Pre-licensing visit·January 10, 2023

The pre-licensing visit was conducted by Licensing Program Analyst (LPA), Sandra Urena. The LPA arrived at the facility at 10:50 a.m., and met with applicant Hrachia Martirosian. This is a new facility application for a total of six residents, five (5) non-ambulatory, and one (1) bedridden. Fire Clearance was approved on 09/16/2022 for one bedridden resident, and resident is allowed to reside in either bedroom #1 or # 2. At 11:00 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 that the 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. House cleaning supplies will be stored in a locked cabinet under the sink. Hot water temperature was recorded at 108.8 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 for resident use. There is no bedroom available for staff use. Bedrooms 2, 3, 4 and 5 are for single occupancy. Bedroom #1 is designated as a shared bedroom. Either bedroom #1, or #2 are approved for one (1) bedridden resident. Lighting in the rooms appeared adequate. All bedrooms had adequate closet and drawer space for clothing, and personal belongings. Bedrooms’ doors # 1, and 2 will need to be leveled to ensure safe passage for residents to the outdoor area. Hallway exit door needs to be leveled to ensure safe passage to the outdoors. Bedroom #2 has a three shelf apparatus with sound equipment that partially obstructs the passageway for exit. Additionally, a drainage pipe is sticking out at the bottom of the wall facing the bathroom. Bedrooms # 3, 4, and 5 need a bed, mattress, pillows and bedding/linens. Bedroom #1 is missing pillows, and bedding linens Continues on LIC809C ... BATHROOMS: The facility has four bathrooms. Bathrooms are private, located inside the bedrooms and are for residents’ use, are fully stocked with paper towels, and liquid hand soap. The showers have non-skid surface mats. Hot water temperatures were recorded in Fahrenheit degrees as follows:109.2 degrees for bathroom in bedroom #1, 110.2 degrees for bathroom in bedroom #2, 115.5 degrees in bathroom for bedrooms #4 and #5, and 116.2 degrees for bedroom #3. Hand washing signs were visible and posted. The bathroom designated for staff use, is located outdoors inside the laundry room. Residents' toilets will be equipped with adjustable handlebars/Safety toilet rails. COMMON AREAS: The common areas were appropriately furnished, and the lighting was adequate. There is a television in the living room area. -Door leading to bedrooms # 3, 4, and 5 needs a foot stop installed to keep it open. Door leading to bedroom #2 needs a foot stop installed to keep it open. -The first aid supplies were complete, including a thermometer. The first aid kit is located in a cabinet in the kitchen area. A current version of a first aid manual is missing. -Residents records, staff records, and medications will be stored in locked cabinet located in the hallway between bedrooms #3 and #4. -The facility’s smoke/carbon monoxide alarm systems are hard wired. All rooms were tested, and all smoke/carbon monoxide alarm systems were in operating condition. A fire extinguisher is properly charged, and is located near the main door entrance, and mounted on the wall in the kitchen area. -The laundry area room is located outside, across from the pool. The supply of linens is sufficient to permit changing weekly or more often as needed to ensure use of linens at all times. Continues on LIC 809C... An operating telephone was not available for resident use. The applicant stated that a cell phone will be purchased, and activated for use by staff and residents. Infection control, and other posters are posted in the dining room area. 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 facility has a gated pool. However, on the day of the visit the gate leading to the pool was not locked. Applicant stated that a padlock will be purchased, and installed to make the body of water inaccessible to residents. Pre-Licensing is incomplete with deficiencies to be resolved. During the inspection, the LPA, and applicant observed the following corrections needed, prior to being licensed: 1. Bedrooms’ doors # 1, and 2 will need to be leveled to ensure safe passage for residents to the outdoor area. 2. Hallway exit door needs to be leveled to ensure safe passage to the outdoors. 3. Bedroom #2 has a three shelf apparatus with sound equipment that partially obstructs the passageway for exit. This will be removed. Additionally, a drainage pipe is sticking out at the bottom of the wall facing the bathroom, which needs to be covered. 4. Bedrooms # 3, 4, and 5 need a bed, mattress, pillows and bedding/linens. Bedroom #1 is missing pillows, and bedding linens. 5. Toilets in all bathrooms will be equipped with adjustable handlebars/Safety toilet rails. 6. Door leading to bedrooms # 3, 4, and 5 needs a foot stop installed to keep it open. Door leading to bedroom #2 needs a foot stop installed to keep it open. 7. An operating telephone was not available for resident use. The applicant stated that a cell phone will be purchased, and activated for use of staff and residents. 8. Applicant stated that a padlock will be purchased, and installed to make the body of water inaccessible to residents. 9. Passage leading from bedroom #1 to backyard area will be leveled to ensure safe passage for resident from patio to backyard area. Continues on LIC809C... The applicant completed Component III Orientation during today's visit. 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 Hrachia Martirosian. A copy of the report was issued .