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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197609597
Report Date: 03/03/2023
Date Signed: 03/03/2023 03:48:49 PM


Document Has Been Signed on 03/03/2023 03:48 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364



FACILITY NAME:BETTER DAYS ASSISTED LIVINGFACILITY NUMBER:
197609597
ADMINISTRATOR:SEDA KHECHUMYANFACILITY TYPE:
740
ADDRESS:19431 ENADIA WAYTELEPHONE:
(818) 800-9266
CITY:RESEDASTATE: CAZIP CODE:
91335
CAPACITY:6CENSUS: 5DATE:
03/03/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
09:10 AM
MET WITH:Alisa ArshakyanTIME COMPLETED:
03:49 PM
NARRATIVE
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Licensing Program Analysts (LPA) Tihesha Smith conducted a Case Management Deficiencies visit in conjunction with a complaint to address deficiencies observed during the investigation of complaint control # 31-AS-20230224164940.

At approximately 11 am LPA Smith reviewed Resident #1s ( R1’s) file and Centrally stored medication and Destruction record. Section II of Destruction record is blank and does not contain any medication, dates, or signatures of Administrator and/or witness.



Due to failure to document the disposal of prescription medication, a deficiency is cited on an LIC 809-D page.

Exit interview was conducted, appeal rights and copy of report issued.
SUPERVISOR'S NAME: Naira MargaryanTELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Tihesha SmithTELEPHONE: 818-307-6280
LICENSING EVALUATOR SIGNATURE:
DATE: 03/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/03/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2


Document Has Been Signed on 03/03/2023 03:48 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364


FACILITY NAME: BETTER DAYS ASSISTED LIVING
FACILITY NUMBER: 197609597

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/03/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/10/2023
Section Cited

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87465 (i) Prescription medications which are not taken with the resident upon termination of services, not [...] retained in the facility as ordered by the resident’s physician and documented in the resident’s record […] shall be destroyed in the facility by the facility administrator and one other adult
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Licensee/Administrator willl review destruction guidelines and submit signed statement to LPA acknowledging responsibilites and written/signed plan on steps to ensure incident will not happen in the future. POC Date:03/10/23
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who is not a resident. Both shall sign a record, to be retained for at least three years. This requirement was not met: Based on observation and interviews the licensee/administrator did not comply with the cited section by failing to follow guidelines in regard to disposition of medication and records which pose a potential risk to residents in care.


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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Naira MargaryanTELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Tihesha SmithTELEPHONE: 818-307-6280
LICENSING EVALUATOR SIGNATURE:
DATE: 03/03/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/03/2023
LIC809 (FAS) - (06/04)
Page: 2 of 2