Complaint Investigation Report

Investigation Bureau for investigation consideration on 8/28/24. The reason for today's visit was provided.

On the visit conducted on 8/28/24, LPA Yee obtained information regarding Resident's date of admission,

Resident #1's length of stay at the home, services that Resident #1 was being provided during the residents stay, reason for the hospitalization and the cause of death. A copy of Resident #1's faciity files, including list of medications, MAR logs and hospice documents were requested but was not able to be provided since the copier was out of order. Per Administrator, all the requested documents will be scanned to LPA Yee by the end of today. On 8/28/24, a tour of the facility was also conducted at 2:54pm to observe the residents and to ensure that the utilities were available, review the food supply and to observe any visually obvious deficiencies. Per tour of the facility, LPA Yee observed all the residents in bed napping or watching television, sufficient perishable and non-perishable foods were observed and additional food supply is being brought in today per staff, utilities, including the air conditioner were observed to be in use. Water temperature was tested in the common and private bathroom. Water temperature tested in the common bathroom read 119.7 degrees Fahrenheit and the water temperature in the private bathroom read 119.7 degrees Fahrenheit. The swimming pool was observed to be secured by a 5 feet fence and was locked. Visually there were no immediate safety concerns observed during today's visit. Based on the 8/28/24 visit, further investigation is needed to make a finding for all of the 11 allegations currently noted as personal rights. Exit interview was conducted with Ada Bozkurt, Staff since the Administrator had to leave at 2:16pm due to child care needs.

On 7/23/25, Licensing Program Analysts (LPAs) Christine Yee and Quoc Huynh conducted a subsequent joint complaint visit to investigate the above allegations and was let into the home by Crystal McKie, Staff. Staff contacted Rebeka Durgaryan, Administrator via telephone to advise of LPAs' visit and she arrived at 9:34am to conduct the visit. The reason for today's visit was provided. On today's visit, LPA Yee conducted interviews with the Administrator at 10:14am, Resident #4 at 1:40pm and Resident #6 at 2:56pm. LPA Huynh conducted interviews with Resident #3 at 2:07pm, Resident #2 at 2:13pm and conducted file reviews at 9:56am and reviewed medications at 2:21pm in conjunction with a required annual inspection. Based on the information received from interviews conducted, files and medications reviewed, it was determined that