Routine inspection·November 19, 2025

Licensing Program Analyst (LPA) Christine Yee conducted an unannounced Annual Inspection visit and used the CARE inspection Tool to conduct the visit. LPA Yee was let into the home by Ani Malkhasyan, Staff. Erna Gevorgyan, Administrator designee was conducted by telephone and she arrived at 11:06am to conduct the visit. The reason for today's visit was provided. The facility is a single storey family home consisting of a living room, a dining room, a kitchen, 4 bedrooms, 2 private bathrooms and a common bathroom. Located in the back of the property is an ADU with a separate address - 6509 Bonner Avenue, and is not part of the facility operations. The facility is fire cleared for 1 AMBULATORY, 4 NON-AMBULATORY and 1 BEDRIDDEN resident. Bedroom #2 or Bedroom #3 approved for 1 bedridden use. The facility is approved for 6 hospice waivers. On today's visit, the entire CARE Inspection tool was reviewed, 6 resident and 6 staff files were reviewed and the Emergency Disaster Preparedness Plan was reviewed. The following was observed: Bedrooms #1 and Bedroom #2 are furnished with 2 beds, 2 night stands, 2 lamps, 2 chairs and a built in closet. No dressers were observed. The left bed in bedroom #2 was equipped with a full bed rail due to resident previously on hospice but has since being discharged and the right bed equipped with a half bed rail. Bed rails need to be removed. There is no physicians order for the use of the bed rails. Bedroom #3 is furnished with 2 beds, 2 chairs, 2 lamps, 2 night stands, 1 built in closet and a shared dresser. The wall needs to be painted due to the resident peeling off the paint each time it is painted. continued on LIC809-C Page 2. Located inside Bedroom #3 is a private bathroom, equipped with a walk in shower, a toilet and a sink. Grab bars were observed. No slip resistant mat was observed. Water temperature was tested and read 116.5 degrees Fahrenheit. Bedroom #4 is currently not furnished and is used for storage. Located inside is a private bathroom equipped with a shower stall, a toilet and a sink. Grab bars were observed. No slip resistant mats were observed. the living room and dining room were furnished with the appropriate furniture for it's designated use. Extra bed linens and towels were observed in the linen closet. The kitchen is equipped with a refrigerator, a stove, a dishwasher, a microwave and a water cool. Plenty of perishable foods for a minimum of 2 days and non-perishable foods for a minimum of 7 days were observed. The Licensee will supplement the non-perishable foods with additional proteins. Medications are stored in a locked kitchen cupboard. The common bathroom is equipped with a walk in shower, a toilet, a sink, a shower chair, grab bars and a toilet riser. No slip resistant mats were observed, Water temperature was tested and read 118.9 degrees Fahrenheit. Hygiene products are stored in the locked bathroom cabinets. The auditory devices on the outside exiting doors were operational. The only fire extinguisher, purchased on 12/10/24 is located by the front door. The hard wired smoke detectors located in the resident bedrooms and the combination smoke/carbon monoxide detector located in the living room and resident hallway were tested and were operational. The first aid kit contained the required scissors, tweezer and thermometer. No first aid manual was observed on today's visit The required postings were observed but the licensee needs to purchase a current labor poster. The laundry room located in the back was observed with a washer and dryer. Also located by the laundry room is a storage shed. A long ramp for wheelchair use to exit from the living room, bedroom #3 and bedroom #2, separates the back property utilized by the ADU. No bodies of water was observed on the property Located in the front is a gazebo furnished with seating and a table for outside activities. Continued on LIC809-C Page 3. The trash cans normally stored in the front yard were observed on the street for trash pickup. Trash cans were in good condition. Per tour of the front yard, along the sides of the home and backyard, the outside areas were clean and well maintained. The Annual Inspection visit was initiated on 11/19/25, but due to laptop issues, a partial report was generated but could not completed for delivery on the date of the site visit. The Report and citations were .completed on 11/20/25 and emailed to the Administrator Designee, Erna Gevorgyan, after telephone contact for her signature. Deficiencies were cited under California Code of Regulations, Title 22, Division 6, Chapter 8. Any deficiencies not cited on today's visit will be cited on a return visit. Exit interview was conducted, Appeals Rights discussed and a copy was provided.