava conducted a file review and identified Staff 1 (S1) not being associated to the facility and also not carrying a fingerprint clearance

Section 87506(a) Resident Records- Licensee was not able to provide resident records for LPA's review during the annual inspection that was made on 09/24/25

Section 87412(a) Personnel Records- Licensee was not able to provide staff records for LPA's review during the annual inspection that was made on 09/24/25.

During today's visit, LPAs observed that section 87355(e)(1) has not been cleared by the licensee. Immediate Civil Penalties for Failure to Correct and Repeat Violation will be issued today, retroactive from 09/25/25 to 10/15/25 this citation (see LIC 421FCs from the annual visit made on 09/24/25 for total amount due). In addition, the following citations are issued on the LIC 809D. Licensee advised that Civil Penalties will continue to accrue until section 87355(e)(1) is corrected.