Pre-licensing visit·November 17, 2022

The pre-licensing visit was conducted by Licensing Program Analyst (LPA), Sandra Urena. The LPA arrived at the facility at 10:00 a.m., and met with applicant Vahe Mkrtchian. This is a new facility application for six residents. Fire Clearance was approved on 09/30/2022 for one bedridden resident, and resident is allowed to reside in either bedroom # 1,2,3, or 4. At 10:25 a.m., the LPA, and the applicant toured the physical plant areas inside and outside to ensure there are no health and safety hazards, and facility is in compliance with Title 22 Regulations. KITCHEN: A seven day supply of non-perishable food was available. The supply of dishes is adequate. Appliances in the kitchen were clean and all appeared functional. Kitchen, and house cleaning supplies will be stored in locked cabinet in the hallway. Hot water temperature was recorded at 118.2 Fahrenheit degrees Trash cans have a tight-fitting lid. There were no pesticides or toxins stored near food, or preparation area. BEDROOMS: Facility has five (5) bedrooms. Four (4) bedrooms are for resident use, and one (1) bedroom for staff use. Bedrooms #2 and #3 are for double occupancy. Bedrooms #1, and #4 are private bedrooms. All bedrooms are approved for one (1) bedridden resident. Facility sketch describes bedroom #3 as the bedroom designated for the bedridden resident. Lighting in the rooms appeared adequate. All bedrooms had adequate closet and drawer space for clothing and personal belongings. BATHROOMS: Two bathrooms are fully stocked with paper towels, and liquid hand soap. The showers have non-skid surface mats. Hot water temperature was recorded at 118.2 Fahrenheit degrees. Hand washing signs were visible and posted. Bathroom #1 and #2 are designated for residents, and staff use. They are fully equipped with handlebars and nonskid surfaces. Continues LIC 809 C... COMMON AREAS: The common areas were appropriately furnished, and the lighting was adequate. Residents and staff records will be stored in a filing cabinet in a locked closet located next to bedroom#1. Medications will be stored in a locked closet located next to bedroom #1. The first aid supplies were complete, including a thermometer and a current version of a first aid manual, which will be locked in the closet next to bedroom #1. The facility’s smoke/carbon monoxide alarm systems are hard wired. The alarm systems are installed in the hallway, living room area, and bedrooms. All rooms were tested, and all smoke/carbon monoxide alarm systems were in operating condition. A fire extinguisher is properly charged, and is located mounted on the wall in the kitchen area, close to the back exit door. The supply of extra bed, and bath linens is adequate, and is located in a closet in the hallway. There is a functioning land line telephone on the premises. Infection control, and other posters are posted throughout the facility, and hallways. The exterior passageways were clean, and clear of any obstructions. The front patio is furnished with outdoor furniture for residents’ use, and shade is available. The building has a central entrance for residents, and visitors. Fire emergency gates are clear of obstructions. The applicant completed Component III Orientation. This report will be sent to the Centralized Application Bureau (CAB). You will be notified by the CAB Analyst when your license has been approved. You are not allowed to begin operating until you have been notified that your license has been approved by the CAB Analyst. Failure to comply could affect approval of your license. Exit interview was conducted, and reviewed with applicant Vahe Mkrtchian . A copy of the report was issued.