Routine inspection·September 9, 2025

Licensing Program Analyst (LPA) Quoc Huynh arrived at the facility unannounced to conduct a required annual visit. The LPA arrived at 11:46AM and was greeted by Staff, informed them of the reason for the visit, and Staff proceeded to notify the Licensee. The Licensee Ani Ghazaryan and Administrator Ara Ghazaryan arrived shortly thereafter. Entrance interview conducted. Beginning at 12:03PM, the LPA and Administrator toured the physical plant areas inside and outside to ensure there were no health and safety hazards, and the facility is in compliance with Title 22 Regulations. The following was observed: KITCHEN: Knives were stored inaccessible in a locked drawer near the sink and locked cleaning supplies stored under the sink. Food in the refrigerator was observed to be properly stored with labels and dates. There was a sufficient supply of non-perishable and perishable foods. OUTDOOR AREA: The facility was located in an Additional Dwelling Unit (ADU) behind a neighboring related facility. The facility was fenced off and separated from the neighboring facility. The exterior had one (1) patio area equipped with furniture for residents and visitors to use. There was one (1) entry and exit way with a gated door for everyday use and in emergencies. There was one (1) shed that contained facility supplies and general storage. Emergency food and water was located in the neighboring facility’s garage in addition to the shed and was adequate. Report Continued on LIC 809-C COMMON AREAS: At the time of the visit, the living room and dining room furniture was observed to be in good condition. Also located in the common areas was a desk and a locked cabinet which contained facility files. LPA observed nightlights throughout the facility. The facility maintained a comfortable temperature throughout the visit. BEDROOMS/RESTROOMS: There were three (3) total bedrooms, each with dual occupancy. Bedroom #3 had a direct exit to the outside and was approved for one (1) bedridden resident. Bedrooms were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. Extra linens were stored in each bedroom closet. There were four (4) total restrooms in the facility: three (3) private resident restrooms and one (1) shared common area restroom. Restrooms were clean and sanitary and in operating condition with grab bars and non-slip surfaces. All restrooms were sufficiently stocked with soap, paper products, and displayed hand washing signs. Each restroom had locked cabinets under the sink that contained cleaning supplies and hygiene products. Hot water was tested and measured between 108.5 degrees F and 113 degrees F. RECORDS: Record review began at 12:27PM. Resident records were reviewed for, but not limited to care plans, physician's report, admissions agreement, and consent forms. All records were in order and the LPA reminded the Licensee to ensure resident Appraisals were reviewed/updated annually. Personnel records were reviewed for, but not limited to health assessments, criminal record clearances, first aid/CPR training, and the appropriate training. All files were in order. INFECTION CONTROL /EMERGENCY DISASTER PLAN: During today's visit, the LPA reviewed the facility's infection control plan and emergency disaster plan. Both documents were observed to be complete and updated annually as required. One (1) fire extinguisher was observed and was purchased on 06/24/2025. Emergency disaster drills are conducted quarterly, with the last documented drill on 07/16/2025. Smoke and Carbon Monoxide alarms were tested at 12:24PM and were operational in addition to the fire door. Report Continued on LIC 809-C MEDICATIONS: Medication review began at 1:25PM. Medications were centrally stored and kept inaccessible in the kitchen. Medications were observed for two (2) residents and were labeled and checked for expiration dates. Medications were properly documented on the centrally stored medications and destruction record. No errors observed during the medication review. The LPA had a discussion with the Licensee to ensure medications were administered according to the labels to avoid any discrepancies. Additionally, the LPA explained to the Licensee that they should not rely on the pharmacies to provide the Centrally Stored Medication and Destruction Records, and they understood. No deficiency cited. Exit interview conducted. A copy of today's report was reviewed and provided.