Facility Evaluation Report
Licensing Program Analyst (LPA) Valeria Conway conducted an unannounced 10-day complaint visit to the facility regarding the above noted allegations. At 11:28 A.M., caretaker Jesusito ”J” Banawa who contacted administrator via phone. At 3:02 P.M. the administrator, Lala Soghomonyan arrived at the facility with administrator assistant Yeva Vartine. LPA explained the purpose of the visit. At 4:45 P.M. Sarkis Dovlatyan joined the visit. Entrance interview conducted.
During today's inspection, between 11:30 A.M. and 3:50 P.M., the LPA briefly toured the facility with the caretaker. LPA interviewed staff and four (4) residents and obtained copies of pertinent documents relevant to the investigation.
During the course of the investigation LPA requested all four (4) resident's files. Records revealed that all four (4) residents in care did not have a pre-appraisal assessments, physician's reports, admission agreements, personal right and consent forms completed in their file, Administrator was not able to provide such documents during today's visit.
The following deficiencies were observed (See LIC 9099-D) and cited from the California Code of Regulations, Title 22 and/or California Health and Safety Code. An immediate $250 civil penalty issued today for a repeat violation.
Exit interview conducted. A copy of the report and appeal rights were provided.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction