Eden Assisted Living

On 05/14/2021 Licensing Program Analyst (LPA) Allison O'Hollaren conducted an unannounced case management visit regarding a self-reported incident that occurred on 04/20/2021. Due to the Shelter in Place set forth by the Governor on March 17, 2020, LPA was not able to conduct the visit in person. The visit was performed by tele-visit. LPA spoke with Administrator, Samuel Tet. During the visit LPA spoke and reviewed incident with Administrator. Administrator confirmed that R1 left the facility unsupervised. Administrator stated R1 may have left through an exit door in R1's bedroom. The exit door did not have a working alarm. After the incident, Administrator activated alarms to all exit doors. Administrator emailed R1's records per LPA's request. The following deficiency was cited from the California Code of Regulations, Title 22. Failure to correct the deficiency and/or repeat deficiencies within a 12-month period may result in civil penalties. Exit interview conducted. Appeal Rights and a copy of this report emailed.

On 07/24/2025 at 11:11 AM, Licensing Program Analyst (LPA) Ardalan Gharachorloo arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Care Staff, Nadine Gabbidon and explained the purpose of the visit. Administrator, Samuel Tet was not present during the visit. LPA toured the facility including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. A comfortable temperature is maintained at 71 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in the residents’ shared bathroom was measured at 113.2 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum of one week supply of non-perishable and 2 day of perishable foods. Centrally stored medication and sharps were locked and inaccessible to residents. Smoke detectors and carbon monoxide detectors were in operating condition during visit. Fire extinguisher was last serviced on 03/17/2025. Emergency Disaster Plan was last updated on 05/18/2025. First aid kit was observed to be complete. Emergency disaster drill was last conducted on 05/18/2025. LPA reviewed 6 residents records and 4 staff records; all were complete. LPA also reviewed a sample of 6 resident’s medications.The following documents were reviewed during the visit: LIC 500 Personnel Report, LIC 610E Emergency Disaster Plan, Liability Insurance, and Current Administrator’s Certificate. No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.

On 07/17/2024 AM , Licensing Program Analyst (LPA) Ardalan Gharachorloo arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Staff, Nadine Gabbidon and explained the purpose of the visit. Administrator Samuel Tet was not be able to be present during the inspection. LPA toured facility including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. All outdoor and indoor passageways are kept free of obstruction. A comfortable temperature is maintained at 69 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in the residents’ shared bathroom was measured at 107 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum of one week supply of non-perishable and 2 day of perishable foods. Centrally stored medication and sharps were locked and inaccessible to residents. Smoke detectors and carbon monoxide detectors were in operating condition during visit. Fire extinguisher was last serviced on 03/29/2024. Emergency Disaster Plan was last posted on 06/20/2024. First aid kit was observed to be complete. Emergency disaster drill was last conducted on 06/20/2024. LPA reviewed 5 residents records and 3 staff records; all were complete.LPA also reviewed residents medications. LPA also reviewed the Emergency disaster Plan, Liability insurance as well as the infection control plan. No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.

On 10/30/23 at 9:30 AM, Licensing Program Analyst (LPA) Daisy Panlilio conducted an unannounced required one year inspection and met with Administrator (ADM) Samuel Tet and explained the purpose of the visit. LPA observed two (2) males and (2) female in bed and one (1) female watching TV in the living room during the visit. LPA inspected the facility inside and outside. Pathways were observed to be free of obstruction and fire hazards. The facility's fire clearance was approved for 4 non-ambulatory and two (2) bedridden residents which includes Hospice Waiver for two (2) residents. A written Emergency/Disaster plan dated 10/10/23 was posted on a bulletin board next to the dining area near a lane line phone. Centrally stored medications were locked in a plastic container above the wall next to the kitchen. Sharp objects were locked in the kitchen drawer next to the sink. Toxic chemicals were locked in the laundry area. There was at least 7 days of nonperishable and 2 days of perishable foods. Facility room temperature was maintained at 71 degrees Fahrenheit. Hot water temperature was measured at 112.8 degrees Fahrenheit in the resident's bathroom. Resident's bathrooms have grab bars inside the shower and next to the shower. The facility has trained staff in Dementia Care, Medication, and Basic Training. Last Fire drill was conducted on 10/10/23. Fire extinguisher was fully charged and last inspected on 03/23/23. Smoke and Carbon monoxide detectors were operational. LPA reviewed two staff and 2 resident files. Staff had criminal record clearances to work and are associated to the facility. Residents records all contain Admission Agreements, Physicians' reports, Consent forms, Personal rights, medical assessments, Needs and Services plans/Appraisals. The facility serves residents with Dementia. The facility has potentially dangerous objects locked and inaccessible to residents in care. Report continue on LIC 809C... 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 Updated copies of the following documents were requested for facility file and are to be submitted to CCL by 11/6/2022: LIC 308 Designation of Administrative Responsibility LIC 309 Administrative Organization LIC 500 Personnel Report LIC 610E Emergency Disaster Plan Liability Insurance Current Administrator’s Certificate No deficiencies cited during visit. Exit interview conducted and a copy of this report provided via email.

On 6/22/2022 at 11:45am, Licensing Program Analyst (LPA) K. Nguyen arrived unannounced to conduct Infection Control Inspection. LPA met with Administrator, TET, SAMUEL and explained the purpose of the visit. During the Infection Control Inspection, LPA toured facility including but not limited to front entrance, screening station, hand washing stations, bedrooms, common areas, kitchen and backyard. Facility has a sufficient 2-day perishable and one week non-perishable food supply. Visitors policy is posted on the front entrance. There is one central entry point for universal screening for staff, residents and visitors. A sign-in policy, thermometer and hand sanitizer were observed at screening station. Cough/sneeze etiquette, social distancing poster were observed. Facility staff were observed to be wearing proper PPE. Facility has a 30-day supply of PPEs maintained at central location and easily accessible for staff. Facility has a mitigation plan and maintains record of routine screening for residents and staff. During record review, LPAs reviewed a sample of 2 staff records and observed 2 of 2 have health screening with TB test on file. Updated copies of the following documents were requested for facility file and are to be submitted to CCL by 06/30/2022: LIC 308 Designation of Administrative Responsibility LIC 309 Administrative Organization LIC 500 Personnel Report LIC 610E Emergency Disaster Plan Liability Insurance Current Administrator’s Certificate No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.